How Do You Know If You Broke Your Shoulder Blade?
A scapular fracture is the break of the scapula (shoulder bone). The scapula is the large flat bone, formed as a triangle and located on each side of the upper part of the back. A scapular fracture also affects other parts of the body, particularly the clavicle, the humerus, the lungs, and the chest.
Fractures of the scapula are very infrequent; they represent 1% of the total fractures and 5% of those involving the shoulder girdle. Strictly anatomical reasons explain the low incidence of these injuries, the thoracic cavity protect it from the front and a voluminous muscular environment from behind. On the other hand, the mobility of the scapula on the thorax allows it to dissipate and cushion the traumatic forces.
Fractures of the scapula are caused by high-energy trauma, mostly from accidents on public roads.
This determines that more than 80% of the cases have associated lesions of diverse consideration, especially serious thoracic trauma.
Approximately 90% of patients suffer associated injuries due to the trauma violence. The most common association of injuries includes ipsilateral upper extremity and thorax. Associations:
-Costal fractures: 25-45% of cases
-Pulmonary injuries: 15-55%
-Humerus fractures: 12%
–Brachial plexus injury: 5-10%
-Vascular injury: 10-12%
–Traumatic brain injury: 25%
-Abdominal trauma: 8%
Location of the Fracture:
Body and spine: 50% (the most frequent), neck: 25%, Glenoid cavity: 10%,
Acromion and coracoides: 7.5%.
Fractures of the glenoid can present in two forms: one when the forces are conducted directly and the other indirectly.
Often they are not diagnosed in their initial presentation because they hardly show swelling or deformity if they are not displaced.
They are often recognized late; remain hidden in the chest radiographs by the superposition of thoracic structures. However, they are usually identified in conventional chest radiographs in polytraumatized patients.
Strict anteroposterior, lateral and axillary scapular projections should be obtained for systematical evaluation of the body, the scapula spine, the apophysis (acromion, coracoides and glenoids) and the joints (scapulothoracic, glenohumeral and acromio-clavicular).
Signs and Symptoms:
-Pain, tenderness, swelling, bruising, or a bump on the injured area.
-Difficulty moving your shoulder and arm.
-Weakness, numbness and a tingling sensation in the shoulder and arm.
-A need to support your arm with the other hand to reduce pain.
- The conservative treatment is of choice in the presence of fractures that are not very displaced and stable, since it leads to excellent results in 90% of the cases.
- The recovery of the vital constants (body temperature, blood pressure, pulse rate, respiration rate) is essential when it comes to a polytraumatized patient.
- Most scapula fractures can be managed orthopedically with a halter that holds the weight of the stroke and fixed until consolidation (3-4 weeks).
- Surgical treatment is rarely indicated.
Indications of Surgery
-Large displacements of the fracture
-Fracture of the glenoid ridge and articular surface if there is incongruence or subluxation of the humeral head.
You may bleed or get an infection if you have surgery. You may have a blood clot in your arm. The clot may break off and travel to your heart or brain and create deadly danger problems, such as a heart attack or stroke.
How can you Relieve the Symptoms?
-Ice: Ice helps to decrease inflammation and pain. Ice can also help prevent tissue damage. Use an ice pack or put crushed ice in a plastic bag. Cover the bag with a towel and place it on your scapula for 15 to 20 minutes every hour or as directed.
-Rest: Rest when you feel it is necessary. Start doing a little more day by day. Return to your daily activities as directed.
A scapula fracture may occur when you fall with the extended hand outward or over the shoulder. A direct blow to the shoulder or upper back can also cause a scapular fracture. This could happen during a fight, a car accident or in any contact sport, such as American football or hockey.
- National Institute for Health and Care Excellence (NICE). (2016). Fractures (non-complex): assessment and management. NICE guideline https://www.nice.org.uk/guidance/ng38/chapter/Recommendations#managing-noncomplex-fractures
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