Occupational Therapy Management for Scapula Fracture

Background

  • Typically occur from high impact sources, with potential for other medical complications.
  • Often managed with closed treatment.
  • Approximately 10% require surgical intervention.
  • Injury normally takes 6-12 weeks to heal.

Considerations & Concerns

  • Avoid heavy lifting up to 6 weeks.
  • Smoking may prolong healing time.

Treatment

  • Pain, Swelling management (Rx, elevation/support, ice)
  • Immobilization of soft tissues with sling (worn up to 3 weeks)
  • Educate patient to mobilize neighboring joints immediately (elbow, forearm, hand)
  • Prevent shoulder stiffness with exercises (10x each set, repeat 4-5x/day) for:
    • Shoulder retraction
    • Pendulum (forwards/backward, side to side, and circles)
  • After 3 weeks of healing: progress to light ADL activities
    • Active assisted shoulder flexion
    • Active assisted shoulder external rotation
  • After 6 weeks of healing:
    • Active shoulder flexion
    • Active shoulder abduction
    • Active shoulder external rotation

OT Intervention

  • Donning/doffing sling: educate patient and family
  • Sleep: supine or semi-fowler’s with pillow support
  • Dressing: hemi-technique
  • Bathing: hemi-technique
  • Bed mobility: using other extremities to get out of bed
  • Toileting: limiting the use of involved side when reaching for posterior with hygiene
  • Sex: positioning, masturbation

Sources

https://www.fracturecare.co.uk/care-plans/shoulder/scapula-fracture/scapula-fracture/~/

https://www.hopkinsmedicine.org/health/conditions-and-diseases/scapula-fracture-shoulder-blade-fracture

Jeff is a licensed occupational therapist and lead content creator for OT Dude. He covers all things occupational therapy as well as other topics including healthcare, wellness, mental health, technology, science, sociology, and philosophy. Buy me a Coffee on Venmo.