How long does it take to recover from a broken scapula. What are the common causes of shoulder blade fractures. What are the symptoms of a fractured scapula. How is a scapular fracture diagnosed and treated.

Understanding the Anatomy of the Scapula

The scapula, commonly known as the shoulder blade, is a crucial component of the shoulder girdle. This triangular-shaped bone plays a vital role in connecting the upper arm bone (humerus) to the collarbone (clavicle) and chest wall. Each person has two scapulae, positioned symmetrically on either side of the upper back.

The scapula’s structure is complex, featuring several important parts:

• The body: The main triangular portion of the scapula
• The glenoid: The shallow socket that forms part of the shoulder joint
• The acromion: A bony prominence at the top of the scapula
• The coracoid process: Another bony projection near the shoulder joint

Surrounding the scapula is an intricate network of muscles, tendons, and ligaments. These soft tissues are essential for the shoulder’s strength and mobility, allowing for a wide range of motion in various activities.

Causes and Prevalence of Scapular Fractures

Scapular fractures are relatively uncommon, accounting for less than 1% of all broken bones in the United States annually, according to the American Association of Orthopaedic Surgeons. The scapula’s protected position and surrounding musculature make it resistant to fractures under normal circumstances.

When scapular fractures do occur, they are typically the result of high-energy trauma. Common causes include:

1. Motor vehicle accidents
2. Motorcycle crashes
3. Falls from significant heights
4. Sports-related injuries
5. Direct blows to the shoulder area

Due to the force required to fracture a scapula, these injuries are often accompanied by other traumatic injuries to the chest wall, lungs, or other parts of the shoulder complex. This makes a thorough medical examination crucial when a scapular fracture is suspected.

Recognizing the Symptoms of a Broken Scapula

Identifying a scapular fracture can be challenging, as symptoms may vary depending on the specific location and severity of the break. However, some common signs and symptoms include:

• Severe pain in the shoulder region, especially when attempting to move the arm
• Difficulty or inability to lift the arm above the head
• Visible swelling and bruising around the shoulder blade area
• Skin abrasions or lacerations on the upper back
• A grinding or crunching sensation when moving the shoulder
• Deformity of the shoulder or upper back

It’s important to note that these symptoms can also be present in other shoulder injuries. Therefore, professional medical evaluation is crucial for an accurate diagnosis.

Diagnostic Procedures for Scapular Fractures

When a scapular fracture is suspected, healthcare professionals employ various diagnostic techniques to confirm the injury and assess its severity. The diagnostic process typically involves:

Physical Examination

A thorough physical examination is the first step in diagnosing a scapular fracture. The doctor will carefully inspect the affected area for signs of swelling, bruising, and deformity. They will also gently palpate the shoulder region to identify areas of tenderness and assess the range of motion.

Imaging Studies

Various imaging techniques are used to visualize the fracture and determine its extent:

• X-rays: Standard X-rays from multiple angles are typically the first imaging study performed. They can reveal most scapular fractures and provide information about their location and displacement.
• CT scans: Computed tomography (CT) scans offer more detailed images of the fracture, especially in complex cases. They can help identify subtle fractures that may not be visible on X-rays and provide valuable information for surgical planning if necessary.
• MRI: While less commonly used for acute fractures, magnetic resonance imaging (MRI) may be employed to assess soft tissue injuries associated with the fracture.

The combination of physical examination and imaging studies allows healthcare providers to make an accurate diagnosis and develop an appropriate treatment plan.

Treatment Options for Scapular Fractures

The treatment of scapular fractures depends on several factors, including the location and severity of the fracture, associated injuries, and the patient’s overall health and activity level. Treatment options generally fall into two categories: non-surgical and surgical.

Non-Surgical Treatment

Many scapular fractures can be treated without surgery. Non-surgical treatment typically involves:

• Immobilization: The arm is kept in a sling or shoulder immobilizer to allow the fracture to heal properly.
• Pain management: Over-the-counter or prescription pain medications may be used to control discomfort.
• Physical therapy: Once the initial pain and swelling subside, a structured physical therapy program is initiated to restore range of motion and strength.

Non-surgical treatment is often successful for fractures that are minimally displaced or involve certain parts of the scapula, such as the scapular body or spine.

