Houston Methodist. Leading Medicine

Shoulder News

Delayed Union of a Scapular Fracture in an Adoloscent

The authors of this case study reported an undiagnosed fracture of the shoulder blade in a 15 year old hockey player with delayed union. He was allowed to return to playing hockey and seven months later was noted to have persistent shoulder pain, limited range of motion, weakness, and winging of the shoulder blade.

While shoulder blade fracture is rare and usually results from high velocity trauma such as a vehicle crash, the authors felt it important to demonstrate that persistent shoulder pain following any upper extremity trauma could be due to fracture of the shoulder blade. Shoulder blade fractures caused by severe trauma usually are associated with broken ribs, collapsed lung, and nerve and blood vessel injuries. Diagnosis may be difficult as plain Xrays may not show a fracture. Magnetic resonance imaging or computed tomography are more accurate in making the diagnosis.

Healing time for shoulder blade fracture is usually six to eight weeks but can depend on age, general health, and proper immobilization. Most can be treated conservatively using ice, heat, and immobilization followed by physical therapy for range of motion and strengthening. Surgery is rarely needed. However, when the diagnosis is not made initially, this can delay healing of the fracture.


C. Curtis, V. Sharma, L. Micheli. Medicine and Science in Sports & Exercise/i> December 2007. Volume 39, Issue 12. pp. 2095-2098.

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