Scapula Fractures

This chapter presents a case scenario of a 28-year-old snowboarder crashed into a tree and was dazed at the scene, had labored respirations, and carried off via stretcher and airlifted to a level I trauma center. A fracture of the scapula in the region of the glenoid neck in addition to a displaced acromioclavicular (AC) joint was diagnosed. A physical exam should include whether abrasions exist over the shoulder, palpation of the AC and sternoclavicular joints, and a neurovascular exam of the extremity. Fractures of the scapula neck and body should be addressed through a posterior approach. The only caveat for physical therapy and rehabilitation in nonoperated scapula fractures is that the patient requires a period of immobilization due to the instability of the fragments. Physical therapy protocols are generally similar for operative and nonoperative management. The chapter also provides recommendations for implementing evidence-based practice in the clinical setting.