2026, Vol. 8, Issue 1, Part A

Background: Scapular fractures are uncommon injuries, comprising less than 1% of all skeletal fractures. The body of the scapula is the most frequently fractured part due to its broad surface and exposure to high-energy trauma, such as road traffic accidents. Most scapular body fractures are managed non-operatively; however, significantly displaced fractures can cause functional limitation, cosmetic deformity, and chronic pain when left untreated.

Case Presentation: A 24-year-old male presented to our institution following a fall from a motorcycle, complaining of pain, deformity, and restricted movement of the right shoulder. Imaging confirmed a displaced fracture through the body of the right scapula without involvement of the glenoid or acromion. Considering the displacement and young, active status of the patient, surgical intervention was indicated.

Method: Open reduction and internal fixation (ORIF) was performed using the Judet approach for optimal exposure. The fracture was anatomically reduced under direct vision. A reconstruction (recon) plate was adapted to the main fracture line for primary stabilization. An additional distal end radius plate was innovatively molded to match the scapular contour and applied to augment fixation and achieve superior contouring and stability.

Result: The postoperative period was uneventful. The patient commenced pendulum and passive range-of-motion exercises at two weeks, progressing to active physiotherapy by six weeks. At the 12-week follow-up, radiographs demonstrated full union. Functional recovery was excellent, with a Constant-Murley score of 96/100 and full return to pre-injury activity levels.