Trauma X-ray - Upper limb

Scapula

Scapula fractures are relatively uncommon. Careful attention should be paid to the standard shoulder views as scapula injuries are often found when not suspected clinically.

Subtle fractures are easily missed if care is not taken.

Key points

  • Check the scapula carefully in the context of trauma
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Scapula - Normal

  • Anatomical parts of the scapula include - body, neck, glenoid, coracoid, spine and acromion
  • The scapula body has lateral, medial and superior borders
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Scapula fracture

  • Displaced fracture of the scapula lateral border
  • Fracture line passing through the scapula body

'Bony Bankart' fracture

There is often injury to the glenoid cartilage as a result of shoulder dislocation. This is known as a 'Bankart' lesion and is not visible on X-rays. Occasionally there is visible injury to the bony glenoid - often called a 'bony Bankart' lesion.

This fracture is most often seen on an X-ray taken following reduction of a glenohumeral joint dislocation.

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Glenoid fracture - (Bony Bankart)

  • A bone fragment is seen lying adjacent to the incomplete rim of the glenoid

Clinical information

  • The X-ray had been acquired following reduction of an anterior shoulder dislocation

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