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
