Razavi Journal of Medicine

Razavi Journal of Medicine

Infraspinatus muscle diameter following posterior surgical approach for scapular fractures: A descriptive observational study of muscle changes and their relationship with shoulder pain and function

Articles in Press

Document Type : Original Article

Authors
Meisam Jafari Kafiabadi 1
Farsad Biglari 1
Mohsen Asadi Shahmirzadi 1
Mehrdad Sadighi 1
Amir Sabaghzadeh 1
Saber Barazandeh Rad 1
Adel Ebrahimpour 1
Babak Toloue Ghamari 1
Farzaneh Ghazy 2
1 Department of Orthopedic Surgery, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Department of Radiology, School of Medicine, Mazandaran University of Medical Sciences, Mazandaran, Iran.
10.30483/rjm.2026.254670.1440
Abstract
Background: Scapular fractures are relatively uncommon but can result in significant morbidity. Understanding their demographic characteristics, fracture mechanisms, associated injuries, radiological dimensions, and functional outcomes is crucial for effective management. This study describes postoperative changes in infraspinatus muscle diameter following the posterior (Judet) surgical approach. It explores their relationship with shoulder pain and its impact on function.

Methods: Nineteen participants meeting the inclusion criteria were enrolled in the study. Demographic data, fracture characteristics, associated injuries, and radiological findings were collected. Ultrasound measurements of the infraspinatus and supraspinatus muscle diameters were performed bilaterally at six-month follow-up, with the radiologist blinded to clinical data. Fatty degeneration was graded using the Goutallier classification on postoperative CT. Functional outcomes were assessed using the American Shoulder and Elbow Surgeons (ASES) performance and pain scores. Statistical analysis was performed to explore relationships between variables.

Results: Most participants were male, with a mean age of 35.95 years. Motorcycle accidents were the leading cause of fractures. Associated injuries were present in 21.1% of participants, with concurrent fractures in the lower extremities being the most common. Radiological evaluation revealed a statistically significant reduction in infraspinatus muscle diameter between healthy and fractured shoulders, but no significant difference for supraspinatus (p=0.233). No significant association was found between muscle diameter reduction and functional outcomes or pain scores. Functional outcomes were generally favorable, with most participants reporting high ASES scores.

Conclusion: This descriptive study provides valuable insights into scapular fractures by examining key factors, including demographic characteristics, fracture mechanisms, associated injuries, radiological dimensions, and functional outcomes. The primary finding is a significant reduction in infraspinatus muscle diameter following the posterior (Judet) surgical approach for scapular fractures. However, this reduction was not significantly associated with shoulder pain (p=0.45) or functional outcomes (p=0.38) at six-month follow-up. These findings suggest that while measurable muscle atrophy occurs, it may not directly translate to short-term clinical impairment. Longer-term follow-up and studies with preoperative measurements are needed to determine the clinical significance of these morphologic changes.
Keywords
Shoulder
Scapula
fractures
Posterior
Surgical Approach
Pain

Acknowledgments: None


Data Availability Statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.


Conflicts of interest: The authors declare no conflict of interest.


Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.


Consent for publication: Not applicable.


Ethics approval and consent to participate: The study protocol was approved by the Institutional Review Board and Ethics Committee of Shahid Beheshti University of Medical Sciences (approval number: IR.SBMU.MSP.REC.1402.366). All procedures were conducted in accordance with the Declaration of Helsinki. Written informed consent was obtained from all participants prior to enrollment.


Author contributions: Conception and design of the study: Meisam Jafari Kafiabadi, Mohsen Asadi Shahmirzadi, Farsad Biglari, Acquisition of data: Amir Sabaghzadeh, Saber Barazandeh Rad, Data analysis: Mehrdad Sadighi, Farzaneh Ghazi, Final approval of the version to be submitted: Meisam Jafari Kafiabadi, Babak Toloue Ghamari, Adel Ebrahimpour

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

 

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Razavi Journal of Medicine

Articles in Press, Accepted Manuscript
Available Online from 08 July 2026