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Joint exposure was then achieved by dissecting the supraspinatus and infraspinatus or posteriorly splitting the infraspinatus and teres minor interval. However, the exposure and fixation of fractures of the inferior glenoid, the scapular neck or the medial scapular body would be limited by this approach. The classic Judet approach13 has been the standard approach for the operative treatment of scapular fractures. The two-portal approach4 used in this study is similar to the modified Judet approach described by Obremsky and Lyman,20 however, this approach usually includes an additional superior dissection of the infraspinatus. The suprascapular nerve and the vascular bundle are routinely identified and dissected (Fig. 3). It is important to note that for [http://www.selleckchem.com/products/MLN8237.html Alisertib datasheet] this approach, the infraspinatus muscle is not completely dissected out of the scapular [http://en.wikipedia.org/wiki/ErbB ErbB] fossa. Thus, the described two-portal approach has all of the advantages of the classic Judet approach13 without the morbidity of the extensive muscle dissection. A recently described minimally invasive approach for scapular fractures10 is better used for corpus fixation than for more demanding articular and neck injuries. Ideberg type II glenoid fractures require, in most cases, only an exposure of the caudal portal between the teres minor and infraspinatus muscles, which is therefore consistent with the approach described by Brodsky et al.5 When adhering to all of the well-defined surgical steps, complications, for example, nerve lesions of the suprascapular and the axillary nerves, can be avoided as observed in this series of patients. Data in the literature regarding the incidence of damage of the suprascapular nerve following surgical treatment of scapular fractures are scarce, though the damage seems to occur in 2�C3% of operated patients.15 Interestingly, there may also be suprascapular nerve damage preoperatively due to trauma itself, as reported by Cole,6 who found that of 18 nerve palsies in 84 patients, 12 were found preoperatively. The importance of an intact infraspinatus to achieve sufficient [http://www.selleckchem.com/products/gsk-j4-hcl.html GSK J4 concentration] shoulder function is well known. Other possible complications include seroma or bleeding, mostly originating from the ascending branch of the circumflex scapular artery, which is usually prevented and controlled at the inferior edge of the glenoid neck. Postoperative seroma or haematoma can develop due to the large subcutaneous flap. Carefully layered closure of the flap and drains will help to prevent this complication. Due mostly to the small series size, the incidence of this complication cannot be assessed precisely, but it seems to be present in