Locked 90°-double plating of scapular spine fracture after reverse shoulder arthroplasty with union and good outcome despite plate adjacent acromion fracture

We report the case of a 74-year-old woman who sustained a scapular spine (SS) fracture after a fall 4 weeks after reverse shoulder arthroplasty (RSA). Open reduction and internal fixation (ORIF) with locked 90°-double plating resulted in union of the SS fracture with a good outcome (subjective shoulder value: 80%; Constant score 67; 1 year) despite of an adjacent lateral acromion fracture 3 weeks after ORIF. This is the second description in the literature of a successful double plate ORIF with union of an SS fracture after RSA. SS fractures are known to lead to poor RSA outcomes with a high mal-union rate and non-union rate. We describe the positioning of the plates and technical steps for successful ORIF to avoid complications, discuss the aftercare and report the outcome.