What is Scapular Fracture

Scapular fracture is a break in the large, triangular bone behind your shoulder (shoulder blade or scapula). This bone makes up the socket joint of your shoulder.

The scapula is well protected by muscles, so scapular fractures are unusual injuries. They often involve a lot of force. People who have a scapular fracture often have other injuries as well. These may be injuries to the lung, spine, head, shoulder, or ribs.

What are the causes?

Common causes of this condition include:

• A fall from a great height.
• A car or motorcycle accident.
• A heavy, direct blow to the scapula.

What are the signs or symptoms?

The main symptom of a scapular fracture is severe pain when you try to move your arm. Other signs and symptoms include:

• Swelling behind the shoulder.
• Bruising.
• Holding the arm still and close to the body.

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms and the details of a recent injury.
• A physical exam.
• X-ray or CT scan to confirm the diagnosis and to check for other injuries.

How is this treated?

This condition may be treated with:

• Immobilization. Your arm is put in a sling. A support bandage may be wrapped around your chest. The health care provider will explain how to move your shoulder for the first week after your injury in order to prevent pain and stiffness. The sling can be removed as your movement increases and your pain decreases.
• Physical therapy. A physical therapist will teach you exercises to stretch and strengthen your shoulder. The goal is to keep your shoulder from getting stiff or frozen. You may need to do these exercises for 6–12 months.
• Surgery. You may need surgery if the bone pieces are out of place (displaced fracture). You may also need surgery if the fracture causes the bone to be deformed. In this case, the broken scapula will be put back into position and held in place with a surgical plate and screws. Surgery is rarely done for this condition.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not drive or use heavy machinery while taking prescription pain medicine.

If you have a splint and a wrap:

• Wear the splint and the wrap as told by your health care provider. Remove them only as told by your health care provider.
• Loosen them if your fingers or toes tingle, become numb, or turn cold and blue.
• Keep them clean.
• If they are not waterproof:
  • Do not let them get wet.
  • Cover them with a watertight covering when you take a bath or a shower.

Managing pain, stiffness, and swelling

• Apply ice to the back of your shoulder:
  • If you have a removable splint or wrap, remove it as told by your health care provider.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times per day.
• Do not lift anything that is heavier than 10 lbs. (4.5 kg), or the limit that your health care provider tells you, until he or she says that it is safe.
• Avoid activities that make your symptoms worse for 4–6 weeks, or as long as directed.

General instructions

• Ask your health care provider when it is safe for you to drive.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay bone healing. If you need help quitting, ask your health care provider.
• Drink enough fluid to keep your urine pale yellow.
• Do physical therapy exercises as told by your health care provider.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have pain that is not relieved by medicine.
• You are unable to do your physical therapy because of pain or stiffness.

Get help right away if:

• You are short of breath.
• You cough up blood.
• You cannot move your arm or your fingers.

Summary

• A scapular fracture is a break in the large, triangular bone behind your shoulder (shoulder blade or scapula).
• The scapula is well protected by muscles, so scapular fractures are unusual injuries. They often involve a lot of force.
• The main symptom of a scapular fracture is severe pain when you try to move your arm.
• Immobilization, physical therapy, and surgery are used to treat this injury. Surgery is rarely done.
• Follow your health care provider’s instructions on taking medicines, using a wrap and splint, putting ice on the injured area, and resting from regular activities.