Scapula Fracture

The scapula — your shoulder blade — is well-protected. It sits deep against your back, wrapped in muscle, and it slides around freely instead of taking impacts head-on. So it takes serious force to break it: a fall from height, a major car wreck, a hard sports collision. That force is rarely contained to just the bone — scapula fractures often come with bruised lungs, collapsed lungs, broken ribs, stretched nerves, or torn blood vessels nearby. The fractures that need the most attention are the ones that crack into the socket part of the joint (the glenoid) — those need a careful look for surgical repair, while breaks in the flat body of the bone usually heal on their own.

• Severe pain at the back of the shoulder immediately after a high-energy impact — a car wreck, a fall from height, or a hard collision
• Tenderness right over the shoulder blade, with visible bruising across the upper back
• Difficulty moving the arm — especially lifting it away from your body or reaching overhead
• Swelling across the back of the shoulder and upper back
• Pain with every deep breath if ribs or the lung are also injured (common with scapula fractures)
• A sensation of grinding or instability at the shoulder if the fracture extends into the socket (glenoid)

Pain at the back of the shoulder after a high-energy injury, with tenderness right over the shoulder blade and trouble moving the arm. Plain X-rays catch most scapula fractures. A CT scan is required when the fracture runs into the socket (the glenoid) and for measuring displacement before surgery. Because these fractures rarely happen alone, the trauma team also looks for the chest, nerve, and blood-vessel injuries that often come with them.

Surgery is for the fractures that disrupt the socket joint surface — when the step in the joint is more than about 5 mm or when more than a quarter of the joint surface has shifted — and for the few scapular-neck fractures that have angled severely out of place. The repair uses plates and screws to put the joint surface back together.

External patient-education references and related OSI pages for additional background:

• Britannica — Bone disease (fractures)
• Britannica — Shoulder (anatomy)
• AAOS OrthoInfo — patient education library
• OSI glossary — orthopedic terminology in plain language