ConditionInjuries & poisoning
Scapula Fracture (Broken Shoulder Blade)
A scapula fracture is a break in the shoulder blade, the flat triangular bone at the upper back that connects the arm to the collarbone. Because it is well protected by muscle, it usually breaks only with major force, such as a car or motorcycle crash or a fall from height. Most people with a scapula fracture have other injuries, often to the ribs, lungs or head, so emergency assessment is essential. Most scapula fractures heal well with a sling and early movement; some need surgery.
Also called: Shoulder blade fracture, broken shoulder blade, fractured scapula, glenoid fracture, acromion fracture
At a glance
- What it is
- A break in the body, neck, socket (glenoid), acromion or coracoid of the shoulder blade.
- Causes
- High-energy trauma: vehicle crashes, falls from height, direct heavy blows.
- Associated injuries
- Rib fractures, collapsed lung, collarbone fracture, head and spine injuries, nerve or blood vessel injury.
- Symptoms
- Severe upper back or shoulder pain, swelling, bruising, pain moving the arm.
- Treatment
- Sling and early physical therapy for most; surgery for displaced socket or neck fractures.
- Healing
- Bone heals in about 6 weeks; full recovery over 3 to 6 months.
When to get help
Call 911 or go to the ER
- Shoulder blade pain after a crash or fall with shortness of breath, chest pain or coughing blood: call 911
- Numbness, coldness or weakness in the arm or hand after the injury
- Head injury, neck pain, or loss of consciousness with the injury
See a doctor within a day or two
- Severe pain and swelling over the shoulder blade or back of the shoulder after a fall or blow
- Inability to raise or move the arm after an injury
Book a routine appointment
- Persistent stiffness or weakness weeks after a shoulder blade injury
- Clicking or grinding in the shoulder blade after healing
First steps after the injury
- Call 911 if the injury came from a crash or fall from height, or if there is any breathing difficulty.
- Keep the arm still against the body; a sling or folded scarf helps.
- Apply ice wrapped in a cloth for 20 minutes to reduce swelling.
- Avoid eating or drinking until assessed, in case surgery is needed for other injuries.
Parts of the scapula and types of fracture
| Part | Notes |
|---|---|
| Body | The flat main portion; the most common site; usually heals without surgery |
| Neck | The narrow area next to the socket; surgery if severely angled |
| Glenoid (socket) | Part of the shoulder joint; fractures may cause instability or arthritis and often need surgery if displaced |
| Acromion | The bony tip at the top of the shoulder |
| Coracoid process | A hook-like projection at the front |
A "floating shoulder" occurs when the scapula neck and collarbone are both broken, which often needs surgery.
Symptoms
- severe pain at the back of the shoulder or upper back
- swelling and bruising over the shoulder blade
- pain when moving the arm, especially lifting it
- holding the arm close to the body
- pain when breathing deeply if ribs are also injured
Associated injuries
Most people with scapula fractures have other injuries:
- rib fractures
- pneumothorax (collapsed lung) and lung bruising
- clavicle fracture
- head, spine and abdominal injuries
- brachial plexus injury or blood vessel damage
These often matter more for immediate safety than the scapula itself.
Diagnosis
A trauma team assesses breathing, circulation and other injuries first. Imaging includes:
- X-rays of the shoulder and chest
- CT scan, which shows the fracture pattern in detail and checks the chest and other areas
Treatment
Non-surgical treatment
Most scapula body fractures are treated with:
- a sling for comfort for 1 to 3 weeks
- pain relief, including acetaminophen (paracetamol) and short courses of stronger medicine; NSAIDs if appropriate
- ice
- early gentle movement within the first 1 to 2 weeks to prevent stiffness, progressing under a physical therapist
Surgery
Surgery with plates and screws may be needed for:
- displaced glenoid (socket) fractures, to restore the joint surface
- severely displaced or angled neck fractures
- floating shoulder injuries
- some acromion and coracoid fractures
Recovery
- Bone healing takes about 6 weeks.
- Physical therapy restores range of motion first, then strength.
- Most people regain good function within 3 to 6 months.
- Heavy lifting and contact sports usually wait at least 3 months.
Complications
- shoulder stiffness and weakness
- persistent pain
- arthritis after glenoid fractures
- malunion causing scapular "winging" or grinding
- nerve injury
Frequently asked questions
How do you know if your shoulder blade is broken?
Signs include severe pain over the shoulder blade or back of the shoulder, swelling, bruising, and pain moving the arm after a significant injury. An X-ray or CT scan confirms it. Breathing difficulty suggests rib or lung injury too.
How long does a broken shoulder blade take to heal?
The bone usually heals in about 6 weeks. With physical therapy, most people regain good shoulder function within 3 to 6 months, though full strength may take longer.
Does a broken scapula need surgery?
Usually not. Most scapula fractures, especially of the body, heal well with a sling and early movement. Surgery is needed for displaced fractures of the shoulder socket or neck, or when the collarbone is also broken.
Why is a scapula fracture considered serious?
The shoulder blade usually breaks only with major force, so many people also have rib fractures, lung injuries or head and spine injuries. These associated injuries need urgent assessment.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Orthopaedic Surgeons (OrthoInfo): Shoulder blade (scapula) fractures
- Orthopaedic Trauma Association: Scapula fractures
- MedlinePlus: Shoulder injuries and disorders
- American College of Surgeons: Advanced Trauma Life Support principles
- StatPearls (NCBI Bookshelf): Scapula fracture