A scapula fracture is what doctors call a fracture of the shoulder blade. Even if the shoulder blade is protected by a strong and distinctive musculature and one could assume that a scapula fracture occurs quite rarely, around four percent of all injuries to the shoulder girdle are a scapula fracture. About two-thirds of fractures directly affect the scapula; about a third the scapular neck and a quarter the acetabulum.
What is a scapula fracture?
In humans, the scapula forms the back of the shoulder girdle; in animals, however, the upper part. The scapula is a triangular, flat bone, while in birds it is roughly saber-shaped and narrow. Scapula fractures occur primarily as a result of enormous physical impact. See wholevehicles for What are the Meanings of Lymphangiom.
Occasionally attacks are classic causes of a corresponding fracture, as here – due to the “tearing at the pocket” or sometimes “pushing impact movements” is acted on, so that a fracture of the shoulder blade is possible.
But car or traffic accidents are also classic indications of a scapula fracture. Skiing, snowboarding or horseback riding can also be triggering factors. The scapula fracture is divided into five types:
- Type A describes the fracture of the shoulder blade
- Type B the fracture of the processes
- Type C the fracture of the socket neck
- Type D a joint involving fracture
- Type E all those scapula fractures that also show humeral head fractures
Causes
The causes are acts of violence. It should be noted, however, that the shoulder blade must be subjected to enormous force in order for the bone to actually break. Above all, sports accidents (skiing, snowboarding, horseback riding), traffic and car accidents or direct violence (e.g. as part of an attack) can be possible triggers for a scapula fracture.
Ordinary falls that are not associated with a high speed are usually not a trigger for a scapula fracture to occur.
Symptoms, Ailments & Signs
The patient complains of severe pain and restricted mobility. The doctor occasionally detects a hematoma, but is relatively good at recognizing a deformed contour of the patient’s shoulder. It is important that in addition to the scapula fracture, any concomitant injuries are also taken into account.
Lesions of the vessels and nerves (axillary nerve and/or injuries to the brachial plexus, injuries to the suprascapular nerve in connection with limited external rotation), thoracic injuries, [collarbone fracture|fractures of the clavicle]] and shoulder dislocations are not uncommon and must also be treated will.
Diagnosis & course of disease
The doctor can diagnose the scapula fracture with an X-ray of the shoulder blade. Axial and tangential images of the shoulder blade are taken. However, since the question of joint involvement, which is of essential importance for further treatment, cannot always be answered, an MRI or CT must be performed in some cases.
Any concomitant injuries that are possible in the context of a scapula fracture can be ruled out or confirmed by a chest x-ray. In the case of quite complex scapula fractures, of course, there are lengthy healing processes. It is important that the doctor also takes physiotherapeutic measures so that a satisfactory therapeutic success is given.
However, if no physiotherapeutic exercises are carried out or if the patient decides against an operation, although the doctor would prefer an operation, long-term effects can very well occur, which are expressed in restricted movement and recurring pain.
Complications
First and foremost, those affected by a scapula fracture suffer from severe pain and a broken bone. The pain also very often spreads to the neighboring regions. There are severe limitations in movement and thus also in everyday life for the patient. This means that normal activities or sporting activities are no longer possible without further ado. Swelling or bruising can also occur due to the scapula fracture and have a negative impact on the affected person’s quality of life.
In many cases, the surrounding tendons or bones are also injured. The nerves can also be damaged, so that the patient suffers from paralysis or other sensory disorders. Due to the severe pain immediately after the accident, the patient may also lose consciousness and be injured in a fall.
As a rule, there are no special complications in the treatment of a scapular fracture. With the help of immobilization and surgery, the symptoms can be alleviated and the broken bone repaired. The life expectancy of the patient is not negatively affected.
When should you go to the doctor?
Since a scapula fracture is a fracture of the bones, this complaint should always be treated by a doctor. Further complaints or complications can only be avoided by correct and, above all, early treatment. A doctor should be consulted for a scapula fracture if the affected person is suffering from extreme pain in the shoulder.
This pain often spreads to the neighboring regions of the body and can even lead to restrictions and discomfort during sleep. Sudden limitations in movement also indicate a scapula fracture and should be examined by a doctor. Since the scapula fracture usually results from another injury, the entire body should be checked for fractures and other injuries.
