Scapula fracture

The scapula is protected by its deep position, surrounding musculature, and mobility. Because it takes significant force to fracture, scapula fractures are closely associated with serious concomitant injuries — pulmonary contusion, pneumothorax, rib fractures, brachial plexus injury, and vascular injury. Fractures involving the glenoid articular surface (intra-articular) require more careful evaluation for surgical repair than extra-articular body fractures.

Posterior shoulder pain after high-energy trauma, tenderness over the shoulder blade, limited shoulder motion. Plain X-rays identify most fractures. CT scan is mandatory for intra-articular glenoid fractures and to characterize displacement for surgical planning. Associated injuries must be identified and treated.

Intra-articular glenoid fractures with > 5 mm step-off and > 25% surface involvement, and certain scapular neck fractures with significant malalignment, are considered for ORIF.

External patient-education references and related OSI pages for additional background:

• Britannica — Bone disease (fractures)
• Britannica — Shoulder (anatomy)
• AAOS OrthoInfo — patient education library
• OSI glossary — orthopedic terminology in plain language