Shoulder blade fracture
A broken shoulder blade, also known as a scapular fracture, is a broken bone in the shoulder blade. The shoulder blade (scapula) is a flat, almost triangular bone that occurs on both sides and forms the rear part of the shoulder girdle. Excessive force on the shoulder blade can cause a break. A shoulder blade fracture can affect different anatomical structures of the shoulder blade. The shoulder blade itself, its bony processes and parts of the shoulder joint can break.
A shoulder blade fracture occurs when the shoulder blade is subjected to enormous force. An accident with extensive injuries, a so-called multiple trauma, is typical. Sports accidents are also possible, for example while skiing, snowboarding or riding. In order for the bone to actually break, the force of force on the flat bones must be extremely high. Therefore, it is a rather rare bone fracture compared to other fractures.
Those affected typically suffer from very severe pain and restricted mobility in the shoulder joint. The shoulder blade is deformed and clearly deformed. You can also see a bruise and swelling over the affected shoulder blade. Depending on the accident, other structures of the shoulder joint can be affected and cause discomfort.
A scapular fracture is accompanied by very strong, dull pain, from which those affected suffer significantly. The pain becomes more severe and sharp as the affected shoulder moves. The nature of the pain can change depending on the extent of possible accompanying injuries.
Please also read our article on this Shoulder blade pain.
Classification of shoulder blade fractures
The shoulder blade fractures can be divided into five types depending on the extent of the injury. A type A fracture describes a fracture of the shoulder blade, while a type B fracture has one or more bony processes of the shoulder blade broken. The type C fracture is a fracture of the socket neck.
If the shoulder joint is involved, it is called a type D fracture. Type E includes all scapular fractures that are accompanied by fractures of the humerus.
The patient is first asked how the accident happened and the symptoms. As part of a physical examination, the doctor takes a look at the affected shoulder and usually sees a misalignment of the shoulder, a swelling and a bruise with the naked eye. X-rays of the shoulder are taken to make the diagnosis of a scapular fracture. The fracture can be shown in the X-ray images. At the same time, the imaging serves to assess the injury and therefore plays an important role in therapy planning.
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The majority of shoulder blade fractures are treated conservatively. Type A fractures are always treated conservatively. For this, the affected shoulder is immobilized with a Gilchrist bandage. Physiotherapeutic exercises, for example pendulum exercises, are also used. Pain is treated with pain reliever medication.
Surgery may be indicated for complicated shoulder blade fractures. After the operation, physiotherapy exercises are indicated in order to favorably influence the healing and freedom of movement of the shoulder.
When is an operation necessary?
With a type B and type C fracture, it is decided individually whether an operation is necessary. In a type of scapular fracture, surgery is performed when there is an unstable fracture. A type C fracture comes into the operating room if there is a particularly severe misalignment, that is, if the shoulder exceeds a certain amount of displacement and tilting. The operation is always performed if the angle is tilted by or more than 40 degrees.
The bone is resilient after about six weeks. However, the healing process takes longer.
During the first four to six weeks after the fracture, the shoulder must be immobilized in order to heal. In order to be able to move the shoulder well in the long term, physiotherapy exercises are then indicated. These are carried out over several months.
After about three to six months, the affected shoulder should be fully operational again.
What can the long-term consequences be?
Possible long-term consequences of a shoulder blade fracture are continued restriction of movement of the affected shoulder and disturbances due to possible nerve damage from the accident or during the operation. Post-operative treatment with physiotherapy is very important in order to enable satisfactory healing success.
Other topics you might be interested in:
- Shoulder blade pain
- Inflammation of the shoulder blade