Video-Assisted Thoracoscopic Surgery (VATS)-Aided Simultaneous Fixation of Scapular Body and Rib Fractures: A Case Report

TL;DR

A rare case of simultaneous scapular and rib fracture fixation using VATS is described, showing improved recovery and reduced invasiveness.

Contribution

A novel VATS-aided surgical approach for simultaneous fixation of scapular and rib fractures is presented.

Findings

The VATS-aided modified Judet approach allowed successful simultaneous fixation of scapular and rib fractures.

The patient showed complete bone union and no functional impairment at 1.5 years post-surgery.

The technique may reduce surgical invasiveness and improve respiratory outcomes.

Abstract

Scapular fractures are rare injuries, whereas rib fractures are more common. Scapular fractures are frequently associated with rib fractures, which may lead to significant respiratory compromise. While surgical fixation has demonstrated benefits for both scapular and rib fractures, simultaneous fixation using a single surgical approach is not widely practiced. A 54-year-old male sustained a right scapular body fracture (AO 14B1) and multiple right rib fractures following a crush injury. Due to severe respiratory pain and prolonged mechanical ventilation, surgical fixation was performed on post-injury day three using a video-assisted thoracoscopic surgery (VATS)-aided modified Judet approach. The third to fifth rib fractures were stabilized with the Matrix RIB™ Fixation System (Johnson & Johnson, New Brunswick, NJ) and the scapular body fracture was fixed with locking compression plates. Postoperatively, the patient was extubated on day eight and discharged to rehabilitation on day 29. At the follow-up at one year and six months, complete bone union was confirmed with no residual functional impairment. The VATS-aided modified Judet approach enabled simultaneous fixation of scapular and rib fractures, potentially reducing surgical invasiveness, improving postoperative respiratory function, and expediting rehabilitation. This technique presents a viable option for managing complex thoracic fractures, warranting further investigation to evaluate its long-term efficacy.

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