Extended superior scapular approach

The exact location of the fracture determines the approach and the positioning of the patient. Generally, extra-articular fractures of the scapular spine are approached posteriorly.

This approach can be performed to treat oblique or transverse spine fractures around reverse and anatomic prostheses.

A reverse prosthesis has been used as an example in the rest of this approach since this fracture occurs more often when reverse prostheses are used.

The incision is made along the scapular spine, which in most cases can be palpated very easily. The extent of the incision will depend on the amount of exposure required.

Using sharp dissection, divide the deltoid from its insertion into the scapular spine and base of the acromion.

Make sure to leave a small tissue border to facilitate subsequent reattachment.

Reattach the base of the deltoid muscle and its deep and superficial fascia to the remaining deltoid cuff on the acromion and spine of the scapula. The subcutaneous fascia and the skin are closed in layers.