The humerus connects to the clavicle using the scapula. The shape of the bone resembles a shovel. This gave the name of the skeleton. The shoulder blade is a flat bone. It consists of several parts. Depending on which element broke when the scapula is damaged, and therapy will be selected.
Causes of Fractures
This part of the skeleton breaks very rarely. No more than 1.5% of cases of scapular fractures are recorded per year compared with other bones. But this does not mean that this component of the skeleton should be neglected.
Fracture of the scapula entails long-term treatment and difficult rehabilitation. The most common cause of such an injury is a fall on your back. It is also easy to obtain a fracture of this type with a direct impact on the scapular region.
Sometimes there were cases when this bone was broken when the muscles of the shoulder joint were stretched. In this case, the voltage is transmitted to the neck of the scapula, and it breaks under the weight of the bones of the hand. Often this problem is faced by athletes who are engaged in throwing the ball. If you slide your hand deep back, such an injury can occur.
Symptoms of the disease
Fracture of the scapula is always pain and swelling. On palpation of a part of the body at the location of the bone, discomfort intensifies. With neck fractures, sometimes the doctor probes the sharp edges of the bone. With dislocations of the shoulder joint, the edges of the scapula remain semicircular and smooth.
The movement of the affected arm is difficult, and during an attempt to raise it there is a sharp pain. In some cases, bruising occurs at the site of injury. They often appear on the 2-3rd day.
A recognizable symptom is a swelling in the shape of a triangle. On this basis, the doctor will quickly determine the diagnosis. Depending on the type of fracture, symptoms may change or occur in a minimal manifestation.
Fracture of the appendix of the scapula
With this type of injury, deformation of the shoulder girdle is observed. Then hemorrhage appears. A doctor can determine the fracture of the suprahumeral process using palpation. It easily detects fragments through the skin. This injury occurs more often from a strong blow from top to bottom directly on the shoulder. Fracture can carry other complications.
Also, the fracture of the coracoid process is not very common. In this case, there is a clear asymmetry of the shoulders. On palpation, the pain intensifies. A characteristic place swells. When you strain your hand or try to perform an action, the pain increases several times.
The coracoid process may shift during a fracture. This occurs when the ligaments of the shoulder and collarbone are torn. Together with a fracture of this process, a shoulder dislocation is often observed. This is a combined injury, and treatment takes place the first 7-14 days in a hospital.
Scapular fracture
This species carries with it complications and prolonged rehabilitation. Such a fracture can be with displacement and without it. The patient often holds the injured arm healthy and presses it to the chest. In the area of the scapula, an oval swelling appears. With a fracture of the neck without displacement, the patient does not feel pain in the region of the forearm. It responds to palpation by the armpit.
In the case when there is a fracture of the scapula with a shift, several other symptoms appear:
- the arm is brought forward, and not laid back;
- the shoulder joint takes on a spherical shape;
- upon palpation, the patient complains of pain exactly at the site of the impact;
- passive hand movements are not difficult.
With a complicated fracture of this type, surgical intervention may be necessary. It is used extremely rarely, but has a 100% need for indications.
Any type of injury requires research in the hospital and immediate treatment. The patient feels acute pain when a fracture of the scapula occurs. Symptoms then gradually subside, and the person goes on with the injury further until he encounters complications of the disease. Therefore, if you suspect a fracture, you should immediately consult a doctor.
First aid
If a person with symptoms indicating a broken shoulder blade is nearby, then he needs to be assisted before the ambulance arrives or before the patient is transported to the hospital on his own:
- give any pain medication in tablets ("Analgin", "Spazmalgon", "Ibuprofen", with intolerable sensations it is allowed to use "Ketanov");
- put a small pillow of cotton wool or a roller of several twisted bandages into the armpit;
- apply any cold to the injury site (products from the freezer must be applied through a diaper or sheet so as not to freeze the skin);
- with the help of a piece of tissue, apply a fixing bandage to the arm pressed to the chest, so that further damage to the vessels and nerves by bone fragments can be avoided;
- the patient must be taken to the hospital only in a sitting position.
These rules will help to avoid additional complications and severe pain for the affected person.
Diagnosis of the disease
Fracture of the scapula is very rare, but any traumatologist or surgeon can determine it. The patient undergoes palpation of the site of the impact, and according to the reaction and description of the victim's feelings, a picture is already formed according to the diagnosis of the doctor.
