The scapula or shoulder blade is a triangular bone in the shoulder joint which is surrounded by muscles and tissues. Any break or crack in the bone can lead to a scapula fracture. It is a rare injury because this bone is relatively stable and can move in different directions which reduces the chances of breakage. In most cases, scapula fracture is accompanied by damage to the ribs, collar bone, spine and lungs.
Causes
- Vehicular accidents that involve high energy traumas
- A fall on the shoulder
- Direct hit with a blunt object
- Trying to prevent a fall by stretching out the arm may damage the shoulder blade
Symptoms
- Severe pain while moving the arm or upper body
- Swelling and tenderness in the thoracic region
- Bruising and discoloration
- Open wounds may be present
- Crepitus, i.e. the sensation of bones grinding against each other
- Limited range of motion
Diagnosis
- Detailed clinical evaluation of the injured shoulder
- The orthopedic doctor may look for any additional injuries
- CT scan or MRI may be required for a detailed view of the soft tissue structures and scapula
- Nerve conduction test may be carried out to check for impulses in the arms and hands. This can help to rule out damage to the blood vessels
Treatment
- Most scapula fractures can be treated with conservative methods and surgery is rarely needed.
- Use of a shoulder sling to keep the joint in place as well as to allow the bones and soft tissues to heal completely.
- Passive stretching exercises may be recommended to regain mobility and reduce stiffness post immobilization
- Non-steroidal anti-inflammatory medicines may be prescribed to relieve pain
- In case a part of the bone is displaced during the injury, surgical reduction may be required. The repositioned bones are held in place using metal screws and plates
- It may take about 6 months or a year for the fracture to heal and the joint function to be restored completely. Regular physical therapy sessions may speed up the recovery.