The scapula is the bone more commonly known as the shoulder blade. When a break or crack known as a fracture develops in the scapula, usually as a result of a direct impact, a scapular fracture has occurred. This injury can be quite painful depending on the severity of the fracture, though some instances of a scapular fracture may only produce minor to moderate discomfort that can be treated non-surgically. The scapula is a very protected bone, so it is difficult to fracture; if a person experiences such a fracture, it is likely that his or her body has undergone a severe strain that may have resulted in other, more serious injuries.
Car accidents are one of the most common causes of a scapular fracture, though other causes are possible. The force required to fracture the scapula must be quite significant, since the bone is well-protected. A person suffering from a scapular fracture will very often have other more serious injuries that require attention, which sometimes means the fracture can go undiagnosed. The patient is likely to experience pain and tenderness in the affected area, and he or she will notice reduced mobility in the shoulder and arm. He or she may also hear a grinding sound when moving the arm or shoulder, which comes from the raw bone ends rubbing against each other. Swelling can occur, as can bruising, especially if the scapular fracture is the result of a direct trauma.
Once the diagnosis has been made, the arm and shoulder must be immobilized to allow the bone to heal on its own. Physical therapy will very likely be necessary once healing is underway. Some small fractures will heal quickly, while more severe fractures will require a prolonged recovery time. The most serious fractures may require a surgery that will allow a doctor to repair the bone with pins or other orthoses, though this is not especially common for a scapular fracture.
A chest x-ray is often performed on patients experiencing pain in the chest or back as the result of a significant impact, though even with the x-rays, it is easy to miss a scapular fracture. This is not as significant of an issue as it would be in other parts of the body, since most fractures in the scapula are minor and can heal on their own. Pain management such as painkillers and immobilization will help the healing process, and light mobility exercises should be done within a week or two of the injury.