Scapulothoracic Abnormal Motion after Conservatively-Treated Clavicular Fractures

Background: Scapulothoracic abnormal motion (STAM), or scapular dyskinesis, can significantly impair shoulder function and is increasingly recognized as a sequela of clavicular fractures. Despite this, its incidence following conservative treatment of clavicle fractures remains under-investigated.
Objective: This study aimed to assess the incidence of scapulothoracic abnormal motion (STAM) after conservative treatment of clavicular fractures.
Patients and methods: A prospective cohort study was conducted from April to September 2024. It involved 21 adult patients with conservatively treated midshaft clavicle fractures at Menoufia University Hospital. Patients were assessed after six months using scapular dyskinesis test, lateral scapular slide test (LSST), Sick Scapula Rating Scale (SSRS), and Simple Shoulder Test (SST). Radiographs were used to evaluate fracture healing.
Results: STAM was identified in 47.6% of patients. mal-union and non-union were significantly associated with STAM (p = 0.008). Patients with STAM had significantly worse SSRS scores (6.2 ± 1.1 vs. 3.4 ± 1.1, p < 0.001) and lower SST scores (9.2 ± 0.8 vs. 11.45 ± 0.7, p = 0.002) compared to those without. No significant associations were found with age, sex, smoking, occupation, or comorbidities.
Conclusion: STAM is a common and clinically significant complication following conservative management of clavicle fractures, particularly in the presence of mal-union or non-union. Early recognition and targeted rehabilitation are essential to optimize shoulder function.