Scapula (Shoulder Blade) Fractures
What Is a Scapula Fracture?
A scapula fracture is a break in the shoulder blade, the large, flat bone located on the back of the shoulder. The scapula connects the collarbone (clavicle) and upper arm bone (humerus) and serves as the attachment site for many muscles that allow the shoulder to move smoothly and remain stable.
Scapula fractures are uncommon, accounting for less than 1% of all broken bones. Because the shoulder blade is protected by surrounding muscles and the rib cage, these fractures usually occur after significant trauma such as a motor vehicle accident, a fall from height, or a high-impact sports injury.
Scapula fractures can involve different parts of the bone, including the body, neck, glenoid (shoulder socket), acromion, coracoid process, or scapular spine. Each type of fracture requires careful evaluation to determine the most appropriate treatment.
Types of Scapula Fractures
Scapular Body Fracture
The scapular body is the broad, flat portion of the shoulder blade. These are the most common type of scapula fracture and frequently heal without surgery.
Scapular Neck Fracture
The neck of the scapula connects the shoulder socket to the body of the shoulder blade. Some fractures remain stable, while others may require surgery if the shoulder alignment is affected.
Glenoid Fracture
The glenoid is the socket of the shoulder joint. Because this fracture involves the joint surface, restoring normal alignment is important to minimize the risk of arthritis and shoulder instability.
Acromion Fracture
The acromion forms the roof of the shoulder and helps protect the rotator cuff tendons. Fractures in this area may occasionally narrow the space for the rotator cuff and require surgical treatment.
Coracoid Process Fracture
The coracoid process is a hook-shaped projection on the front of the shoulder blade that serves as an attachment point for several muscles and ligaments. Most coracoid fractures heal with nonsurgical treatment, although surgery may be necessary when the fracture is significantly displaced or occurs with other shoulder injuries.
Scapular Spine Fracture
The scapular spine is the ridge of bone along the back of the shoulder blade. These fractures are uncommon but can significantly affect shoulder strength and function. They may also occur after reverse total shoulder replacement surgery.
Causes
Scapula fractures usually result from significant force. Common causes include:
- Motor vehicle or motorcycle accidents
- Falls from ladders or significant heights
- Bicycle accidents
- Contact sports
- Skiing and snowboarding accidents
- Crush injuries
- Direct blows to the shoulder
In older adults with osteoporosis, some fractures may occur after lower-energy falls.
Symptoms
Symptoms of a scapula fracture may include:
- Severe pain around the shoulder or upper back
- Swelling and bruising
- Difficulty lifting or moving the arm
- Pain with shoulder movement
- Tenderness over the shoulder blade
- Grinding or popping sensations with movement
- Occasionally numbness or tingling if nearby nerves are affected
Because these injuries often occur after significant trauma, injuries to the ribs, lungs, clavicle, spine, or upper extremity may also be present.
Diagnosis
Your orthopedic specialist will perform a thorough examination and review how the injury occurred.
Diagnostic testing may include:
- X-rays to identify the fracture
- CT scan to better define complex fracture patterns and assist with surgical planning
- MRI when associated injuries to the rotator cuff, labrum, or ligaments are suspected
Additional imaging may be recommended if other injuries are suspected.
Treatment Options
Treatment depends on several factors, including:
- The location of the fracture
- Whether the fracture extends into the shoulder joint
- Amount of displacement
- Shoulder stability
- Bone quality
- Your age and activity level
Non-Surgical Treatment
Most scapula fractures can be successfully treated without surgery.
Treatment may include:
- Sling immobilization
- Ice and pain medication
- Early gentle shoulder motion
- Physical therapy to restore flexibility, strength, and function
Many patients recover excellent shoulder function with appropriate rehabilitation.
Surgical Treatment
Surgery may be recommended when:
- The fracture is significantly displaced
- The shoulder joint is unstable
- The fracture involves the glenoid (socket)
- The shoulder girdle alignment has been disrupted
- Multiple fractures affect shoulder stability
- The fracture fails to heal properly
Surgical treatment typically involves open reduction and internal fixation (ORIF), in which the broken bones are carefully repositioned and secured using specially designed plates and screws.
Rehabilitation and Recovery
Recovery varies depending on the type and severity of the fracture.
Non-Surgical Recovery
- Sling for approximately 2-4 weeks
- Early supervised range-of-motion exercises
- Progressive strengthening as healing occurs
- Bone healing typically within 8-12 weeks
- Continued improvement for up to one year
Surgical Recovery
- Sling for approximately 4-6 weeks
- Physical therapy beginning soon after surgery
- Gradual strengthening over several months
- Full recovery commonly takes 6-12 months
Most patients are able to return to normal daily activities, work, and recreational sports following complete healing.
Possible Complications
Although most patients heal well, complications can occasionally occur, including:
- Shoulder stiffness
- Weakness
- Malunion (healing in an abnormal position)
- Nonunion (failure of the fracture to heal)
- Post-traumatic arthritis, particularly after glenoid fractures
- Chronic shoulder pain
- Rotator cuff dysfunction
Early diagnosis, appropriate treatment, and a dedicated rehabilitation program help minimize these risks.
When Should You Seek Medical Care?
Seek immediate medical attention after any significant shoulder injury, especially if you have:
- Severe shoulder pain
- Inability to move your arm
- A visible deformity
- Significant swelling or bruising
- Numbness or tingling
- Shortness of breath or chest pain following trauma, which may indicate associated rib or lung injuries
Why Choose Midwest Orthopedic and Musculoskeletal Alliance?
The fellowship-trained orthopedic surgeons at Midwest Orthopedic and Musculoskeletal Alliance provide comprehensive care for every type of shoulder blade fracture, from simple injuries to the most complex fractures involving the shoulder joint. Our team combines advanced imaging, modern surgical techniques, evidence-based rehabilitation, and coordinated multidisciplinary care to restore shoulder function and help patients safely return to work, athletics, and the activities they enjoy.
Whether your injury requires nonsurgical treatment or advanced fracture reconstruction, we are committed to delivering personalized, compassionate care focused on achieving the best possible outcome.
Schedule Your Shoulder Blade Fracture Consultation
If you have experienced a shoulder blade fracture or significant shoulder injury, contact Midwest Orthopedic and Musculoskeletal Alliance today at 414-384-6700. Our team in Southeastern Wisconsin is here to help.