Scapular Fracture
GENERAL INFORMATION:
What is a scapular fracture? A scapular (SKAP-u-lar) fracture (FRAK-chur) is a break in the scapula (shoulder blade). The scapula is a large, triangular, flat bone on each side of the upper back. Each scapula is attached to the humerus (arm bone). In the front, the scapula is connected to the clavicle (collar bone). Together with the clavicle, the scapula connects the upper arm to the trunk of the body. They allow for greater movement of the arm. It is protected by the many muscles of the back, arms, and neck.
What causes a scapular fracture? Scapular fractures are not common, and if they happen, it is usually caused by an injury or trauma. Other parts of the body, especially the clavicle, humerus, lungs, and chest, are also usually affected. This may occur when you fall on your outstretched hand or land on your shoulder. A direct blow to the shoulder or upper back area may also cause a scapular fracture. This may happen during a fight, a car accident, or in any contact sport, such as football and hockey.
What are the signs and symptoms of a scapular fracture? You may have pain, tenderness, swelling, bruising, or a bump in the injured area. The bones may poke through the skin, not look normal, or look out of place. The shoulder and arm may feel weak, numb, and tingly. You may have trouble moving your shoulder and arm. You may need to support the arm with your other hand to decrease the pain.
How is a scapular fracture diagnosed? 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.
How is a scapular fracture treated? Treatment will depend on the damage and the kind of fracture you have. Most broken scapulas heal on their own. You may need to rest and do special exercises to help heal your scapula. It is very important to keep your arm from moving to allow the scapula to heal. You may need any of the following:
- Medicines: Medicines may be given to ease your pain. You may also need antibiotic medicine or a tetanus shot if there is a break in the skin.
- Sling: There are several types of slings that may be used to prevent a broken scapula from further damage. Your arm may also be placed in a simple strap for support and comfort.
- Supportive therapy: Ice packs may be put on your fractured scapula to decrease swelling, pain, and redness. Physical therapy may be needed once swelling and pain are gone to help your scapular fracture heal faster. Exercises that increase range of motion may be done as the pain decreases. This helps to bring back the strength and power of your shoulders and arms.
- 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.
Where can I find more information? Having a scapular fracture may make it hard for you to continue your usual activities. It may make things difficult for both you and your family. Contact the following for more information:
- American Academy of Family Physicians
PO Box 11210
Shawnee Mission, KS 66207-1210
Phone: 1-913-906-6000
Web Address: http://www.aafp.org
- American Academy of Orthopaedic Surgeons
6300 North River Road
Rosemont, IL 600184262
Phone: 1-847-8237186
Web Address: http://www.aaos.org/
- American Physical Therapy Association
1111 North Fairfax Street
Alexandria, VA 22314
Phone: 1-800-999-2782
Web Address: http://www.apta.org
CARE AGREEMENT:
You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.
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