What are the other Names for this Condition? (Also known as/Synonyms)

• Fracture of the Scapula
• Scapula Fracture
• Shoulder Blade Fracture

What is Fracture of the Shoulder Blade? (Definition/Background Information)

• A Fracture of the Shoulder Blade is a very uncommon injury that occurs when the bone (the scapula or shoulder blade) that connects the humerus (upper arm bone) to the clavicle, fractures or breaks
• These fractures are usually caused by a high-energy impact that results from an athletic sport, motor vehicle accident, or a fall from a substantial height

There are several different types of Shoulder Blade Fractures, some of which are categorized based on the injury impact force. The fracture types include:

• Open fracture: In this type of fracture, the bone breaks and pierces the skin, requiring immediate medical treatment. Apart from this, ligament, muscle, and tendon damage, may also occur
• Closed fracture: In this type, the bones do not pierce the skin. However, injury to the soft tissues under the skin, may occur
• Displaced fracture: In this type of fracture, the bone may fragment around the point of breakage and get misaligned; hence, surgery is usually required
• Comminuted fracture: In a comminuted fracture, the bone is broken into three or more pieces. It is considered one of the most unstable type of fracture

Based on fracture location:

• Middle third fracture: A fracture that occurs in the middle of the shoulder blade
• Distal third fracture: A fracture that occurs in the outer third of the shoulder blade
• Proximal third fracture: Proximal fractures occur on the inner third of the shoulder blade

Who gets Fracture of the Shoulder Blade? (Age and Sex Distribution)

• Fractures of the Shoulder Blade are non-specific fractures, and as such, may occur in individuals of any age, race, ethnic group, and gender
• However, men between 25-45 years old, have a higher rate of incidence

What are the Risk Factors for Fracture of the Shoulder Blade? (Predisposing Factors)

Common risk factors associated with a Shoulder Blade Fracture include:

• Participation in high-risk contact sports, such as football
• Reduced bone mass (osteoporosis)

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Fracture of the Shoulder Blade? (Etiology)

Some causal factors of a Fracture of the Shoulder Blade include:

• Falling from a significant height; especially landing on one’s shoulders (or the fracture occurring since the individual is overweight)
• Direct trauma to the shoulder associated with an automobile accident
• Taking part in any rough or high-impact sport

What are the Signs and Symptoms of Fracture of the Shoulder Blade?

Signs and symptoms of a Fracture of the Shoulder Blade include:

• Increased pain in the shoulder associated with movement
• Swelling, tenderness, and bruising (skin abrasions) in the shoulder
• Shoulder stiffness
• Visible enlargement of the shoulder muscles

How is Fracture of the Shoulder Blade Diagnosed?

Diagnostic methods that a physician may use to help diagnose Fractures of the Shoulder Blade include:

• Physical examination: A thorough physical examination is important in identifying any noticeable deformities, swelling, contusions, in the shoulder. Individuals are also expected to provide an explanation of the circumstances that caused the injury. In addition to this, a complete medical history can aid in arriving at a definitive diagnosis
• X-ray: X-rays are the most common methods to evaluate a fracture, especially if the bone has been displaced. This diagnostic test will provide a clear image of the bone, identify the exact location of the injury, and determine the extent of the fracture
• Computerized tomography (CT) scan: A CT scan takes a series of x-ray images from several different angles. These images are then merged to create cross-sectional images of bones and soft tissues of the body, which then allows a physician to examine the shoulder and surrounding structures
• Magnetic resonance imaging (MRI): An MRI is a more detailed scan that uses radio waves and a magnetic field to generate high-quality images of the interior bones (scapula, clavicle, humerus, and chest bones) and soft tissues

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Fracture of the Shoulder Blade?

Complications of Shoulder Blade Fractures could include:

• Permanent damage to nerves and blood vessels
• Poor or delayed healing; this may cause the bone to ‘heal shorter’ than it was before
• The immobilization required to heal such fractures may occasionally result in painful shoulder inflammation, stiffness, and reduced range of motion (frozen shoulder)
• Infection of the bone (osteomyelitis)
• Degenerative joint disease (osteoarthritis), if the Shoulder Blade Fracture involves the glenohumeral joint (ball and socket joint at the shoulder)

How is Fracture of the Shoulder Blade Treated?

The treatment measures for a Fracture of the Shoulder Blade may be classified as nonsurgical and surgical.

Non-surgical treatments include:

• Applying ice to the shoulder can help reduce pain and swelling
• Complete immobilization of the shoulder with a cast is required to restrict movement
• Non-steroidal anti-inflammatory oral medications, such as indomethacin and naproxen, may be used to treat a Shoulder Blade Fracture. These medications can help decrease the pain and swelling
• Individuals are likely to need physical therapy exercises after the cast is removed. The goals of these exercises are to strengthen the forearm muscles, improve flexibility, and decrease stiffness. It may take several months for an individual to complete the physical therapy program and regain full strength and functionality

Surgical treatments include:

• Closed reduction: Closed reduction is a surgical method that involves realigning the bone back to its original position, without making an incision at the fracture site. This procedure is usually performed under a local anesthesia, or with conscious sedation using muscle relaxants
• Open reduction and internal fixation (ORIF): Open reduction is a surgical procedure to realign the fractured bone, to its original position. Surgical hardware (such as plates, screws, or rods) is then used to stabilize the fractured bone under the skin

How can Fracture of the Shoulder Blade be Prevented?

To prevent Fractures of the Shoulder Blade, individuals should be careful and consciously aware, while performing any physical activities, such as sports, or even some normal daily activities that could lead to situations involving accidents. Children must be provided a safe environment to work, study, or play. Any possible dangers should also be anticipated and appropriate safety measures adopted.

A few ways to further help prevent unwanted injuries or Shoulder Blade Fractures include:

• Individuals who participate in any high-risk sports, should wear appropriate safety equipment to help prevent the possibility of such fractures
• Wearing appropriate footwear (such as the proper shoe size) may help prevent accidents
• Consuming foods rich in calcium, such as milk, yogurt, and cheese, help build bone strength. Regular diet with appropriate calcium-intake is recommended, even after such fractures. For women, the recommended amount of calcium, increases with age and menopause

What is the Prognosis of Fracture of the Shoulder Blade? (Outcomes/Resolutions)

• A high percentage of Fractures of the Shoulder Blade, heal without any serious complications
• In individuals with Diabetes, it may take longer to heal, due to a lack of proper function of the immune system
• In those individuals, who smoke or chew tobacco, the healing process may take longer time, due to the restriction of blood vessels
• A full recovery and a return to sports or normal daily activities usually requires about 6 weeks, depending on the severity of the injury
• When properly treated and rehabilitated, usually under the guidance of a physiotherapist/specialist, a high percentage of individuals regain their full strength and range of motion in the injured shoulder

Additional and Relevant Useful Information for Fracture of the Shoulder Blade:

Arthritis is a joint disorder characterized by an abnormal inflammation that affects one or more joints, within the body. An inflammatory arthritis of the shoulder affects the shoulder joints; especially the cartilage, bone, soft tissue surrounding the joint, muscles, and tendon.