Scapula Fractures

The shoulder blade (scapula) is a triangular-shaped bone that is protected by a complex system of surrounding muscles. Scapula fractures represent less than 1% of all broken bones and many of them can be treated without surgery.

High-energy, blunt trauma injuries, such as those experienced in a motorcycle or motor vehicle collision or falling from a significant height, can cause a scapula fracture. Other major injuries often accompany scapular fractures, such as fractures in the shoulder, collarbone and ribs, or damage to the head, lungs, or spinal cord.

One or more parts of the scapula may be fractured.

  • Scapular body (50% to 60% of patients)
  • Scapular neck (25% of patients)
  • Glenoid
  • Acromion
  • Coracoid

Treatment

Nonsurgical Treatment

Nonsurgical treatment with a simple sling works for most fractures of the scapula. The sling holds your shoulder in place while the bone heals. Your doctor may want you to start moving your shoulder within the first week after the injury to minimize the risk of shoulder and elbow stiffness. The sling is discontinued as your pain improves. Passive stretching exercises should be continued until complete shoulder motion returns. This may take 6 months to 1 year.

Surgical Treatment

Certain types of scapular fractures may need surgery:

  • Fractures of the glenoid articular surface in which bone has moved out of place (displaced)
  • Fractures of the neck of the scapula with a lot of angulation
  • Fractures of the acromion process that cause the arm bone to hit against it (impingement syndrome)

During this operation, the bone fragments are first repositioned (reduced) in their normal alignment, and then held together by attaching metal plates with special screws to the outer surface of the bone.

Pain Management

Pain after an injury or surgery is a natural part of the healing process. Your doctor and nurses will work to reduce your pain, which can help you recover faster.

Medications are often prescribed for short-term pain relief after surgery or an injury. Many types of medicines are available to help manage pain, including opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and local anesthetics. Your doctor may use a combination of these medications to improve pain relief, as well as minimize the need for opioids.