To confirm the doctor's assumptions, an X-ray examination is performed in two projections. The results can 100% confirm or refute the preliminary diagnosis.
Treatment methods
With any type of fracture, the site of injury must be anesthetized initially. At home, you need to drink a pill of pain medication. The hospital may inject Novocain into the fracture site.
Then a tight bandage is applied with a roller under the arm. Thus, the patient walks 3-4 weeks. Recovery occurs after no less than 5-6 weeks.
In severe cases with combined damage, surgery is performed. This method is not used often when a scapular fracture is diagnosed. Treatment and rehabilitation after it are more difficult and longer.
Types of Immobilization
Holding the hand in a special position helps the shoulder blade to grow together in the right way. What immobilization is needed for a fractured scapula? Gypsum fixation is now rarely used.
A modern analogue of such immobilization is much more convenient. The skin under it breathes, and diaper rash does not occur, especially in the summer. Also, when applying such a bandage, the patient experiences less discomfort and pain. The procedure is quick. With such a bandage it is more convenient to dress and move.
Thus, the discomfort when wearing is experienced by the patient is minimal. In combination with wearing a Deso bandage, therapeutic exercises for the arm are prescribed. More often it is performed for the bones of the hand and elbow.
With a fracture of the neck, a slightly different method of immobilization is carried out. The hand is fixed with the help of a retracting tire. When the neck is displaced, skeletal distension first occurs. This procedure lasts about 4 weeks. After that, the hand is placed on a specially designed pillow, and gymnastics is performed for another 2 weeks. Such treatment is very exhausting for the patient, and rehabilitation is delayed for 5-6 weeks.
Complications after an injury
Fracture of the scapula is not as harmless as it seems. During treatment, a dislocation of the bones of the forearm may occur. This is due to the inability to hold the head of the forearm bone with fragments of the scapula.
During such injuries, cartilage in the shoulder joint suffers. Over time, the patient in this place may develop arthrosis. Fracture with displacement threatens with deformation of the scapula. Then this bone cannot move freely along the ribs. This is accompanied by pain and an unpleasant crunch.
Surgical intervention may cause:
- chronic dislocations;
- muscle atrophy;
- intercostal neuralgia;
- stiffness in movement of the hand.
But if the operation is not done on time, then a person can completely lose working capacity and remain disabled. It is very important to respond in time to a fractured scapula. Consequences of a negative nature will then be minimized.
The main period is rehabilitation
From the first days of immobilization, you need to do therapeutic exercises. In this case, it will not cause negative consequences of a fracture of the scapula. Rehabilitation should be carried out by a specialist. You do not need to do any exercises yourself, otherwise you can harm the damaged bone.
Under the supervision of an experienced physician, you need to conduct several classes. Then you can continue gymnastics at home. You need to start with a few finger exercises. All procedures and loads are performed at a slow pace.
In this period, it is worthwhile to limit the flexion and extension of the fingers. You can also perform circular brush movements. Exercises should have a duration of at least 15 minutes. On the day you need to do 4-5 repetitions.
10 days after the injury, you can begin to exercise for the muscles of the shoulder. To do this, slowly raise the arm until a slight pain. Sometimes after 2 weeks of wearing the Deso bandage, it is changed to a kerchief type of fixation. In this case, the range of exercises can be somewhat expanded.
While wearing a Deso dressing, a doctor may prescribe a physical procedure. In this case, UHF and magnetotherapy are used. Procedures help relieve the inflammatory process and remove pain. Also, bone fusion is much faster.
Recovery after removal of immobilization
In this period, rehabilitation and moderate-intensity physical activity come to the fore. If rehabilitation is carried out on time and correctly, then the ability to work will be fully restored within a few weeks.
The intensity of exercises is constantly increasing, and the use of sports equipment is encouraged:
- balls;
- wooden and plastic sticks;
- sports elastic bands;
- expanders;
- small rubber balls for exercises of the hand and fingers.
All rehabilitation is aimed at restoring the work of weakened muscles and joints. Water activities are welcome. Thus, the patient experiences less stress, and rehabilitation can be extended up to 40 minutes.
First, it is better to conduct exercises in the bathroom, in warm water. In this case, the muscles are steamed and easier to stretch and contract. After several classes, you can start swimming in the pool or pond in the summer.
No need to give a strong load on the body. The main goal is the gradual restoration of the work of all muscle groups and joints.