When they occur in the glenoid fossa, fractures are usually small chips out of the bone or extensions of fractures occurring in the scapular neck.The scapula is protected from the front by the ribcage and chest, and from the back it is protected by a thick layer of muscles. Also, the scapula is able to move, so traumatic forces exerted on it are dissipated, not absorbed by the bone. Thus a large amount of force is required to fracture it. Diagnosis
Most fractures of the scapula can be seen on a chest X-ray; however, they may be missed during examination of the film. Serious associated injuries may distract from the scapular injury, and diagnosis is often delayed. Computed tomography may also be used. Scapular fractures can be detected in the standard chest and shoulder radiographs that are given to patients who have had significant physical trauma, but much of the scapula is hidden by the ribs on standard chest X-rays. Therefore, if scapular injury is suspected, more specific images of the scapular area can be taken. Classification
Body fractures
Described based upon anatomic location

Neck fractures
Coracoid process fractures
Acromion fractures
Glenoid fossa fractures
Described by the Ideberg classification

Treatment
Treatment involves pain medication and immobilization at first; later, physical therapy is used. Ice over the affected area may increase comfort. Movement exercises are begun within at least a week of the injury; with these, fractures with little or no displacement heal without problems. Over 90% of scapular fractures are not significantly displaced; therefore, most of these fractures are best managed without surgery.
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