Surgical Treatment

Surgery may be necessary for more complex fractures, particularly those involving the glenoid (shoulder socket) or significantly displaced fractures. Surgical options include:

• Open reduction and internal fixation (ORIF): This procedure involves realigning the fractured bone pieces and securing them with plates and screws.
• Minimally invasive techniques: In some cases, less invasive surgical approaches may be used to reduce scarring and promote faster recovery.

The decision to pursue surgical treatment is made on a case-by-case basis, considering factors such as fracture pattern, patient age, and activity level.

Scapular Fracture Recovery Timeline

The recovery time for a scapular fracture can vary significantly depending on the severity of the injury and the chosen treatment approach. However, a general timeline for recovery might look like this:

1. Weeks 1-4: Initial healing and pain management. The arm is kept immobilized in a sling.
2. Weeks 4-8: Gentle range of motion exercises are introduced as pain allows.
3. Weeks 8-12: Progressive strengthening exercises begin, and more normal use of the arm is encouraged.
4. Months 3-6: Continued strengthening and return to most normal activities.
5. Months 6-12: Full recovery and return to all activities, including sports, for most patients.

It’s important to note that this timeline can vary significantly between individuals. Some patients may recover more quickly, while others may require a longer rehabilitation period.

Rehabilitation and Physical Therapy for Scapular Fractures

Rehabilitation plays a crucial role in the recovery process following a scapular fracture. A structured physical therapy program is designed to:

• Restore range of motion to the shoulder joint
• Strengthen the muscles surrounding the scapula and shoulder
• Improve overall shoulder function and stability
• Prevent complications such as frozen shoulder

The rehabilitation process typically progresses through several phases:

Phase 1: Protection and Pain Control

During the initial phase, the focus is on protecting the healing fracture and managing pain. This phase may include:

• Use of a sling or immobilizer
• Gentle pendulum exercises to maintain some shoulder mobility
• Pain management techniques, including ice and heat therapy

Phase 2: Range of Motion Restoration

As healing progresses, the emphasis shifts to restoring shoulder mobility. Exercises in this phase may include:

• Passive and active-assisted range of motion exercises
• Gentle stretching of the shoulder and surrounding muscles
• Scapular stabilization exercises

Phase 3: Strengthening and Functional Recovery

The final phase of rehabilitation focuses on rebuilding strength and returning to normal activities. This phase typically involves:

• Progressive resistance exercises for the shoulder and upper body
• Functional training specific to the patient’s work or sport activities
• Continued focus on proper scapular mechanics and posture

Throughout the rehabilitation process, close communication between the patient, physical therapist, and treating physician is essential to ensure optimal recovery.

Long-Term Outlook and Potential Complications

With appropriate treatment and rehabilitation, most patients with scapular fractures can expect a good long-term outcome. Many individuals return to their pre-injury level of activity within 6 to 12 months after the injury.

However, as with any significant injury, there are potential complications to be aware of:

• Shoulder stiffness or frozen shoulder
• Chronic pain or discomfort
• Decreased range of motion
• Weakness in the affected arm
• Post-traumatic arthritis in the shoulder joint

Regular follow-up with healthcare providers and adherence to the prescribed rehabilitation program can help minimize the risk of these complications and promote optimal recovery.

In conclusion, while scapular fractures are relatively uncommon, they can significantly impact a person’s quality of life. Understanding the nature of the injury, available treatment options, and the recovery process is crucial for patients and their caregivers. With proper medical care and dedicated rehabilitation, most individuals can overcome this challenging injury and return to their normal activities.

Scapular Fracture (Shoulder Blade) Recovery Time

April 21, 2017

The shoulder blade is a triangular-shaped bone that connects your upper arm bone to your collarbone and chest wall. You have two shoulder blades, one located on either side of your upper back. An intricate web of muscles, which work to give the shoulder strength and allow it to move smoothly, protects it.

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. Thick layers of muscles, tendons, and ligaments surround the scapula, and are responsible for the smooth movement of the shoulder joint.

Shoulder blade fractures are not as common as some other joint injuries. According to the American Association of the Orthopaedic Surgeons, they make up less than 1 percent of all broken bones in the United States each year. Because it’s so hard to break a shoulder blade, fractures are usually caused by major traumas, such as car or motorcycle crashes, sports accidents, or extreme falls.

