Shoulder Blade Fractures

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What is a shoulder blade fracture?

Your shoulder blade is a bone with a triangular shape whose function is to link your collar bone and chest wall. Every human has two shoulder blades. Each shoulder blade lies on either side of your upper back. The shoulder blade is protected by muscles that strengthen it and allows it to move smoothly.

Shoulder blade fractures are rare. A study by the American Association of Orthopedic Surgeons suggests that shoulder blade fractures do not makeup to 1 percent of bone fractures in the United States yearly. Because breaking a shoulder blade is a difficult thing, most fractures are associated with traumas, like motorcycle or car crashes, extreme falls, or sports accidents.

Many parts of the shoulder blade may be fractured. These include:

Scapular body fracture

Most fractures occur in the largest part of the shoulder blade called the scapular body area. This is as written in the Wheeless’ Textbook of Orthopedics, an online medical text maintained by the Duke University Medical Center Department of Orthopedic Surgery.

Scapular neck fracture

Scapular blade fractures are the second most common type of shoulder blade fractures. They occur in the scapular neck area. The scapular neck area is the narrow portion of the shoulder blade that lies below the shoulder socket. This is the point where the bone links to the upper arm bone.

Acromion

The acromion is a high point on your shoulder blade that links it to the collarbone. The acromion may be fractured, but it’s rare.

Glenoid

The glenoid is the socket that links the upper arm bone to the shoulder blade. Fracture is rare in this part of the shoulder blade.

Coracoid

This is a hook-like bony structure that connects the shoulder blade and the collarbone. A fracture in this part of the shoulder blade is also very unlikely.

Symptoms of a shoulder blade fracture

Symptoms may differ for fractures to different parts of the shoulder blade. General symptoms include:

• Severe pains when moving your arms
• Bruising, swelling, and abrasions on the skin at the back of your shoulder blade
• Being unable to lift your arm right over your head.

You may also experience symptoms caused by trauma. Fractures are generally serious conditions, so you must see your doctor without delay if you experience any symptoms.

Causes of shoulder blade fracture

Shoulder blade fractures may occur when you fall from a height, or when you’re hit hard on the hand. In many cases, fractures are caused by:

Falling on an outstretched arm

When a person is falling, he or she tends to reach out to an arm or even both arms as a way of protecting his or her body from injury. This tightens your arm muscles and makes your shoulder blade prone to a fracture.

Receiving a hard hit on the shoulder

A hard blow to the shoulder for instance from a motorcycle accident or a car, a hard object, or a fall can cause a fracture on the shoulder blade.

Diagnosing a shoulder blade fracture

If your doctor suspects that you have a shoulder blade fracture, he or she will perform a physical examination for confirmation. Your doctor will check your shoulder’s alignment and position, and also inspect your arm for physical injuries that may have occurred when you had the fracture.

A physical examination may not be possible if you have severe injuries. But whether an examination is possible or not, your doctor will recommend chest and shoulder imaging tests. They may order a CT scan or X-rays to determine the exact location of the fracture.

Complications of a shoulder blade fracture

A shoulder blade fracture may cause some complications, which in most cases affects the chest, spine, and skull.

An untreated shoulder blade fracture will heal over time but may not heal in the right position. A condition where the shoulder blade heals in the wrong position is called a malunion. A malunion causes stiffness and residual pain, mobility issues, or even cause a bump to form on the back of your shoulder blade.

Most malunions are usually fixed with surgery.

Treatment for shoulder blade fracture

There are different treatments for shoulder blade fractures. Treatments may be classified as nonsurgical and surgical.

Nonsurgical treatments

Most cases of shoulder blade fractures do not require surgical treatment. Your doctor will give you a sling that will keep your shoulder in place while your bones are healing.

You may also be asked to undergo physical therapy to reduce pain and stiffness, and also to increase mobility. Your shoulder should be rested until you are ready to undergo physical therapy. Physical therapy will continue until your shoulder is fully mobile. Your doctor will advise you on when to remove your sling. Most times, this happens when your pain starts to subside.

Surgery

Certain shoulder blade fractures may require surgery to treat. These include:

• Fractures that involve displacement of the glenoid
• Acromion fractures that cause rubbing of the upper arm bone against it
• Fractures on the neck of the scapula

You will be anesthetized during surgery. Your bones will be realigned properly. The surgeon may attach them with wires, screws, or metal plates. Surgery is usually accompanied by rest, followed by physical therapy until there’s a full restoration of your mobility.

Prognosis

Surgical treatment for shoulder blade fracture has a few risks. These include:

• Infection
• Severe bleeding
• Adverse reaction to anesthesia
• Nerve injury
• Surgical errors

Successful treatment usually guarantees a return to a healthy, active life in less than a year.