Fractured scapula - recovery and sling

[goanna]

Hi All
Wondering if anyone has experience in this? I came off the bike on a slippery section of path 8 days ago and have fractured my scapula.
At the orthopedic fracture clinic one week after the fall, I was advised that I shouldn't wear a sling - unless I was in pain.
Everything I have read about scapula fractures indicates that you should wear a sling pretty much full-time - including while sleeping - for roughly 4-6 weeks, to allow the bone to heal.
Has anyone come across advice suggesting that a sling shouldnt be worn?
Thanks
G

[open roader]

I've done this before aged 26 and I think the answer is :- it depends.

I had a vertical fracture to my scapula (roughly north/south) right across the entire plate as the blade is positioned standing with arms at my side.

I had a couple of orthopedic opinions on mine as I'd also fractured the clavicle and some vertebra as well.

I opted for the non surgical natural recovery for fear of infection. I wore the sling that was recommended for the first 6 weeks, then it was another 6 weeks of sling free rest. However, you have to remember the collar bone on the same side was also broken clean though as well.

In hindsight I wish I opted for surgery and had the clavicle plated and vertebrae fused which would have resulted in wearing the sling for only a week post op. I had a really bad heal on the clavicle (29mm out of alignment) and the scapula is also misaligned by 4mm which was very problematic with muscular soreness in the first 5 years but after 25 years it's only the clavicle that gives me musscle issues.

It's possible that if you have a horizontal fracture that is not across the entire blade as mine was that slingless rest is the best recovery option.

[warthog1]

I did my scapula a few years back. No sling.
Unfortunately did my clavicle (plated), some ribs, pubic rami and chipped a vertebra at the same time.
A bit of bed rest required. Can honestly say I didn't feel the scapula due to the other sh it.
Yours may be worse though.

Edit; better reply above. No idea which way mine was broken as the other stuff took the focus.

[Mr Purple]

Interesting that they didn't recommend a sling - most of the guidelines for a scapula do say 2-6 weeks with a sling.

Honestly the way the scapula works I wouldn't be surprised if the sling is a bit useless anyway. A sling immobilises the shoulder, and a scapula only really gets involved in shoulder movement above shoulder height - so it probably won't do much most of the time.

Having a fractured scapula would probably be a more effective way of telling you not to move your scapula than a sling.

[robbo mcs]

There is a huge variation in scapular fractures. If it is just a linear fracture through the peripheral aspect of the blade or neck, then it is a relatively minor fracture. Same location but comminuted it is more serious. If it goes through the spine or involves the supraspinous region it is more complicated again. If it goes through the glenoid, then effectively it is a shoulder joint fracture and most likely needs surgery. Then there are the acromion and coracoid process, which are part of the scapula as well.

Also, will depend on the patient. A muscular young person is a different ball game to a little old lady with no muscle mass. You have muscles both deep and superficial to the bone, so if you have decent muscle mass, they are partially stabilising it already. Also going to depend on other injuries, as it is very often associated with rib or clavicle injuries, or lung injuries.

So bottom line, it is almost impossible to comment on management, without knowing details. However, what you were told makes sense to me.

Also, I can't ever recall seeing a case of non-union of a scapular blade fracture, so they must heal pretty easily

[goanna]

Thanks all,
I'm not sure what type of scapula fracture I have, pain is less than it was 10 days ago so assume it is on the mend. I'll follow doctor's orders!