Scapular fractures are caused by direct trauma involving a large amount of force or violence. Associated injuries to the chest wall, lungs, and shoulder occur in a majority of people with broken shoulder blades. Consequently, if a scapula is fractured, other areas of the body should be diligently examined for additional problems. Common causes of broken shoulder blades include the following:

·       Motor vehicle accidents

·       Long trips or falls

·       Direct trauma to the shoulder

·       Falls onto an outstretched arm

Fractures to the different parts of the shoulder blade may cause slightly different symptoms. But generally, symptoms include:

·       Severe pain when you try to move your arm

·       Inability to lift your arm over your head

·       Swelling, bruising, and skin abrasion at the back of your shoulder blade

Other injuries, especially those caused by trauma, may present the same symptoms as a fractured shoulder blade. All fractures are serious, so it’s important to see a doctor right away if you experience any of the above symptoms. Those whose shoulder blade fractures are treated successfully can expect to return to an active, healthy life within six months to a year.

To learn more about how to recover from a scapula fracture, call Watauga Orthopaedics today at (423) 282-9011 to request an appointment. You can also schedule an appointment online with one of our board-certified orthopedic surgeons.

Filed Under: Fracture Tagged With: Broken Scapular, Broken Shoulder Blade, Can You Brake Your Shoulder Blade?, Scapular Fracture, Shoulder Blade Fracture

Scapular Fracture (Broken Shoulder Blade)

Exercise therapy for a fracture of the humerus

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A fracture of the humerus is a serious injury. The shoulder joint is the most mobile. His injuries significantly affect the ability to work and activity of a person. Shoulder fractures are open and closed, with or without displacement. Depending on the location of the violation of the integrity of the bone tissue, the following types of fractures of the humerus are distinguished:

• fracture of the head, surgical, anatomical neck, tubercles;
• fracture of the body of the humerus;
• fracture of the block, external and internal epicondyles.

A patient after a shoulder fracture refrains for a long time from any activity that causes pain. Doctors recommend avoiding pulling, pushing, heavy lifting, and activities that involve raising your arms. Therapeutic exercise allows you to go through the healing process without complications. The rehabilitators of the Yusupov hospital individually select a set of exercises, taking into account the time and place of the fracture, the patient’s condition and the presence of concomitant diseases. To speed up the recovery of the function of the upper limb, physiotherapists conduct a complex treatment, including massage, electrical procedures.

The Yusupov hospital has all the conditions for the rapid recovery of patients with a fracture of the humerus. Exercise therapy for a shoulder fracture begins as soon as possible. Patients perform exercises under the guidance of a senior exercise therapy instructor. During rehabilitation, patients are consulted by a neurologist, a traumatologist. Rehabilitologists use innovative methods of physical rehabilitation.

Therapeutic exercise for a fracture of the humerus

Exercise therapy after a fracture of the shoulder is carried out at the immobilization stage of treatment, in the first 3 weeks after the fracture. The rehabilitators of the Yusupov hospital individually select a set of physical exercises that the patient performs for 30 minutes 6-8 times a day. The hand must be bandaged at all times, except for classes. Active movements (rotation, flexion and extension, turning in and out) in the hand, wrist and elbow joints stimulate blood circulation in the arm, reduce swelling and reduce the risk of blood clots.

Pendulum movements of the hands are excellent for relieving pain at any time. The patient can remove the diseased limb from the bandage and, in a standing position with an inclination forward, make several pendulum swings with his hand. In the exercise therapy complex after a fracture of the humerus, rehabilitation specialists include the following exercises:

• abduction and adduction of the upper limb or elbow to the body;
• crossing the arms in front of the chest;
• cotton first in front of the chest and then behind the back;
• twists of the body with hands clasped in front of the chest.

When the patient is discharged home, he/she receives a list of exercises to be done daily.

Therapeutic exercise after a shoulder fracture

The functional stage of rehabilitation lasts 3-6 weeks. 3-4 weeks after a shoulder injury, the patient is recommended regular exercise therapy. Rehabilitologists at the Yusupov Hospital use modern devices from leading European manufacturers to restore limb function. The purpose of rehabilitation at this stage is to restore the previous volume of active and passive movements. The set of exercises is constantly expanding, but the starting position remains the same.

