Fracture of the Shoulder Blade (Scapula)
What is a Scapula Fracture?
The scapula (shoulder blade) is a flat, triangular bone providing attachment to the muscles of the back, neck, chest and arm. The scapula has a body, neck and spine portion.
Scapular fractures are uncommon but do occur and require a large amount of force to fracture. They are usually the result of intense trauma, such as a high-speed motor vehicle accident or a fall from a height onto one’s back. They can also occur from a fall on an outstretched arm if the humeral head impacts on the glenoid cavity.
What are the Symptoms of Scapula Fracture?
Symptoms of a scapular fracture include the following:
- Pain
- Swelling
- Bruising
- Impaired mobility
- Numbness, tingling or coldness of the hand and forearm
- Popping sound, also referred to as crepitus, heard or felt at the time of the fracture
Diagnosis of Scapula Fracture
Scapular fractures should be evaluated by an orthopaedic surgeon for proper diagnosis and treatment. Your surgeon will review your medical history and perform a thorough physical examination of your shoulder. Other diagnostic studies may be ordered, including:
- X-rays
- CT scan
- MRI
Treatment of Scapula Fractures
Most scapular fractures are not significantly displaced due to the strong supporting soft tissue structures surrounding it. Therefore, most scapular fractures are treated conservatively and with early motion to reduce the risk of stiffness and will usually heal without affecting shoulder movement.
Non-surgical Treatments for Scapula Fractures
Conservative treatment options include:
- Immobilization: A sling is used for comfort and to support the shoulder to allow healing to take place. This is usually worn about 3-6 weeks depending on the type of fracture and how well you heal.
- Prescription medications: Pain medications will be prescribed for your comfort during the healing process.
- Physical therapy:Early progressive range of motion exercises is essential in restoring full shoulder function. Your physician will most likely refer you to a physical therapist for instruction on proper exercises and early motion of the shoulder to prevent complications.
Surgical Treatment for Scapula Fractures
Fractures of the scapula involving the neck or glenoid or with severe displacement have been associated with poor outcomes when treated non-operatively. It will usually require surgical intervention to realign the bones properly and restore a functional, pain free range of motion to the shoulder joint.
Scapular fracture repair surgery has historically been performed through a large, open incision. Newer, minimally invasive techniques have evolved and surgery to repair scapular fractures can now be performed through arthroscopy.