Fractures of the collarbone and scapula (scapula)

What is it about ?

A broken collarbone is usually caused by a fall with the arm outstretched or over the shoulder.

A fracture of the scapula (scapula) is usually the result of severe trauma, which can also cause damage to the lungs, ribs or large blood vessels in the chest.

When pieces of fractured bone do not stay in their original position, it is referred to as a displaced fracture or displacement.

What is their frequency?

One of the most common fractures is a collarbone fracture. Scapular fracture or scapular fracture is much less common.

How to recognize them?

A fracture of the collarbone can be suspected when the latter, in addition to being painful, is in an abnormal position.

A scapular fracture is also painful, but there is usually no displacement.

How is the diagnosis made?

An x-ray can be used to make the diagnosis. Some types of shoulder fractures also require a CT scan.

What can your doctor do?

Most collarbone fractures heal well without surgery, even if there has been displacement. The doctor prescribes a supportive arm sling for 2-3 weeks. Bone can heal after 6-9 weeks and under normal conditions. Sometimes a kind of lump appears through the skin, but this has no influence on the use of the collarbone and shoulder.

An operation is necessary in very specific cases: if the fractured fragments threaten to pierce the skin or if a nerve or a blood vessel is stuck.

In some cases, the need to operate will be assessed:

• if the displacement is too great;
• if the fracture is at the outer (lateral) end of the collarbone, near the shoulder and is accompanied by a tear of one or more ligaments;
• if the fracture has not healed after 6 months and the area still hurts.

Physiotherapy can begin smoothly after 3 weeks. Muscle building begins after 6-9 weeks.

Scapular fractures are usually treated without surgery, a supportive sling is needed for 2-3 weeks.

Fractures of the neck of the scapula and those that extend to the joint surface require a CT scan and surgery if the fracture has moved significantly.

In some cases, the collarbone and neck of the scapula are broken. This is called a floating shoulder and it always requires an operation.

Want to know more?

• Shoulder bones (image) – Larousse

• The radiography, here, Where to find on this page of Cliniques St Luc UCL
• Scanner (CT-scan) – Erasme Hospital

Source

Foreign clinical practice guide ‘Fractures of the clavicle and scapula’ (2004), updated on 03.05.2017 and adapted to the Belgian context on 08.01.2020 – ebpracticenet