Introduction: Scapulothoracic disruptions with associated scapular and acromial fractures are extremely rare and complex injuries, with limited guidance available in the current literature regarding their combined surgical management. These injuries can severely impair shoulder stability and function, necessitating anatomical reconstruction to restore biomechanics. Case Report: We present the case of a 43-year-old male who sustained a high-energy trauma resulting in a type 1 scapulothoracic disruption (Zelle’s classification), including fractures of the scapular body, lateral border, and acromion process. Surgical intervention involved dual-column reconstruction plate fixation of the scapula and tension band osteosynthesis for the acromion. Postoperative rehabilitation led to excellent radiological union and full functional recovery, with return to all activities by 4 months. Conclusion: This case highlights the importance of anatomical fixation in restoring both scapulothoracic and glenohumeral mechanics. Dual-column plating provided stable scapular reconstruction, while acromial fixation ensured deltoid reattachment and preservation of shoulder abduction. The combined approach yielded a favorable clinical outcome in a rare injury pattern and was successfully delivered free of cost under a government-funded healthcare scheme. Biomechanically sound surgical constructs and guided post-operative rehabilitation are a key to optimal recovery in such complex injuries. Keywords: Scapular fractures, shoulder injuries, acromial fractures, tension band wiring, shoulder girdle injuries.
Naskar et al. (Wed,) studied this question.
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