S42.154 Nondisplaced fracture of neck of scapula, right shoulder

Name of the Condition

• Nondisplaced fracture of neck of scapula, right shoulder

Summary

A nondisplaced fracture of the neck of the scapula, right shoulder, refers to a break in the narrow portion of the shoulder blade bone that connects the body of the scapula to the glenoid fossa (shoulder joint), where the bone fragments remain in their normal anatomical alignment. This condition affects the right shoulder and may impact shoulder stability and movement due to the neck's role in supporting the shoulder joint. Nondisplaced fractures typically result from lower-energy trauma compared to displaced fractures.

Causes

Traumatic injury is the primary cause of this fracture. Common mechanisms include falls, motor vehicle accidents, sports-related impacts, or direct blows to the shoulder or back. The right shoulder may be affected due to the direction of impact or body positioning during the injury. Lower-energy trauma, such as a fall onto the shoulder, often results in nondisplaced fractures.

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 determine if it is nondisplaced. The right shoulder is specifically evaluated to identify the location and extent of the injury. Additional tests may be ordered to rule out associated injuries.

Treatment Options

Treatment for a nondisplaced fracture of the neck of the scapula, right shoulder, often includes immobilization with a sling or brace to support the shoulder and allow healing. Pain management with medications may be prescribed. Physical therapy is usually recommended to restore range of motion and strength once the fracture has healed. Surgical intervention is rarely needed for nondisplaced fractures unless there are complications.

Prognosis and Follow-Up

The prognosis for a nondisplaced fracture of the neck of the scapula, right shoulder, is generally favorable, with most patients recovering fully without long-term complications. Follow-up appointments are important to monitor healing and adjust treatment as needed. Physical therapy may be continued to ensure proper recovery of shoulder function. Most patients return to normal activities within several weeks to months, depending on the severity of the injury.

Complications

• Chronic pain or stiffness in the shoulder.
• Limited range of motion or weakness.
• Nonunion or delayed healing of the fracture.
• Associated injuries to surrounding tissues or nerves.

Lifestyle & Prevention

• Use protective gear during contact sports or high-risk activities.
• Maintain bone health through a balanced diet and regular exercise.
• Avoid falls by using assistive devices if needed, especially in older adults.
• Practice proper body mechanics to reduce the risk of injury during physical activities.

When to Seek Professional Help

Seek medical attention if you experience severe pain, swelling, or deformity after an injury to the right shoulder. Immediate care is also recommended if you have difficulty moving the arm or notice signs of nerve damage, such as numbness or tingling. Follow up with a healthcare provider if symptoms worsen or do not improve with initial treatment.

Tips for Medical Coders

When coding for a nondisplaced fracture of the neck of the scapula, right shoulder (S42.154), ensure the documentation specifies the anatomical location (right shoulder) and the fracture type (nondisplaced). Verify that the injury is isolated to the scapular neck and not associated with other fractures or complications. Accurate documentation of the mechanism of injury and clinical findings is essential for proper code assignment.