S42.153 Displaced fracture of neck of scapula, unspecified shoulder

Name of the Condition

• Displaced fracture of neck of scapula, unspecified shoulder

Summary

A displaced fracture of the neck of the scapula, unspecified shoulder, involves a break in the narrow portion of the shoulder blade bone that connects the body of the scapula to the glenoid fossa (shoulder joint), with the bone fragments shifted out of their normal alignment. This condition affects shoulder stability and function due to the neck's role in supporting the shoulder joint. Displacement occurs when the force of injury is sufficient to move the bone fragments from their anatomical position.

Causes

Traumatic injury is the primary cause of this fracture. Common mechanisms include high-impact events such as motor vehicle accidents, falls from a significant height, or direct blows to the shoulder or back. Sports-related collisions or forceful impacts during physical activities may also result in this type of fracture.

Risk Factors

• Participation in contact sports or activities with a high risk of falls.
• Osteoporosis or other bone-weakening conditions.
• Advanced age, which may increase susceptibility to fractures from minor trauma.
• Previous shoulder or upper arm injuries that affect bone integrity.

Symptoms

• Pain in the shoulder or upper back, especially with movement.
• Swelling, bruising, or tenderness over the shoulder blade.
• Limited range of motion in the shoulder joint.
• Difficulty lifting or rotating the arm.
• In severe cases, visible deformity or instability.

Diagnosis

Diagnosis begins with a physical examination to assess pain, swelling, and range of motion. Imaging studies, such as X-rays or CT scans, are typically used to confirm the fracture and evaluate the degree of displacement. Additional tests may be ordered to rule out associated injuries to surrounding structures.

Treatment Options

Treatment depends on the severity of the fracture and the patient's overall health. Non-displaced fractures may be managed with immobilization, pain relief, and physical therapy. Displaced fractures often require surgical intervention to realign and stabilize the bone fragments, followed by rehabilitation to restore function.

Prognosis and Follow-Up

Most patients recover well with appropriate treatment, though recovery time varies based on fracture severity and treatment approach. Follow-up appointments are necessary to monitor healing and adjust rehabilitation plans. Long-term outcomes generally depend on the extent of the injury and adherence to treatment recommendations.

Complications

Potential complications include nonunion (failure of the bone to heal), malunion (healing in an incorrect position), nerve or blood vessel damage, and chronic pain or stiffness. In some cases, arthritis or reduced shoulder function may develop.

Lifestyle & Prevention

• Use protective gear during contact sports or high-risk activities.
• Maintain bone health through a balanced diet rich in calcium and vitamin D.
• Engage in regular weight-bearing exercise to strengthen bones.
• Take precautions to prevent falls, especially in older adults.

When to Seek Professional Help

Seek immediate medical attention if you experience severe pain, visible deformity, inability to move the arm, or signs of nerve or vascular injury (e.g., numbness, discoloration). Follow up with a healthcare provider if pain persists or worsens after initial treatment.

Tips for Medical Coders

Document the specific shoulder (right, left, or unspecified) and the presence of displacement to ensure accurate coding. Include details about the mechanism of injury, imaging findings, and treatment provided to support the diagnosis. Verify that the fracture is localized to the neck of the scapula and not another part of the bone.