Broken Shoulder Blade Overview
The scapula or shoulder blade is a bony structure found on the upper back that connects the upper arm to the chest wall (thorax). It also forms the socket part of the shoulder joint connecting the upper arm (humerus) to the socket (glenoid). The acromion and coracoid processes are bony bumps found on the upper part of the scapula, and they function to connect the scapula to the collarbone. The scapula is surrounded by thick layers of muscle that are responsible for the smooth movement of the shoulder joint.
- The shoulder blade (scapula) is rarely broken (broken bones are also called fractures). Of all bone breaks, shoulder blade breaks occur less than 1% of the time.
- Scapular fractures occur more often in young men ages 25 to 45 because of the activities and trauma they encounter. These occur with athletic activities, motor vehicle accidents, and other forms of blunt trauma.
- Broken shoulder blades are often caused by heavy forces that might also include severe injuries to the chest, lungs, and internal organs.
Broken Shoulder Blade Causes
Scapular fractures are caused by direct trauma involving a large amount of force or violence. Associated injuries to chest wall, lungs, and shoulder occur in up to 80% of people with broken shoulder blades. Common causes of broken shoulder blades include the following:
- Motor vehicle accidents
- Falls with direct trauma to the shoulder
- Falls onto an outstretched arm
- Direct trauma such as from a baseball bat or hammer
Broken Shoulder Blade Symptoms
Pain, swelling, and bruising may occur over the shoulder blade in the upper back or on the top of the shoulder overlying the coracoid and acromion processes.
Other signs of a broken shoulder blade may include:
- Holding the injured arm close to the body
- Moving the arm increases the pain
- Inability to lift the arm
- Having pain with each deep breath due to movement of the chest wall with each breath; this movement may in turn move the shoulder blade, causing pain.
- Shoulder appears flattened or deformed
When to Seek Medical Care
Call your doctor if you notice any of these conditions:
- Pain with movement of the shoulder
- Swelling of the shoulder
- Bruising around the shoulder
- If shoulder pain fails to improve within 3-5 days
Significant trauma to the shoulder, chest wall, back, or neck can cause severe injuries and should be evaluated in a hospital's emergency department.
- If you experience any of the following with an injury, call 911 for an ambulance immediately:
- Shortness of breath
- Decreased sensation in the affected arm
- Abdominal pain
- Go to the emergency department for evaluation if you experience the following:
- Severe pain or deformity of the shoulder
- Inability to move the shoulder or arm
- Weakness, numbness, or persistent tingling in the injured arm
Exams and Tests
A doctor will be able to diagnose a broken shoulder blade after a thorough physical examination and imaging.
- Shoulder and chest X-rays are taken.
- CT scans of the abdomen and chest are sometimes indicated to evaluate other injuries.
- MRI or CT scans of the shoulder are sometimes needed to diagnose fractures of the shoulder socket (glenoid).
- Fractures of the scapula are sometimes discovered during extensive evaluations after major trauma from falls, motor vehicle accidents, or direct trauma.
Broken Shoulder Blade Treatment Self-Care at Home
Because shoulder blade fractures are often associated with severe, potentially life-threatening injuries, they should be evaluated in a hospital's emergency department.
- Immobilize the arm immediately. Don't move it. This can be accomplished with a sling looped over the neck and the bent elbow, which holds the affected arm close to the body.
- Apply ice to the area to reduce swelling and discomfort.
- Apply ice for 20 minutes at a time, and avoid direct contact of the ice to the skin.
The goal of treatment is to maintain function of the shoulder. Most fractures of the body of the scapula are treated without surgery.
- Ice is used for swelling, and pain medications are used for pain control.
- The shoulder is immobilized in a shoulder sling for 3-4 weeks until the pain goes away.
Surgical treatment may be needed for certain types of scapular fractures, mostly those involving the shoulder socket (glenoid) or neck of the shoulder blade. Early consultation with an orthopedic surgeon (a surgeon who specializes in bone injuries) or a trauma surgeon will help determine what course of treatment is best for you.
Early physical therapy with exercises designed to improve the range of shoulder motion usually is started about one week after the injury. It is important to start these exercises early to avoid a frozen shoulder. A loss of motion in the shoulder can occur if the shoulder is not used for a prolonged period.
Next Steps Follow-up
Broken shoulder blades should receive ongoing treatment by an orthopedic surgeon or sports medicine specialist to ensure proper healing.
- Follow the instructions you are given when you leave the hospital and avoid potential trauma while recovering.
- Pain medications and immobilization will likely be needed to control pain while early in the recovery period.
Broken shoulder blades can be prevented by avoiding high-risk activities such as the following:
- Activities with potential for falls from significant heights such as rock climbing, hang-gliding, or skydiving
- Contact sports
- Driving without a seatbelt
Most fractures of the shoulder blade heal without complications within 6-8 weeks. Fractures that involve the shoulder socket or scapular neck develop more complications.
- Complications may include the following:
- Loss of range of motion
- Loss of strength
- Persistent pain
- Early arthritis
- Many people with scapular fractures have other serious injuries, and their prognosis depends on the nature of these other injuries.
Synonyms and Keywords
scapula fracture, fractured shoulder blade, broken scapula, broken shoulder blade