Fracture of the Shoulder Blade (Scapula Fracture)
I had an accident and broke my shoulder blade (scapula)
The shoulder blade is an important part of the shoulder joint. It can get fractured usually in a high energy impact trauma. Due to the nature of the accident being a high energy trauma, often other injuries are present and require more urgent attention (i.e. chest and lung). Regardless, you might find yourself in an emergency department, suffering from pain and information overload and need some guidance and care. Please feel free to get in touch (07 3394 4073) and we will endeavour to look after you acutely. Should you happen to be at Greenslopes Private Hospital Emergency Centre ask your treating doctor to notify us. This is a straight forward referral process and Dr Rhau is often able to see you on short notice.
Who gets a scapula fracture?
Fractures of the scapula (shoulder blade) happen in high energy trauma such as a fall from a greater hight or accidents at speed. The bone itself is mostly covered by larger muscle bellies and the scapula is quite mobile against the chest which make scapula fractures rather rare.
How is scapula fracture diagnosed?
Clinically pain on moving the shoulder and local bruising as well as skin abrasions should raise the suspicion of scapula fracture. X-rays and CT scan are able to show scapula fractures in detail.
How is scapula fracture treated?
The majority of scapula fractures can be treated non operative with sling immobilisation for two to six weeks followed by physiotherapy. A relatively high degree of comminution and fracture displacement can be tolerated as the blade of the scapula is well covered with muscle bellies which aide in stability and support union. However, the scapula forms one of the partners of the shoulder joint. The joint building part is called ‘glenoid’. Fractures to the glenoid neck or the actual glenoid joint surface with step or gap formation require surgical reduction and fixation in order to regain a useful shoulder function.
Surgery for scapula fracture
These cases require overnight admission as the procedure can take several hours. Specific plate and screw systems are available to achieve anatomical reduction and fixation. Access to the scapula is via direct incision at the back. Primary aim is to achieve stable fixation in order to commence physiotherapy as soon as possible.
Preparing for surgery for scapula fracture
Prior to the procedure, we will arrange for one preconditioning physiotherapy session where we fit a shoulder immobiliser, explain some simple exercises and give you an ice bladder with icing instructions. If required we will also arrange for a bulk billed pre-admission clinic at the hospital. This is run by a specialist anaesthetist who will gather information and request investigations that are required for safe anaesthesia. Our reception staff will advise of costs, hospital and admission details. Often these surgeries are carried out as emergency surgery and we will endeavour to provide as much information as possible prior to the procedure.
Recovery from surgery for scapula fracture
After surgical fixation sling immobilisation is necessary for roughly six weeks. Physiotherapy can commence within a few days following the procedure mainly for elbow and wrist motion but also passive shoulder motion. Once comfortable active assisted exercises for the shoulder joint will be added. The surgical incision will be closed with internal sutures and the wound will have healed when you will have your scheduled two week postoperative appointment with me. X-ray will follow at the six week mark before sling immobilisation can be discontinued. This marks a change in rehabilitation where the focus will shift towards increasing range of motion and strength. Recovery of full range of motion and strength can be expected at the 12 weeks mark following surgery.