scapula fracture

The scapula, or shoulder blade, is a bone in the back of your shoulder that connects the shoulder to the spine. In general, it is simple to feel. The scapula/shoulder blade is a large triangular bone that connects the upper back/thoracic cage and is well connected by a complex system of muscles. The shoulder blades connect the arm to the thorax, while the scapula muscles ensure proper arm movement over the thorax.

The majority of scapula fractures can be effectively managed with closed treatment. If treated with closed techniques, some injuries with significant displacement have poor long-term outcomes for the shoulder and upper extremity as a whole.

Because scapula fractures are frequently associated with other, potentially life-threatening injuries, surgery should be postponed until the patient is medically stabilized.

Detail Description of Scapula Fracture

Shoulder blade fractures happen as a result of high-energy, blunt trauma injuries, like car accidents or substantial height falls. Other injuries to the chest, lungs, and internal organs are frequently present along with these wounds. To avoid your injuries getting worse, it is crucial to get in touch with your Florida Orthopaedic Institute doctor as soon as you can.

Fortunately, less than 1% of all broken bones are caused by these kinds of fractures. Men aged 25 to 45 are the most commonly affected by shoulder blade fractures.

Symptoms of scapula fractures 

Symptoms of a scapula fracture can include severe pain and tenderness in the shoulder area, swelling, bruising, difficulty moving the arm or shoulder, and deformity or misalignment of the shoulder blade. 

A scapular fracture typically causes excruciating pain. This pain is frequently:

  • Immediate
  • Upper back, across the shoulder blade, and/or on the top of the shoulder
  • Arm movement or deep breathing can aggravate the pain because chest wall movement can cause the fractured scapula to move.

Acute pain is felt both when moving the arm and when it is at rest. The injured person may be unable to lift his or her arm at all.

Additional symptoms linked to scapula fractures

  • Bruising and swelling in the upper back and shoulder.
  • A grinding sensation when moving the shoulder (if movement is possible).
  • The inability to lift the affected arm, as well as the desire to keep the arm and shoulder still.
  • Weakness or tingling in the arm that persists.

Even worse, the shoulder may appear flattened, drooped, or disfigured. Due to the high energy required to cause a scapula fracture, they are frequently accompanied by fractures to the ribs and/or other bones in the shoulder. The patient may also sustain injuries to other parts of the body, such as the head, lungs, chest, or spinal cord.

Various regions of the scapula affected by fracture

A person’s upper back has two scapula bones, one on each side, and each scapula connects to a clavicle (collarbone) and a humerus (upper arm bone). A scapula is a large, triangular-shaped bone that is divided into several sections:

  • The scapular neck is the bone that connects the glenoid to the scapular body.
  • The scapular body is the scapula’s large, flat, triangle-shaped area.
  • Acromion, a bony projection of the scapula at the top of the shoulder that forms a joint with the end of the clavicle (the acromioclavicular joint).
  • Coracoid, a curved, hook-like projection off the front of the scapula located beneath the clavicle, between the ball and socket of the shoulder and the first rib.
  • Glenoid refers to the shoulder socket.

Causes of scapula fractures

The following are risk factors for scapular fractures:

  • Playing a contact sport, such as football.
  • Fall-prone activities include horseback riding, bicycling, and rock climbing.
  • Osteoporosis is related to decreased bone mass.
  • Driving without a seatbelt on.

Because the scapula is shielded by the chest and shoulder muscles, scapula fractures are infrequent. For a fracture to happen, considerable force is required. Therefore, a thorough medical examination should be carried out to make sure there are no other injuries.

Diagnosis of scapula fractures

Your doctor will examine the position and posture of your shoulder to determine the best course of treatment. Because other injuries are frequently present with scapula fractures, your doctor will look for them. He or she will also take care of any soft-tissue injuries (abrasions, open wounds, and muscular trauma). If you have other serious injuries, a thorough physical examination may be impossible.

To determine the extent of scapula injury, your doctor may also order imaging tests of your shoulder and chest. X-rays provide detailed images of dense structures such as bone. A computed tomography (CT) scan may also be ordered by your doctor to provide a more detailed image.

Treatment overview

There are both surgical and nonsurgical ways to treat shoulder blade fractures. They are mostly only capable of being treated non-surgically. Surgery, however, can be required if the shoulder blade bones are misaligned and do not mend properly.

Non-Surgical Treatment

Your shoulder blade fracture may only require nonsurgical treatments to heal, depending on its severity. It’s crucial to cease using your injured arm right once and apply ice to ease any pain and swelling. A sling is frequently used in nonsurgical therapies to stabilize the shoulder while the bone heals.

To reduce the likelihood of elbow and shoulder stiffness, your doctor could also advise you to begin moving your shoulder during the first week following the injury. The sling will soon be unnecessary when the pain subsides. It may take six months to a year, but stretching exercises should be continued until full shoulder motion is restored.

Surgical Treatment

Surgical procedures can be required if the shoulder blade fracture is serious or if it cannot heal on its own. The shoulder blade bone fragments are first realigned during surgery, and then they are secured in place by fastening metal plates with specialized screws to the outside of the bone.

Fractures that necessitate surgery usually involve fracture fragments involving the shoulder joint or an additional clavicle fracture. The fracture fragments are fixed with plates and screws during surgery.

The following scapular fractures may necessitate surgery:

  • Fractures of the glenoid articular surface that have shifted.
  • Fracture of the scapula neck with angulation.
  • Acromion process fractures that cause the arm bone to collide with it (impingement syndrome).

Postoperative Care:

  • To support the operated shoulder, a bandage is wrapped around it, and the operated arm is in a sling.
  • Ice should be applied to reduce pain and swelling.
  • At all times, the incision should be kept clean and dry.
  • The patient will be given specific instructions regarding activity and rehabilitation.
  • Physical therapy is prescribed to restore shoulder function and strength, and it is critical that the patient adhere to the physiotherapist’s exercise plan in order to improve motion and strength in the shoulder and prevent stiffness.
  • The patient is asked to eat a healthy diet and refrain from smoking or drinking at least during the healing phase, in addition to taking medications as prescribed.

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