SHOULDER-BLADE (SCAPULA) FRACTURE, CORACOID PROCESS |
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General Information
DEFINITION--A complete or incomplete break in the coracoid process of the scapula (shoulder blade).
BODY PARTS INVOLVED
Scapula.
Shoulder joint.
Soft tissue around the fracture site, including nerves, tendons, ligaments and blood vessels.
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SIGNS & SYMPTOMS
Severe pain at the fracture site.
Swelling of soft tissue around the fracture.
Tenderness to the touch.
CAUSESDirect blow or indirect stress to the bone. Indirect stress may be caused by twisting or violent muscle contraction.
RISK INCREASES WITH
Contact sports such as football, soccer or hockey.
History of bone or joint disease, especially osteoporosis.
Poor nutrition, especially calcium deficiency.
HOW TO PREVENT
Build your strength with a good conditioning program before beginning regular athletic practice or competition. Increased muscle mass helps protect bones and underlying tissue.
Use appropriate protective equipment.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's diagnosis.
Self-care during rehabilitation.
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and physical exam by a doctor.
X-rays of injured areas.
POSSIBLE COMPLICATIONS
AT THE TIME OF INJURY:
Shock.
Pressure on or injury to nearby nerves, ligaments, tendons, muscles, blood vessels or connective tissues. AFTER TREATMENT OR SURGERY:
Delayed union or non-union of the fracture.
Impaired blood supply to the fracture site.
Arrest of normal bone growth in children.
Infection in open fractures (skin broken over fracture site), or at the incision if surgical setting was necessary.
Shortening of the injured bones.
Unstable or arthritic joint following repeated injury.
Prolonged healing time if activity is resumed too soon.
Proneness to repeated injury.
PROBABLE OUTCOMEIt is impossible to predict exactly how long it will take for any fracture to heal. Variable factors include age, sex, and previous state of health and conditioning. The average healing time for this fracture is 6 to 8 weeks. Healing is complete when there is no motion at the fracture site and when X-rays show complete bone union.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AID
Keep the person warm with blankets to decrease the possibility of shock.
Cut away clothing, if possible. Don't move the injured area to do so.
Follow instructions for R.I.C.E., the first letters of REST,
ICE, COMPRESSION and ELEVATION. See Appendix 1 for details.
CONTINUING CARE
If bone fragments are displaced, the doctor will set the broken bones with surgery or, if possible, without. The bones should be set as soon as possible after injury. Six or more hours after the fracture, bleeding and displacement of body fluids may lead to shock. Also, many tissues lose their elasticity and become difficult to return to a normal position.
If bone fragments are not displaced, these fractures require only simple treatment and heal relatively quickly. The strong muscles that attach to and surround the scapula usually prevent the displacement of the fractured parts.
Immobilization with a compression bandage and sling will be necessary for 14 days.
After 48 hours, localized heat promotes healing by increasing blood circulation in the injured area. Use hot baths, showers, compresses, heat lamps, heating pads, and heat ointments or liniments. AFTER IMMOBILIZATION:
Use ice massage. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a baseball. Do this for 15 minutes at a time, 3 or 4 times a day, and before workouts or competition.
MEDICATIONYour doctor may prescribe:
Narcotic or synthetic narcotic pain relievers for severe pain.
Stool softeners to prevent constipation due to inactivity.
Acetaminophen (available without prescription) for mild pain after initial treatment.
ACTIVITY
Actively exercise all muscle groups not immobilized. These muscle contractions promote fracture alignment and hasten healing.
Resume normal activities gradually after treatment.
Begin reconditioning the injured area after clearance from your doctor.
Resume driving only after healing is complete.
DIETDuring recovery, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.
REHABILITATIONBegin shoulder exercises (see Shoulder Exercises in Rehabilitation entry) 10 to 14 days after injury. Use ice massage for 10 minutes prior to exercise.
CALL YOUR DOCTOR IF
You have signs or symptoms of a shoulder-blade fracture.
Any of the following occurs after surgery or treatment:
Pain, swelling or drainage increases in the surgical area.
You develop signs of infection (headache, muscle aches, dizziness, or a general ill feeling and fever).
You experience nausea or vomiting.
You notice swelling above or below the compression bandage.
You have numbness or complete loss of feeling below the fracture site.
Pain continues for more than 6 weeks.
You become constipated.
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