Scapula fracture

Background

• Occurs via direct trauma to shoulder area or FOOSH
  • Fractures of body and glenoid are most common
• >75% are associated with other injuries (ribs, lung, shoulder girdle)

Clinical Features

• Localized tenderness over scapula with ipsilateral arm held in adduction
• Any arm movement will worsen pain

Differential Diagnosis

Thoracic Trauma

• Airway/Pulmonary
  • Bronchial injury
  • Diaphragm injury
  • Hemothorax
  • Pulmonary contusion
  • Tracheal injury
  • Trachobronchial injury
  • Traumatic pneumothorax
    • Tension pneumothorax
• Cardiac/Vascular
  • Cardiac contusion
  • Cardiac trauma
  • Cardiac tamponade
  • Commotio cordis
    • Traumatic aortic transection
• Musculoskeletal
  • Clavicle fracture
    • Clavicle fracture (peds)
  • Flail chest
  • Rib fracture
  • Scapula fracture
  • Scapulothoracic dissociation
  • Sternoclavicular dislocation
  • Sternum fracture
• Other
  • Esophageal injury or Perforation
  • Pneumomediastinum
  • Traumatic asphyxia

Evaluation

• Dedicated scapular series (AP, lateral, axillary) will identify most fractures

Management

• Rule-out other injuries
  • Low threshold for additional CT imaging or obs
• Sling, ice

See Also

• Fractures (Main)

References

Authors

Jordan Swartz, Ross Donaldson, Jonathan Snyder, Daniel Ostermayer, Neil Young