The patient should aim for gradual arm extension and standing exercises without bending forward. Every day he should do the following physical exercises 4-6 times:

• raise a straight arm in front of him;
• swing your arms forward, backward and to the sides from the initial position “standing with a slight forward inclination”;
• abduction of the arms behind the back with the reduction of the shoulder blades (the arms bent at the elbows should first be in front of the chest).

At this stage of recovery, rehabilitators use block simulators. Patients perform lifting and lowering of the injured limb on them, spreading the arms to the sides. Therapeutic exercise is complemented by water procedures. The patient is recommended in the pool to perform a variety of movements with the limbs, crossing the arms in front of the chest, exercises that imitate freestyle swimming and breaststroke. Staying in water increases the effectiveness of training, gives an additional load on the muscles, improves blood circulation in them. Physiotherapists include in the rehabilitation complex 10-12 procedures of magnetotherapy, balneological treatment.

Training stage of rehabilitation

7-8 weeks after the fracture of the humerus, the patient, under the supervision of rehabilitation specialists of the Yusupov hospital, fully restores the functionality of the injured shoulder and upper limb. Further physical exercises are aimed at strengthening the muscles and fully restoring the range of motion. Exercise therapy should take place 3-4 times a day. The patient is made up of a set of exercises, each of which he is recommended to repeat 10-12 times.

Therapeutic exercise at this stage of recovery after a shoulder fracture consists of the following exercises:

• lifting the arms in front of you from a standing position;
• abduction, adduction, rotation, pronation and supination of the upper limb;
• push-ups and push-ups;
• hanging on the bar or wall bars;
• manipulation with dumbbells weighing no more than 5 kg and with medicine balls.

Stretching exercises are effective: placing a gymnastic stick or towel behind the back, “walking” with the fingers along the wall to the sides and up. These manipulations allow you to achieve a complete restoration of the mobility of the arm in all directions.

With a rationally selected rehabilitation scheme, a patient with a fractured shoulder fully recovers in 2-3 months. Only after that, rehabilitators prescribe exercises designed to develop stretching, physical strength, and endurance.

Therapeutic exercise after a fracture of the shoulder joint

Therapeutic exercise for a fracture of the shoulder joint begins 10-14 days after the bandage is applied. First, patients perform passive gymnastics, and then active ones with a further increase in load. The tasks of exercise therapy after a fracture of the shoulder joint are as follows:

• restore the range of motion of the injured limb;
• restore tissue elasticity;
• strengthen the muscular apparatus.

The rehabilitation specialist makes up a set of exercises individually for each patient. Initially, the patient performs the following exercises:

• swinging the upper limb forward and backward in the shoulder joint with relaxed muscles, tilting the torso towards the injured arm;
• clenching and unclenching fingers;
• flexion and extension of the limb in the elbow joints, holding the lower third of the forearm of the diseased limb with a healthy hand.

At the end of the second week, the rehabilitologist recommends performing small amplitude pendulum-like swinging movements to the side, small circles with a straight arm. From the fifteenth day, exercises begin to be applied that prepare the hand for raising to a horizontal level: the amplitude of pendulum movements with a straight arm increases, swinging movements of the limb are performed to the side, pushing the diseased hand with a healthy one with short jerks. There are many different exercises for physiotherapy exercises with a fracture of the shoulder joint. The video is on the Internet. The rehabilitators of the Yusupov hospital do not recommend performing them without consulting a specialist.

The patient can make a slight tilt of the torso towards the affected arm, throw the arm behind the back with a light swinging movement, bending it at the elbow, gradually increasing the amplitude. It is recommended to slowly raise the elbows, reducing the load on the deltoid muscle by resting the palms on the torso. Rotational movements in the shoulder joint are effective when the torso is tilted towards the diseased limb (the arm hangs freely with the elbow extended). You can take the elbow to a horizontal position with the support of a healthy limb for the lower third of the forearm of the injured arm. When performing this exercise, the sore arm should be bent at the elbow joint at an acute angle.

Rehabilitologists at the Yusupov hospital will draw up an individual plan for exercise therapy after a fracture of the humerus. To effectively restore the function of the limb, the specialists of the rehabilitation clinic use modern simulators and author’s methods. Call the Yusupov Hospital and the coordinating doctor will make an appointment with the doctor.

