The scapula (shoulder blade) is a flat, triangular bone providing attachment to the muscles of the back, neck, chest and arm. It has a body, neck and spine portion. Fractures in the scapula are uncommon as they require a large amount of force to break the bone. They are usually the result of intense trauma, such as a high-speed motor vehicle accident or a fall from height onto one’s back. They can also occur from a fall on an outstretched arm if the humeral head (end of the upper arm bone) impacts on the glenoid cavity (shallow depression in the scapula into which the humeral head fits).
Symptoms of a scapular fracture may include the following:
Scapular fractures should be evaluated by an orthopaedic surgeon for proper diagnosis and treatment. Your surgeon will perform the following:
Diagnostic studies may include X-rays, CT scan and MRI.
Most scapular fractures are not significantly displaced due to the strong supporting soft tissue structures surrounding it. Therefore, a majority of scapular fractures are treated conservatively and with early motion to reduce the risk of stiffness. They will usually heal without affecting shoulder movement.
Conservative treatment options include:
Fractures of the scapula involving the neck or glenoid or with severe displacement have been associated with poor outcomes when treated non-operatively. They will usually require surgical intervention to realign the bones properly and restore a functional, pain-free range of motion to the shoulder joint.
Scapular fracture repair surgery has historically been performed through a large, open incision. Newer, minimally invasive techniques have evolved and surgery to repair the scapular fractures can now be performed through arthroscopy.