A scapular fracture indicates a break in the scapula, or shoulder blade. If the bones are in appropriate alignment (position), the initial treatment consists of iceand medications to help relieve pain. Immobilization with a sling or shoulder immobilizer for up to six weeks is recommended to protect the bones while they heal. Severe fractures that are displaced (not in appropriate alignment) require surgery to restore and maintain the fractures in good position. Surgery usually includes repositioning the fracture fragments and holding the position with sutures, wires, plates, or screws. After immobilization (with or without surgery), stretching and strengthening of the injured and weakened joints (elbow and shoulder) and surrounding muscles (due to the injury and the immobilization) are necessary.
Posterior view of scapular fracture, as seen on 3-D CT scan
Anterior-lateral view of scapular fracture on 3-D CT scan
Frequent Signs and Symptoms
- Severe arm pain at the time of injury
- Tenderness, swelling, and later bruising of the arm, chest, or back
- Visible deformity if the fracture is complete and bone fragments separate (displaced) enough to distort normal body contours
- Numbness, coldness, or paralysis below the fracture involving the forearm or hand from pressure on or stretching of blood vessels or nerves (uncommon)
- Pain with attempted motion of the shoulder such as lifting or rotation of the arm
Etiology (Causes)
- High-energy trauma, such as a motor vehicle accident
- Indirect stress due to falling on an outstretched hand or bent elbow
- Direct blow to the scapula