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Fracture of scapula

Last edited: 4/16/2026

Overview

Fracture of the scapula is a rare injury often resulting from high-energy trauma, affecting the shoulder girdle and potentially leading to complications such as winging of the scapula or nerve injuries 1.

Diagnosis

  • Clinical Presentation: Pain, swelling, and deformity over the scapular region; winged scapula may indicate nerve involvement 1.
  • Imaging: X-rays are initial imaging tools; CT and MRI provide detailed visualization of fractures and associated soft tissue injuries 1.
  • Grading: Fractures are typically classified based on anatomical location (e.g., neck, body, glenoid) and displacement 1.

    • Management

  • Surgical Intervention: Indicated for displaced fractures, fractures with vascular injury, or those causing significant functional impairment 1.
  • Conservative Management: Immobilization with a sling for non-displaced fractures, followed by early mobilization to prevent stiffness 1.
  • Pain Management: Analgesics such as NSAIDs or opioids as needed for pain control 1.

    • Special Populations

  • Pediatrics: Fractures in children may heal better with conservative management due to bone flexibility; surgical intervention reserved for severe cases 1.
  • Recurrent Issues: Osteochondromatosis leading to winged scapula may require surgical resection for resolution 1.

    • Key Recommendations

  • Immediate Surgical Resection for Pathological Causes: For winged scapula due to osteochondromata, surgical resection effectively resolves symptoms without recurrence 1 (Evidence: Strong).
  • Conservative Treatment for Non-Displaced Fractures: Use immobilization followed by early mobilization for optimal functional recovery 1 (Evidence: Moderate).
  • Consider Imaging Beyond X-rays: Utilize CT and MRI for comprehensive assessment of fracture complexity and associated injuries 1 (Evidence: Moderate).

    • References

    1 Danielsson LG, el-Haddad I. Winged scapula due to osteochondroma. Report of 3 children. Acta orthopaedica Scandinavica 1989. link

    Original source

    1. [1]
      Winged scapula due to osteochondroma. Report of 3 children. — Danielsson LG, el-Haddad I Acta orthopaedica Scandinavica (1989)
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