Fractures of the Shoulder Blade (Scapula)

Fractures of the shoulder blade are somewhat uncommon, making up less than 1% of all broken bones in the US each year. However, these can be debilitating injuries that greatly affect your daily activities.

Overview

Your shoulder is made up of three different bones. They are your upper arm bone (humerus), shoulder blade (scapula), and collarbone (clavicle). The scapula itself is a triangle-shaped bone that is protected by many surrounding muscles, giving it strength and the ability to move smoothly. 

In a fracture of the shoulder blade, one or more parts of the scapula could be fractured. The different parts are the scapular body, scapular neck, glenoid, acromion, and coracoid. The majority of fractures affect the scapular body (50-60%) or the scapular neck (25%).

Fractures of the Shoulder Blade Causes

The many muscles surrounding the bone make it very difficult to break the shoulder blade. That’s why these fractures are often caused by high-energy, blunt trauma to the shoulder region like hard falls or car accidents. Due to the nature of the events that cause shoulder blade fractures, these injuries are also often accompanied by other injuries to the chest, lungs, or internal organs. 

Situations that often cause a fracture of the shoulder blade are:

• Falling onto an outstretched arm
• Being hit hard in the shoulder like from a car or motorcycle accident, fall, or an object like a baseball or baseball bat

Men between the ages of 25 and 45 seem to suffer from these injuries the most.

Fractures of the Shoulder Blade Symptoms

Symptoms of shoulder blade fractures include:

• Extreme pain when moving the affected arm
• Inability to lift the affected arm over your head
• Swelling around the back of the shoulder
• Bruising around the affected shoulder
• Scrapes around the affected area

Fractures of the Shoulder Blade Treatment

Typically, these fractures can be treated nonsurgically. Still, that doesn’t mean that you should skip seeing a doctor. Shoulder blade fractures that have not been treated properly can end up healing in the wrong position, which is called malunion. Malunion can eventually lead to residual pain and stiffness, mobility issues, and a bump on the shoulder blade. When this occurs, shoulder surgery is usually required to fix the improperly healed fracture. 

Immediately after the fracture occurs, you should stop moving your arm and apply ice as soon as possible. This will help reduce swelling and discomfort. A doctor will likely recommend you wear a sling to hold the shoulder in place as the bones heal. Within the first week of the injury, your doctor will probably recommend you begin moving the shoulder to prevent shoulder and elbow stiffness. They will also probably give you a prescription for physical therapy to increase the mobility of your shoulder and reduce stiffness and pain. As the pain starts to lessen, the sling may not be necessary anymore. Stretching and strengthening exercises will be recommended and should continue until complete movement of the shoulder is regained.

Certain types of shoulder blade fractures will require surgery to heal properly. This includes fractures where the glenoid is displaced, severe fractures of the scapula neck, and acromion fractures that cause the upper arm bone to rub against it. In addition, if your fracture does not heal with the above nonsurgical treatments, surgery might be needed. During the surgery, the bone fragments of the shoulder blade will be put back in their normal alignment. Then they will be held in place with metal plates and special screws attached to the outer surface of the bone.

With proper treatment of your fracture, you should be able to return to your active, healthy lifestyle within six months to a year.