The humerus is connected to the collarbone with the help of a shoulder blade. The shape of the bone resembles a shovel. This gave the name of the part of the skeleton. The shoulder blade is a flat bone. It consists of several parts. Depending on which element has broken when the scapula is damaged, the 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 to other bones. But this does not mean that this component of the skeleton should be treated with disdain.
A broken scapula entails long-term treatment and difficult rehabilitation. The most common cause of this injury is a fall on the back. It is also easy to get a fracture of this type with a direct blow to the scapular region.
Sometimes there were cases when this bone broke when the muscles of the shoulder joint were stretched. The tension is transmitted in this case to the neck of the scapula, and it breaks under the weight of the bones of the hand. Often such a problem is faced by athletes who are engaged in throwing the ball. Bringing the arm far back can cause such an injury.
Symptoms of the disease
A broken scapula is always painful and swollen. Atpalpation of a part of the body at the location of the bone increases discomfort. With fractures of the neck, 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.
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 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 vary or be minimal.
Fracture of the process of the scapula
With this type of injury, deformation of the shoulder girdle is observed. Then there is hemorrhage. A fracture of the suprabrachial process can be determined by a doctor with the help of palpation. It easily determines fragments through the skin. This injury occurs more often from a strong blow from top to bottom directly on the shoulder. A fracture can carry with it other complications.
It's also not very common for a coracoid fracture to occur. In this case, there is a clear asymmetry of the shoulder girdle. On palpation, the pain intensifies. The characteristic place swells. When tensing the arm or trying to perform an action with it, the pain intensifies several times.
The coracoid process can be displaced when fractured. This occurs when the ligaments of the shoulder and collarbone are torn. Along with a fracture of this process, dislocation of the shoulder is often observed. This is a combined injury, and treatment occurs in the first 7-14days in hospital.
Fracture of the neck of the scapula
This type brings with it complications and long-term rehabilitation. Such a fracture can be with or without displacement. The patient often holds the injured hand he althy and presses it to the chest. An oval-shaped swelling protrudes in the region of the scapula. With a neck fracture without displacement, the patient does not feel pain in the forearm area. He responds to armpit palpation.
When a displaced scapular fracture occurs, slightly different symptoms appear:
- arm brought forward, not pulled back;
- shoulder joint becomes spherical;
- during palpation, the patient complains of pain at the site of impact;
- passive hand movements are not difficult.
A complicated fracture of this type may require surgery. It is used extremely rarely, but has a 100% need for indications.
Any kind of injury requires investigation in the hospital and immediate treatment. The patient feels acute pain when the scapula fracture occurs. The symptoms then gradually subside, and the person walks on with the injury until he encounters the complications of the disease. Therefore, if you suspect a fracture, you should immediately consult a doctor.
First Aid
If there is a person nearby with symptoms indicating a fracture of the scapula, then he needs to be assisted before the ambulance arrives or before transporting the patient to the hospital on his own:
- give any painkiller in tablets("Analgin", "Spazmalgon", "Ibuprofen", with intolerable sensations, it is allowed to use "Ketanov");
- put a small pillow of cotton wool or a roll of several twisted bandages in the armpit;
- apply any cold to the injury site (products from the freezer should be applied through a diaper or sheet so as not to frostbite the skin);
- use a piece of cloth to apply a fixing bandage on the arm pressed to the chest, so that further injury to blood vessels and nerves by bone fragments can be avoided;
- The patient should only be transported to the hospital in a sitting position.
These rules will help to avoid additional complications and severe pain to the injured person.
Diagnosis of disease
Fracture of the scapula is very rare, but any traumatologist or surgeon can determine it. The patient is palpated at the site of impact, and according to the reaction and description of the sensations of the victim, a picture is already formed according to the diagnosis by 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
For any type of fracture, it is initially necessary to anesthetize the site of injury. At home, you need to drink a painkiller tablet. The hospital can inject Novocain into the fracture site.
Thena tight bandage with a roller under the arm is applied. Thus, the patient walks for 3-4 weeks. Recovery of working capacity occurs in no less than 5-6 weeks.
In severe cases with combined injuries, surgical intervention is performed. This method is not used as often when a scapular fracture is diagnosed. Treatment and rehabilitation after it are more difficult and longer.
Types of immobilization
Fixing the arm in a specific position helps the scapula heal properly. What kind of immobilization is needed for a fracture of the scapula? Cast fixation is now rarely used.
The 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 fast. With such a bandage, it is more convenient to dress and move around.
Thus, wearing discomfort is minimal for the patient. In combination with wearing a Dezo bandage, therapeutic exercises for the hand are prescribed. More often it is carried out for the bones of the hand and elbow.
When the neck is fractured, a slightly different method of immobilization is performed. The hand is fixed with the help of the outlet splint. When the neck is displaced, skeletal stretching occurs first. This procedure takes 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, andrehabilitation is delayed for 5-6 weeks.
Complications after injury
A broken scapula is not as harmless as it seems. During treatment, 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, the cartilage in the shoulder joint suffers. Over time, the patient in this place may develop arthrosis. A fracture with a displacement threatens to deform the scapula. Then this bone cannot move freely along the ribs. This is accompanied by pain and an unpleasant crunch.
Surgery may cause:
- chronic dislocations;
- muscle atrophy;
- intercostal neuralgia;
- stiffness in hand movement.
But if the operation is not carried out in time, then a person can completely lose his ability to work and remain disabled. It is very important to react in time to a fracture of the scapula. The consequences of a negative nature will then be minimized.
Main period - rehabilitation
From the first days of immobilization, you need to do therapeutic exercises. In this case, a fracture of the scapula will not cause negative consequences. Rehabilitation should be carried out by a specialist. You do not need to do any exercises on your own, 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 loadsperformed at a slow pace.
In this period, it is worth limiting yourself to flexion and extension of the fingers. You can also make circular motions with the brush. Exercises should be at least 15 minutes long. Do 4-5 reps per day.
10 days after the injury, you can begin to exercise for the muscles of the shoulder. To do this, slowly raise the hand until a slight pain appears. Sometimes, after 2 weeks of wearing the Dezo bandage, it is changed to a kerchief type of fixation. In this case, the circle of exercises can be somewhat expanded.
While wearing the Deso bandage, the doctor may prescribe the passage of physiotherapy. In this case, UHF and magnetotherapy are used. Procedures help to remove the inflammatory process and remove pain. Also, bone healing is much faster.
Recovery after removal of immobilization
In this period, rehabilitation and medium-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 in a few weeks.
Exercise intensity is constantly increasing and the use of sports equipment is encouraged:
- balls;
- wooden and plastic sticks;
- sports elastic bands;
- expanders;
- small rubber balls for hand and finger exercises.
All rehabilitation is aimed at restoring the work of weakened muscles and joints. Water activities are encouraged. Thus, the patient experiences less stress, and rehabilitationcan be extended up to 40 minutes.
First, it is better to exercise in the bath, in warm water. In this case, the muscles are steamed and more easily stretched and contracted. After a few sessions, you can start swimming in the pool or pond in the summer.
No need to first give a strong load on the body. The main goal is the gradual restoration of the work of all muscle groups and joints.
