A scapula fracture, often referred to as a shoulder blade fracture, is a relatively uncommon injury that typically occurs due to high-energy trauma, such as a fall from a height or a motor vehicle accident. The scapula, which is a flat, triangular bone situated at the back of the shoulder, plays a crucial role in shoulder mechanics as it forms the foundation for the shoulder joint and provides attachment points for various muscles. Fractures of the scapula can take several forms, including fractures of the body, glenoid, acromion, and coracoid process. Among these, glenoid fractures are particularly significant because they can lead to unstable shoulder joints. The classification of scapula fractures often follows the principles of anatomical regions, with the involvement of surrounding soft tissues and the potential for associated injuries to the thoracic region, nerves, and blood vessels being key considerations in management. Patients with a scapula fracture frequently present with shoulder pain, swelling, and decreased range of motion, and they may report symptoms that indicate injury to the brachial plexus or blood vessels, such as weakness, numbness, or changes in circulation in the arm. Diagnosis is primarily made through physical examination and imaging studies, with X-rays being the first-line imaging modality; however, in complex cases, a CT scan may be warranted for better visualization of the fracture pattern and any associated injuries. Treatment for scapula fractures can be non-operative or operative, depending on the type of fracture, the degree of displacement, and the presence of concomitant injuries. Non-operative management is typically indicated for most scapula fractures, focusing on pain control, shoulder immobilization, and guided rehabilitation to restore range of motion and strength. However, surgical intervention may be required for displaced fractures, particularly those involving the glenoid, or if there is a failure to improve with conservative treatment. Surgical options include open reduction and internal fixation, which aims to restore the normal anatomy of the scapula and stabilize the shoulder joint. Post-surgical rehabilitation is critical to achieving optimal functional outcomes and typically involves a graduated program of exercises to restore strength, flexibility, and coordination while ensuring protection of the healing fracture. The prognosis for scapula fractures is generally favorable, with most patients experiencing a return to their pre-injury level of activity, although recovery times can vary based on the specific fracture characteristics and treatment methods employed. Overall, recognizing the potential complexity and associated injuries of scapula fractures is essential for appropriate management and ensuring a positive outcome for patients.