How to develop a hand after a fracture of the shoulder joint

The shoulder joint is a mobile connection of the humerus with the shoulder blade. Its fracture is considered a serious injury that will affect the activity and ability to work of a person. A person will have to refrain from activities that provoke pain for the duration of treatment and recovery. A fracture can occur for various reasons, for example, due to a fall from a height onto the hands or elbow, due to direct blows to the shoulder joint area, due to automobile or sports injuries. In any case, you will need to see a doctor, take an x-ray, and then undergo treatment. During and after therapy, you will have to do special exercises that will allow you to recover faster. It is recommended to understand in more detail how to engage in physical therapy.

Shoulder exercises

Therapeutic exercise allows you to quickly restore mobility and get rid of the consequences of an injury. It is necessary to regularly do special exercises in order to achieve positive results soon. You can use the simulator to develop the shoulder joint. It will allow you to recover faster after an injury, and also prevent the occurrence of complications. It is recommended to understand in more detail what exercises you need to do to develop the shoulder. Physiotherapy exercises will have to be done daily and for at least two weeks.

Exercises:

• Internal resistance. You should stand at the door, bend your arm at the elbow of the arm being developed, and then rest your palm against the door frame. It is necessary to try to press the palm as hard as possible and remain in this position for up to 5 seconds. It will take 2 sets of 15 repetitions.
• External resistance. You will also have to stand at the door and bend your arm at the elbow, but rest against the back of the hand. The rest of the exercise is done in the same way as the previous one.
• Isometric Flexion. It is necessary to stand facing the wall, bend your arm and press it to the body. The fist of the diseased limb should be pressed against the wall. In this position, you need to stay up to 5 seconds, and then rest and again press against the wall.
• Isometric extension. You will have to turn your back to the wall, bend your elbows and rest against them. With the problematic limb, you need to press on the wall, hold this state for 5 seconds, then rest.
• Cushion compression. You need to take a pillow, place it between your forearms and chest. You need to squeeze the pillow with your hands and hold for 5 seconds. You will have to do 2 sets of 15 repetitions.
• Vertical wiring. You need to go to the middle of the room, stand up straight and keep your feet shoulder-width apart. Hands should be taken to the sides and try to raise as high as possible, then fix for 5 minutes and return to the starting position. The action should be repeated 10 times.

The exercise should be done carefully and be careful not to cause sharp pain. If after exercise therapy it becomes worse, you should immediately consult a doctor.

Shoulder fracture exercises

Exercises should be performed during the immobilization phase of therapy, in the first 3 weeks after the fracture. The patient will need to exercise for 30 minutes approximately 6 times a day. In this case, the hand must be bandaged before and after classes. Exercise can reduce swelling, increase blood circulation in the upper limb, and reduce the likelihood of blood clots.

You can perform pendulum movements with your hands, this will get rid of pain. To do this, remove the bandage, then in a sitting or standing position, make a few swings. The hand must be raised forward.

It is also necessary to cross the arms in front of the chest, this also allows the development of the upper limb. You can clap first in front of your face, and then behind your back. It is important that this does not lead to acute pain. It is also helpful to turn the torso with the arms clasped in front of the chest.

Such exercises must be performed every day and several times in order to have a result. Report the occurrence of discomfort to the doctor so that there are no complications. It is likely that he will change the training scheme, focusing on the individual characteristics of the patient.

Exercises after a fracture of the shoulder joint

The functional stage of rehabilitation lasts from 3 to 6 weeks. As early as 4 weeks after receiving a shoulder injury, a person is advised to regularly engage in physiotherapy exercises. You can practice with or without modern equipment. In the second case, the effectiveness of exercise therapy will be lower, but the result can still be achieved. That is why doctors often advise using exercise equipment. If this is not possible, then you will have to select exercises that can be performed without a special apparatus. During their implementation, you need to carefully monitor the change in well-being.

Every day you will have to do the following exercises 6 times:

• Raise your straight arm in front of you, then lower it. This action should be repeated at least 15 times.
• Swing the arms forward, then back and to the sides. In this case, the person should stand, leaning slightly forward.