Scapular Fracture


Require a significant amount of blunt force and are frequently associated with intrathoracic injuries

DIAGNOSIS

TREATMENT

  1. Closed Fracture:
  2. Otho Consult if
  3. Presence of a scapula fracture mandates investigation for associated intrathoracic injuries. Displaces glenoid articular fracture, angulated glenoid neck fractures, & certain acromial & coracoid fractures may require surgical intervention.

COMPLICATIONS

  Initial Treatment
Splint type & position Arm sling for comfort
Initial follow-up visit Within 1 to 2 weeks of injury
Pt instructions Icing in the first 48 to 72 hours
Early ROM exercises as pain permits within the first week
  Follow-up Care
Cast or Splint type & position Body, spine, coracoid: none
Glenoid neck: sling for comfort
Acromion: sling for 2 to 3 weeks
Healing time 4 to 6 weeks
Follow-up visit interval Every 2 to 4 weeks to assess progress with shoulder rehabilitation
Repeat radiography interval Within 2 to 4 weeks of injury
Must see radiographic healing before starting resistance exercises (usually within 2 to 4 weeks)
Pt instruction Pendulum exercises followed by progressive ROM, including extension and abduction
Resistance exercises especially for rotator cuff muscles
Indications for Ortho consult Displaced glenoid neck fractures with clavicle fracture or with more than 1 cm displacement or 20 degrees inferior angulation.
Glenoid fracture with more than 25% articular involvement, >5 mm stepoff, or displaced humeral head.
Displaced coracoid and acromion fractures

Fractures of the scapula:
   Body (A) 
   Coracoid process (B),
   Acromion (C),
   Glenoid fossa (E),
   Spine (F),
   Glenoid neck (F).