3.  A 26yo male comes walks into your ED after a 4-
wheeler accident. On exam, he holds his arm close
to his body and refuse to let you abduct his arm. He
says his right upper chest, upper back, and shoulder
all hurt. Exam is otherwise normal.

5.  Identification of a fracture lucency can be difficult
 Fracture of the body most common, but don’t forget to
carefully examen the acromion and glenoid
 Consider adding scapular Y view if clinical concern
 Necessary for two-plane evaluation of scapula

6.  Body of scapula
 Immobilization with a sling
 Physical therapy as early as one week after injury
 Neck or glenoid involvement of scapular fracture
 Surgical reduction
 Prognosis
 Isolated scapular body fracture have excellent prognosis
 Fractures of scapular neck and scapular glenoid more
likely to have complications such as impaired strength and
ROM, as well as early arthritis

7.  Because of the unique anatomy of scapular there are a
variety of mechanisms of injury causing fractures but
are generally the result of large, blunt forces
 Associated injuries seen in 80-90% of pts, warranting a
close exam and likely trauma imaging, including CT of
Chest/Abdomen/Pelvis
 Essential to rule out articular involvement with a high-
quality AP shoulder film with no overlap of the
humerus over the glenoid

11.  Marx J MD; Hockberger R MD; Walls R MD. Rosen’s
emergency medicine. 7th ed.
 Simon R; Sherman S; Koenigsknecht S. Emergency
orthopedics: the extremities. 5th ed. McGraw Hill
Publishing.
 Wheeless C R III MD. Wheeless textbook of
orthopedics. www.wheelessonline.com.