Nonoperative treatment of severely deformed fractures of the scapula was historically common. However, the findings of newer research have challenged the notion that conservatively managing these fractures results in the most successful outcomes. In an attempt to possibly reveal important indicators for surgical treatment, I reviewed studies on scapula fractures involving scapular anatomy; associated injuries; technological advances that have helped with fracture evaluation; and treatment outcomes between nonsurgical and surgical methods. Although a universally accepted classification scheme of scapula fractures does not exist, use of 3D reconstruction with computed tomography can help define the level and category of fracture deformity. Most fractures heal predictably well with nonoperative management, yet fixation techniques should at least be considered for treating severely deformed scapula fractures. Individualized factors such as patient characteristics, measurable fracture type, and associated injuries may help in determining possible indicators for surgical treatment.
Kuehn, Sean B.. "Severely Deformed Extraarticular Fractures of the Scapula: A Review." UNM Orthopaedic Research Journal 4, 1 (2015). https://digitalrepository.unm.edu/unm_jor/vol4/iss1/11