An orthopedist is usually consulted for this injury. In emergencies or in the event of an accident, an ambulance can be called or the hospital can be visited directly. As a rule, the complaint is treated completely and the disease progresses positively.
Treatment & Therapy
In almost all cases, the scapula fracture is treated conservatively. Conservative treatment is based on immobilization using a Gilchrist bandage. Sometimes – depending on the intensity of the pain – so-called pendulum exercises can be carried out after just one or two weeks.
If there is a type A fracture, this type of injury is always treated conservatively. If the doctor diagnoses a type B fracture, attention is paid to the degree of dislocation. Fractures that are only slightly displaced or not displaced at all are treated conservatively, even in the case of a type B fracture, while unstable fractures must be stabilized by means of surgical treatment. As part of the stabilization, the doctor relies on screw connections.
If there is a type C fracture, the degree of displacement and tilting decides whether the patient is treated surgically or conservatively. If there is a malposition that is more than one centimeter or more than 40 degrees, osteosynthesis is recommended. If, on the other hand, there is a combination injury (e.g. in connection with a collarbone fracture), there is no option for conservative treatment.
This is because the collarbone has to be stabilized by plating as part of that injury. Fractures that also affect the neck of the socket and subsequently pinch the suprascapular nerve must be examined carefully, since nerve injuries must also be treated. After the therapy (regardless of whether it was a conservative or surgical method), the patient must carry out physiotherapeutic exercises so that satisfactory healing can take place.
Because in the context of a scapula fracture, not only the treatment is decisive; the post-operative measures are also decisive as to whether a symptom-free life can be continued after such an injury or not. Targeted exercises should be carried out so that the muscles are strengthened again and sometimes affected nerves can be trained again.
Prevention
The scapula fracture cannot usually be prevented. This is because the fracture occurs as a result of a violent impact. So you can at most – in the context of sporting activities – be careful not to fall or fall directly on the shoulder. However, since “normal falls” are not actually the cause of a corresponding fracture, avoiding falls in “fast” sports is of great importance.
Aftercare
In order for the fracture to heal as quickly as possible, those affected should not put any strain on their shoulder. Sports and physical activities should also be avoided or at least adapted to the disease. Those affected should not overexert themselves. Poor posture or one-sided strain should also be avoided by those affected.
For a favorable recovery, attention should be paid to a rigid posture of the body and, if it occurs, correct it in good time. The affected region should be warmed up sufficiently so that it is protected from tension. If those affected do not adopt a correct posture, the disease can deteriorate significantly in a very short time.
Those affected should have an intact social environment and good contact with family members so that sufficient help can be claimed. Due to the illness, those affected are dependent on help. Everyday tasks cannot be carried out independently and require the support of relatives. This should also be used for relief.
Without adequate rest, the affected shoulder cannot heal. Sleep hygiene must also be adapted to the disease. Affected people have to find a correct position so that the shoulder is not strained and there is a nocturnal awakening. Those affected should urgently undergo physiotherapy. This can help to avoid poor posture and improve the mobility of the affected shoulder.
You can do that yourself
In the area of self-help, sick and affected people should ensure that their skeletal system is relieved at an early stage. In order for the fracture to heal as well as possible, the shoulder must be protected from overexertion during the healing process. The physical and sporting activities are therefore to be adapted according to the possibilities and should be reduced to a minimum.
One-sided loads and poor posture should also be avoided. Although the patient automatically assumes a relieving posture, corrections of a rigid posture should take place regularly. Poor posture leads to a worsening of the overall situation and can trigger muscle problems. It is important to ensure that the affected region is supplied with sufficient heat to avoid tension. The performance of physical tasks should be taken over by people from the social environment so that no complications arise. Sufficient protection of the shoulder is necessary for healing. The conditions of night sleep are also to be changed temporarily. For a restful sleep, sleep hygiene should be adapted to the limitations of the upper body,
Physiotherapeutic exercises can be carried out to support this. Training units are discussed with the therapist, which can then be implemented on your own responsibility. This promotes mobility and reduces possible side effects. In addition, the exercises prevent any incorrect posture.
