Scapular Fracture

WHAT YOU SHOULD KNOW:

• A scapular (SKAP-u-lar) fracture (FRAK-chur) is a break in the scapula (shoulder bone). The scapulas are two large, triangular, flat bones on each side of the upper back. Scapular fractures are not common injuries. They may happen when you fall on your outstretched hand or land on your shoulder. A direct hit by a hard object during sports, fights, or accidents may also break the scapula. You may have pain, tenderness, swelling, or bruising in the injured area. You may have trouble moving your shoulder and arm.
  
  
• An x-ray, magnetic resonance imaging (MRI), or computerized tomography (CT) scan may be used for diagnosis. Your broken scapula may need a sling or even surgery as treatment. With treatment, such as surgery and medicine, complications may be prevented and you may resume your normal activities.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• Treatment for a scapular fracture may cause unpleasant side effects. Medicines may cause you to have nausea (upset stomach), vomiting (throwing up), or stomach ulcers (sores). You may bleed or get an infection if you have surgery or an open wound.
  
  
• You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening.
  
  
• If left untreated, the bones may not go back to the way they were before. You may have problems with arm movement or decreased grip strength. Diagnosing and treating a scapular fracture as soon as possible is very important. Call your caregiver if you have concerns about your fracture, treatment, or care.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Activity:

It is important to not roll onto the fractured bone while you are sleeping. You may need to lie on your stomach to keep you from rolling onto your injured side. Sleeping on your side with a pillow behind your back may also help you to stay off the injured area. If you ever feel weak or dizzy, sit or lie down right away.

Medicines:

You may be given the following medicines:

• Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
  
  
• Medicines to treat pain, swelling, or fever: These medicines are safe for most people to use. However, they can cause serious problems when used by people with certain medical conditions. Tell caregivers if you have liver or kidney disease or a history of bleeding in your stomach. Tetanus shot: This is medicine to keep you from getting tetanus if the fracture also has an open wound. It is given as a shot. You should have a tetanus shot if you have not had one in the past 5 to 10 years. Your arm can get red, swollen, and sore after getting this shot.

Tests:

Imaging tests may be needed to see if your scapula is broken. These may also be done to check for other injuries, such as other broken bones or a muscle problem. You may be given dye through an IV in your vein in some of these tests. The dye helps the scapula show up better in the pictures. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell your caregiver if you are allergic to shellfish, or have other allergies or medical conditions. You may have any of the following:

• Computerized tomography scan: This is also called a CT or CAT scan. A special x-ray machine uses a computer to take pictures of your scapula.
  
  
• Magnetic resonance imaging scan: This is also called an MRI. An MRI uses magnetic waves to take pictures of your scapula, clavicle, humerus, or chest bones. During an MRI, pictures are taken of your bones, muscles, joints, or blood vessels. You will need to lie still during an MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This may cause serious injury.
  
  
• X-rays: You may need x-rays of your scapula, clavicle, and humerus to check for broken bones or other problems. X-rays of your lungs and both your injured and uninjured scapula may be taken.

Treatment options:

• Ice: A caregiver may use ice on your scapula to decrease swelling, pain, and redness. Put crushed ice in a plastic bag and wrap it with a towel. Place the ice bag on the area for 15 to 20 minutes every hour as needed. If ice is put on the injured area for too long or if it is slept on, it may cause frostbite.
  
  
• Physical therapy: You may need to see a physical therapist to teach you special exercises. These exercises help improve movement and decrease pain. Physical therapy can also help improve strength and decrease your risk for loss of function.
  
  
• Sling: You may need to use a sling for a period of time to allow the scapula to heal.
  
  
• Surgery: You may need surgery to return the bones back to their normal position if the fracture is severe. Surgery may also be needed to fix a scapula that sticks out through the skin. Pins, plates, and screws may be used to hold the bone together. Further problems, such as an injury to a nerve, blood vessel, or other organs may also be treated with surgery.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Scapular Fracture (Inpatient Care)