Scapula Fracture

synonyms: scapular body fracture, scapula fracture

Scapula Fx ICD-9

• 811.00 (fracture of scapula, upper end, unspecifiec part, closed)
• 811.09 (fracture of other parts of scapula, closed)

Scapula Fx Etiology / Epidemiology / Natural History

• Uncommon injury.
• Generally high-energy direct blow to the posterior shoulder.

Scapula Fx Anatomy

• See also Shoulder Anatomy.

Scapula Fx Clinical Evaluation

• ATLS resuscitation. These are typically high enegery injuries, assessment should begins with the A,B,C's.
• C/O shoulder pain after trauma.
• Evaluate for tenderness, ecchymosis, soft tissue injury.
• Document axillary, median, ulnar, radial nerve function and radial pulse.

Scapula Fx Xray / Diagnositc Tests

• AP, scapular lateral and axillary views.
• CT scan with 2-3mm cuts often helpful to fully define fracture pattern.
• Consider Chest xray to rule out associated injuries.

Scapula Fx Classification / Treatment

• Location: Scapular body, glenoid neck, glenoid fossa, coracoid process, acromion.
• 68% involve the inferior aspect of the glenoid neck, 71% involve the superior vertebral border (Armitage BM, JBJS 2009;91A:2222).
• Scapular body fractures are generally treated conservatively.
• ORIF technique: generally utilize Judet apporach with skin incision paralleling the spine of the scapula and medial border of the scapula. Deltoid is detached from scapular spine. Infraspinatus reflected laterally exposing scapular body.

Scapula Fx Associated Injuries / Differential Diagnosis