Experts estimate 80 to 95% of people with a scapula (shoulder blade) fracture have additional injuries. ¹ Greiwe RM. Shoulder and Elbow Trauma and its Complications Volume 1: The Shoulder. Cambridge, UK: Woodhead Publishing; 2015. Examples include:

Rib fractures
Collapsed lung
Bruised lung
Injury to the brachial plexus (a series of nerves based in the neck and shoulder)
Clavicle fracture
Head or spine injury

See The 3 Types of Shoulder Fractures

A scapular fracture diagnosis may be delayed because injuries that occurred with the scapula fracture may be serious and require immediate medical attention.

See When to Seek Help for a Sports Injury

The physical examination
The physician will try conducting a thorough physical examination. However, this is not always possible given the potentially serious injuries that typically occur with a scapular fracture.

If an examination is conducted, the physician may attempt to do the following:

Evaluate the skin to detect any open fractures (bones that have pierced the skin).
Note areas of tenderness, swelling, ecchymosis (discoloration of the skin), and crepitus (a grinding sensation).
Consider shoulder positioning and range of motion, which will be limited if any exists at all.
Look for other injuries.
Palpate (touch) the chest wall and clavicle (collarbone).

See Stress Fracture Diagnosis

Whether or not a physical examination is conducted, the physician aims to get images of the chest and injured shoulder. The chest wall could be involved in a scapular fracture, since it protects the shoulder blade.

Dr Ian Bryam is an orthopedic surgeon specializing in shoulder, elbow, and sports medicine. He practices at the Bone and Joint Institute of Tennessee. Dr. Byram has served as a team physician at the high school and college level, and he has helped provide orthopedic care for the New York Yankees. He is the co-author of numerous articles published in professional medical journals.