Cole osteotomy and reorientation of scapular neck. A, Posterior Judet approach and surgical exposure of scapular nonunion. Note scapular deformity (solid arrow). Dashed arrow shows neurovascular bundle at spinoglenoid notch. B, Small external fixator used to maintain desired reduction at lateral border of scapula. Solid arrow shows superomedial angle. C, After corrective osteotomy and anatomic reduction, a 3.5-mm dynamic compression plate and a 2.7-mm reconstruction plate with conventional or locking screws are used for fixation. Solid arrow points out superomedial angle and dashed arrow the spinoglenoid notch. D, Thirty-two-month postoperative anteroposterior radiograph showing complete scapular healing in anatomic alignment with no evidence of hardware loosening. SEE TECHNIQUE 58.19. (From Cole PA, Talbot M, Schroder LK, Anavian J: Extra-articular malunions of the scapula: a comparison of functional outcome before and after reconstruction, J Orthop Trauma 25:649, 2011.) SEE TECHNIQUE 58.19.