Scapula Fracture

Fractures of the Shoulder Blade

scapula fracture
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A scapula fracture is an uncommon injury. The scapula, or shoulder blade, is a wide, flat bone that sits behind the rib cage. The scapula connects to the clavicle (collar bone) in the front of the body, and to the humerus (arm bone) at the side. Part of the scapula is lined with cartilage (the glenoid) and forms the socket of the ball-and-socket shoulder joint.

Scapular fractures are rare injuries that generally occur with significant, high-energy traumatic injuries such as motor vehicle collisions or falls from a height.

  When a scapular fracture does occur, doctors need to look carefully for the occurrence of other chest injuries.  Because of the energy necessary to cause a scapular fracture, it is common for there to be other types of chest injuries including pulmonary contusions, rib fractures, and pneumothorax.

Types of Scapular Fractures

  • Scapular Body Fractures
    Scapular body fractures are the most common type of scapula fracture. These injuries seldom require any specific treatment more than a simple arm sling. The important fact is that scapular body fractures are commonly (80-90%) associated with other injuries such as lung and chest injuries.
  • Scapular Neck Fractures
    Scapular neck fractures occur just adjacent to the glenoid--part of the shoulder joint. Again, most of these fractures can be treated without surgery unless there is significant angulation of the broken bones. In these cases, the shoulder joint can be affected if surgery is not done to realign the bones.
  • Glenoid Fractures
    Glenoid fractures involve the cartilage surfaces of the shoulder joint. These fractures require surgery when the should joint becomes unstable or if the fragments are far out of alignment. Patients with glenoid fractures are at risk of developing shoulder arthritis.

Treatment of Scapular Fractures

There is great variability in treatment of scapular fractures.

  Surgery is often recommended for glenoid fractures because of the effects on the shoulder joint.  However, there is significant variability on the treatment of scapular body fractures.  While there are many published guidelines, these don't always agree, and most authors agree that individual patient characteristics often play a role in determining the best treatment.

Sources:

Cole PA, et al. "Management of Scapular Fractures" J Am Acad Orthop Surg March 2012 vol. 20 no. 3 130-141.

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