Reviewed by Dr. Kenneth Alleyne
The scapula, otherwise known as the shoulder blade, provides the rear wall and roof of the shoulder joint. An extremely strong bone surrounded by muscle and soft tissue, the scapula is not often broken; broken scapulas represent less than 1 percent of all fractures in the body. Breaks occur most often in men aged 35 to 45. As it is most often caused by an extremely strong blow, a broken scapula often accompanies other ailments, such as broken ribs, skull, or collarbone, a bruised or collapsed lung, and injury to the nerves between the shoulder and neck.
Detailed Description
Symptoms
Severe localized pain and visible deformity most often accompany a broken scapula. If nerve damage is involved, the arm of the affected side will become numb or cold. Causes and Risk Factors
Causes
A scapular fracture is most often caused by severe trauma to the shoulder blade or nearby area. A fall on an outstretched arm is also a common cause. Risk Factors
According to Rockwood and Green's Fractures in Adults, motorcycle and automobile accidents comprise between 61 and 75 percent of broken shoulder blades. Contact sports such as soccer and football also increase the risk of breaking the bone.
Treatment
Immediate Action:
If a broken scapula is suspected, the patient should consult a doctor immediately. Immobilize the joint by placing the arm in a sling or by holding the affected arm against the side of the body with the healthy arm. Apply ice to the area in 20- to 30-minute intervals, taking care not to freeze the skin around the area or apply too much pressure to it, which may cause pain. Since severe trauma is often associated with a broken scapula, keep the patient warm and seek immediate medical attention to minimize the risk of shock.
Procedures
A broken scapula is often treated conservatively, meaning that an orthopedic specialist will manipulate the bones back into place and instruct the patient to wear a sling for two to three weeks. Sometimes surgery is necessary to set the shoulder in place or tighten ligaments and tendons that were stretched by the fracture. Medications
Narcotics or non-steroidal anti-inflammatory drugs (NSAIDs) may be used to control swelling and pain. Local anesthetic may be used when reduction [link] is necessary. General or local anesthetic may be applied if surgery is required. Use medications only as directed. Prevention
A diet high in calcium and other bone-healthy nutrients and a regimen of strengthening the bones of the shoulder are the best preventative measures against a broken scapula.
Last updated: 12-Dec-00
