Scapula fractures are not common, and can often cause severe pain. Up to 75% of all scapula (shoulder blade) fractures are due to traumatic events, such as motor vehicle or bicycle accidents.1 They can also be sustained through contact sports, such as football, or sports involving significant heights, such as rock climbing or cheerleading.

adult scapula fracture Scapular fractures are one of three main fractures that affect the shoulder
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The 3 Types of Shoulder Fractures

Scapula fractures make up fewer than 1% of all fractures and 3% to 5% of shoulder fractures—most shoulder fractures affect the other two bones in the shoulder joint, the clavicle (collarbone) and humerus (upper arm) bones.2 Scapula fractures are most common in men aged 25 to 45.

See Clavicle Fractures: Types and Symptoms and Proximal Humerus Fractures of the Shoulder

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Fractures can occur in different areas of the scapula
A person has two scapula bones, one on each side of the upper back, and each scapula connects to a clavicle (collarbone) to a humerus (upper arm bone). A scapula is large, triangular-shaped bone divided into many parts:3

  • Scapular body, the large, flat, triangle-shaped area of the scapula
  • Acromion, a bony projection of the scapula located at the top-most part of the shoulder, forming a joint with the end of the clavicle (the acromioclavicular joint)
  • Coracoid, a curved, hook-like projection off the front of the scapula located under the clavicle, between the shoulder’s ball and socket and the first rib
  • Glenoid, the shoulder socket
  • Scapular neck, the portion of the bone that connects the glenoid and the scapular body

Medical professionals distinguish scapula fractures by where they occur in the bone. Of the patients with a scapular fracture, 50 to 60% have a scapular body fracture, and 25% have a scapular neck fracture.3

See 3 Questions and Answers about Shoulder Blade Fractures

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Scapula Fractures Symptoms

A person with a scapular fracture typically experiences severe pain. This pain is often:

  • Immediate
  • Localized to the upper back, across the shoulder blade, and/or at the top of the shoulder
  • Aggravated by arm movement or taking deep breaths, because chest wall movement may cause the fractured scapula to move

Acute pain is felt when moving the arm and at rest. The injured person may not be able to lift the arm at all.

Other symptoms associated with scapula fractures:
In addition to pain, a person with a scapular fracture may experience:

  • Bruising and swelling in the shoulder and upper back
  • A grinding sensation during shoulder movement (if movement is possible)
  • The inability to lift the affected arm, and the desire to hold the arm to keep it and the shoulder still.
  • Weakness or persistent tingling in the arm

The shoulder may even appear flattened, drooped, or disfigured. Scapula fractures are often accompanied by fractures to the ribs and/or other bones in the shoulder due to the high energy required to cause a scapula fracture. The patient may also suffer injuries elsewhere in the body, such as injuries to the head, lungs, chest, or spinal cord.

It is important to seek medical attention if the above symptoms are experienced. Emergency medical attention is also recommended if the person is short of breath, has reduced feeling in the injured arm, decreased blood flow to the arm (diminished pulse), abdominal pain, or any other concerning symptoms.

See When to Seek Help for a Sports Injury

Causes and Risk Factors for Scapula Fractures

Risk factors for scapular fractures are as follows:

  • Participating in contact sports, including football
  • Activities with the potential of falling, such as rock climbing, bicycling, or horseback riding
  • Decreased bone mass associated with osteoporosis
  • Not wearing a seatbelt when driving

See Stress Fracture Risk Factors

Scapula fractures are uncommon because the scapula is protected by the chest and shoulder muscles. Significant force is needed for a fracture to occur. Therefore a complete medical assessment should be performed to ensure that there are no additional injuries.

References:

  1. Scapular fractures (including glenoid). Musculoskeletal Medicine for Medical Students website. http://www.orthopaedicsone.com/pages/viewpage.action?pageId=76775712. Last edited July 13, 2012. Accessed May 9, 2016.
  2. Hobbs HR, Garrett BR, Sanchez P, Roche SJL, Vrettos BC. Open reduction and internal fixation of scapula fractures. SA Orthopaedic Journal. 2008; 8-13. Found in Goss TP. Scapular fractures and dislocations: diagnosis and treatment. J Am Acad Orthop Surg 1995;3:22-33.
  3. Scapula (Shoulder Blade) Fractures. American Academy of Orthopaedic Surgeons website. http://orthoinfo.aaos.org/topic.cfm?topic=a00359. Last reviewed March 2014. Accessed May 10, 2016.

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