Do anatomical contoured plates address scapula body, neck and glenoid fractures? A multi-observer consensus study

Authors

Keywords:

scapula fracture, open reduction and internal fixation (ORIF), scapula plate analysis, 3D printing, fracture classification, South Africa

Abstract

Background: The surgical management of scapula body, neck and glenoid fractures remains a challenge. This study focuses on templating an available anatomical pre-contoured plating system using three-dimensional (3D)-printed scapulae to assess the ability of these plates to address the aforementioned fractures and to determine consensus on classifying scapula body, neck and glenoid fractures.

Methods: We used a cohort of 22 3D-printed scapulae prototypes and an available anatomical precontoured plating system to determine anatomical congruency and fit. Nine investigators templated the scapulae using four pre-contoured plates, and the investigators classified the 22 scapulae using the Ideberg and AO/OTA classification systems.

Results: Eleven out of 22 fractures were found to be fixable using the plates under study. The long lateral plate addressed 83% of fractures involving the lateral border, while the glenoid plate was unable to adequately address any glenoid fractures. We observed good to excellent (p ≤ 0.001) interobserver reliability for three of the four plates. The interobserver reliability was moderate (ICC = 0.74) for the AO/OTA classification and good (ICC = 0.88) for the Ideberg classification.

Conclusion: We believe that the anatomical pre-contoured plating system does not address all the fracture patterns encountered in clinical practice and further development in plate design is required. There is good to moderate interobserver reliability using the Ideberg fracture classification for intra-articular fractures and the AO/OTA classification for extra-articular fractures involving the body.

Level of evidence: Level 3

Author Biographies

Japie J de Wet, University of Cape Town

Division of Orthopaedic Surgery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa

Roopam Dey, University of Cape Town

Division of Orthopaedic Surgery, Faculty of Health Sciences, University of Cape Town and Division of Biomedical Engineering, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa

Basil Vrettos, University of Cape Town

Shoulder and Elbow Unit, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa

Jean-Pierre du Plessis, University of Cape Town

Division of Orthopaedic Surgery, Faculty of Health Sciences, University of Cape Town and Orthopaedic Research Unit, Cape Town, South Africa

Cameron Anley, Stellenbosch University

Shoulder and Elbow Unit, Tygerberg Hospital, Division of Orthopaedics, Stellenbosch University, Stellenbosch, South Africa

Pududu A Rachuene, Sefako Makgatho Health Sciences University

Dr George Mukhari Academic Hospital, Sefako Makgatho Health Sciences University, Pretoria, South Africa

Leanne C Haworth, University of Cape Town

Division of Biomedical Engineering, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa

Habtamu M Yimam, University of Cape Town

Division of Biomedical Engineering, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa

Sudesh Sivarasu, University of Cape Town

Division of Biomedical Engineering, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa

Stephen JL Roche, University of Cape Town

Shoulder and Elbow Unit, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa

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Published

2021-11-18

Issue

Section

Trauma

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