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