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Title: What's the Diagnosis? Written by Dr. Katherine Baugher

Category: Visual Diagnosis

Posted: 6/13/2011 by Haney Mallemat, MD (Updated: 6/13/2011)

Question

13 y.o. with shoulder trauma (during basketball game). Arm held in adduction and exquisite scapular tenderness. Diagnosis?

Answer

Answer: Scapular Fracture

 

Scapular Fracture

  • Uncommon (1% of all fractures)

  • Extensive force required; high probability of associated injuries (pneumothorax, shoulder dislocation).

  • 5 types: body/spine, acromion, neck, glenoid, and coracoid

  • Arm held in adduction and pain with shoulder movement; may mimic rotator cuff tear.

  • Obtain X-rays (AP shoulder and lateral scapula) or CT (if displaced).

  • Conservative management for non-displaced fractures; Orthopedic reduction for displaced fractures.

  • Complications include post-traumatic arthritis or bursitis.

  • NSAIDs are first-line analgesics.

References

Rosen P, Barkin R. Emergency Medicine: Concepts and Clinical Practice. Mosby Year Book; 2010:573-574.

Zlowodzki M, Bhandari M, Zelle BA, Kregor PJ, Cole PA. Treatment of scapula fractures: systematic review of 520 fractures in 22 case series. J Orthop Trauma. Mar 2006;20(3):230-3.