Most scapula fractures do not require surgery. Surgery may be required if a fracture displaces bones, forcing them out of their normal positions.
Examples of nonsurgical treatment include:
- Using a sling or shoulder immobilizer to prevent movement. Shoulder immobilizers may have additional straps and cuffs for the arm, wrist, and fingers for more stabilization. The shoulder is immobilized until the pain diminishes, typically 3 or 4 weeks depending on the type or severity of the fracture.
- Taking pain medication to help reduce pain and swelling. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen and ibuprofen are commonly recommended, however these medicines are avoided before surgery as they can cause excessive bleeding.
- Regularly icing the affected area to reduce swelling. The ice pack can be covered with a towel or cloth to prevent ice burn.
Rehabilitating from nonsurgical treatment can involve monitoring a person’s pain, inflammation, and posture by a therapist. A strengthening program may also be added. It can take 6 to 12 months to completely restore shoulder motion.
In certain cases, surgery to repair a broken scapula is necessary. Surgery for a scapular fracture may be recommended when:
- The angle of the bone causes a deformity in the limb (angular deformity)3
- The bone positioning is no longer in its correct, anatomical position (displacement)3
- The glenoid socket is fractured, causing instability of the ball and socket joint
- Additional bones, such as the clavicle, are fractured4
A surgeon may postpone surgery if other injuries have occurred on the same side of the body.3 Since scapula fractures are routinely linked with traumatic events, the course of action often depends on these associated injuries. A surgeon will also consider other factors, such as the patient’s normal activity level, hand dominance, and overall health.3
Following surgery, rehabilitation generally involves:
- Wearing a sling to prevent arm movement.
- Physical therapy beginning with mild shoulder motions; more aggressive exercises can be applied about eight weeks after surgery. Resistant exercises are usually added 12 weeks post-surgery.
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The physician may recommend working with a physical therapist for rehabilitation.