Fracture of scapula - Causes, symptoms and treatment. MF.

Shoulder is a bone that connects the humerus with the clavicle. Fracture occurs as a result of falling on the shoulder blade or with a direct blow to the area of ​​the scapula, sometimes a fracture of the scapula can occur when falling on an elongated arm. Depending on which part of the anatomical part is divided:
• fractures of the body and the angles of the scapula;
• fractures of cervical spine;
• fracture of the articular process of the scapula( the scapula, connecting with the head of the humerus, forms the shoulder joint);
• fractures of the acromial and coracoid processes of the scapula.

Anatomy of shoulder blade and foreleg

Often a fracture of the scapula is combined with other injuries, more often than the clavicle or ribs.

Symptoms of

scapular fracture • Pain and tenderness when probing at a fracture site;
• Swelling in the area of ​​the fracture and the entire scapula. With a fracture of the articular process and the neck of the scapula, a swelling is observed in the region of the shoulder joint, which can be confused with the damage of the latter;

• Crunch of fragments in the fracture region;
• Deformation occurs only when offset. Most often, the displacement occurs when the fracture of the neck of the scapula. In this case, the shoulder joint is omitted compared to the healthy side;
• Restriction of movements in the shoulder and shoulder joint.

First aid for suspected fracture of the

scapular. The patient is seated, the injured limb is fixed to the trunk with a kerchief bandage, additionally fixing it with bandage tours. With severe pain, you can give the patient an anesthetic drug( aspirin, analgin, ketorol, diclofenac, etc.).

First aid for fracture of scapula

Diagnosis of injuries to scapula

Diagnosis is confirmed by X-ray examination. Ingoma, with concomitant damage to the capsule of the shoulder joint or the presence of blood in the joint, ultrasound examination of the shoulder joint is performed.

But, for all its simplicity, fracture of the scapula is often not diagnosed on time. Because the scapula fractures occur in patients with polytrauma, when other organs are damaged, doctors' attention may be riveted to more vital injuries, and the fracture of the scapula is diagnosed later, when the danger to life has already passed. Unfortunately, with especially severe injuries, it takes so much time( several weeks and even months) to treat other life-threatening injuries and their complications that the fracture of the scapula has time to accumulate with the displacement.

scapula fracture treatment The fractures of the body, corners, coracoid and acromial processes of the scapula are treated conservatively, with the help of the Deso gypsum dressing or its modern analogue, for 3-4 weeks.

Dezo's bandage and its modern analogue

Fractures of the cervix and articular process are immobilized by the outgoing tire for 4-6 weeks.

Retracting splint

The fractures of the neck of the scapula with displacement are treated with a skeletal traction by the elbow process( 3-4 weeks), then the plaster bandage is applied for another 3 weeks. In the case of unsuccessful skeletal traction, the operative removal of the displacement and fixation of the fracture by knitting needles, screws and plates is performed. After the operation, the cast is applied for 3-4 weeks. Screws and other metal structures are removed after several months or years after the operation.

Rehabilitation after a fracture of the

Shoulder 2 days after the injury, we actively move the fingers of the brush on the damaged side and hold the gymnastics for a healthy hand.

A week after the injury, we start isometric contractions of the shoulder muscles( without making the appropriate movements).

Physiotherapy treatment aimed at reducing pain and inflammation can be carried out already during the period of gypsum immobilization. During this period, magnetotherapy is prescribed for the injury site and UFO for a healthy shoulder joint.

After removal of gypsum, we proceed to develop movements in the shoulder joint and isolated movements with a scapula. All exercises are performed in conjunction with a healthy hand.

The complex of exercises of IFC with a fracture of the scapula( each repeat 10-15 times, several times a day):

• In the standing position with hands down, raise and lower the forearms( "shrug" the shoulders);
• In the same position, we make circular movements in the shoulders, hands are not torn from the trunk;
• We reduce and dilute the blades;
• Raise and lower arms outstretched;
• Bring out extended arms, then make circular motions;
• Close the brush on the back alternately;
• Exercises with arms outstretched repeat with a gymnastic stick, after a few weeks with dumbbells( no more than 2-3x kg.).

Together with the exercises, a repeated course of physiotherapy is appointed - magnetotherapy, laser, ultrasound, UHF, ozokerite applications. Baths with sea salt and mud treatment are also used. In the presence of muscle atrophy( weakness), it is permissible to perform massage sessions. A very good help in rehabilitation after a fracture of the scapula will perform exercises in the pool or sea water.

Prediction after fracture of the

Should the fracture of the body and the corners of the scapula, the function is restored in 4-6 weeks. Fracture of the cervical spine requires a longer period of recovery - from 2 to 3 months, which is associated with the need for the development of the shoulder joint and the difficulty in treating the displacement of the fracture.

Fracture of the articular process of the scapula in the distant period( after several years) can cause the development of arthrosis of the shoulder joint.

Doctor traumatologist Voronovich VA