While rare, scapula fractures (or, fracture of the shoulder blade) can occur as a result of high-energy blunt traumas, such a car, truck and motorcycle accidents, falls from height, and other catastrophic accidents. The scapula is a difficult bone to fracture because it is well protected by an intricate system of muscles. In fact, less than one percent of all fractures involve the scapula.
Because it takes a serious accident to cause scapula fracture, a patient often suffers other major injuries, such as broken ribs, spinal cord injury, brain injury, or lung damage.
Symptoms of scapula fracture
People who suffer shoulder blade fracture, may experience:
- Swelling at the back of the shoulder
- Abrasions of the skin
- Extreme pain with arm movement
Diagnosing scapula fracture
After a physical examination, a doctor will take x-rays to determine the nature and severity of scapula fracture. In some cases a doctor will perform other diagnostic tests, such as CT scan or MRI.
In the majority of patients, the scapular body is fractured, though one-quarter of these injuries affect the scapular neck. A minority also involves the glenoid, acromion, and/or coracoid.
In addition to assessing bone damage, a doctor will also evaluate the surrounding areas for muscular trauma, abrasions, open wounds, and damage to connective tissues.
Treatment of scapula fracture
Fortunately, a sling is often sufficient to immobilize the shoulder and arm and facilitate bone healing. Most fractures of the scapula require 1 to 4 weeks of immobilization before a simple doctor-recommended exercise program can begin. Following immobilization, a patient’s shoulder will feel stiff put limited activity can help to loosen the shoulder joint. However, complete rehabilitation can take anywhere from 6 months to a year.
While most fractures can be treated in this manner, certain types of scapular fracture may require hospital care or further evaluation, with the possibility of surgery to treat the fracture. These include:
- Isolated scapular body fracture
- Glenoid articular fracture involving displacement of the bone
- Scapula neck fracture with severe angular deformity
- Acromion fracture with impingement
In these cases, surgery may be an option for patients with expectedly poor outcomes without such treatment. However, surgery for scapular fracture is not without risk.