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"Marshall" - Labrador with Fractured Scapula


Photo: Marshall nose to camera
Marshall

"Marshall", a young adult Labrador, was involved in a road traffic accident. The initial examination was optimistic that he had only received superficial bruising and some minor contusions. He was however very clearly lame on his left forelimb.

My colleague Ingrid identified a large amount of swelling around his elbow and scheduled this area of the leg for radiography. The x-rays didn't demonstrate any fracture or dislocation.

Anti-inflammatory drugs were prescribed and his exercise was restricted. A week later when Marshall was persistently lame I was asked for my opinion.

There was indeed a very large amount of swelling around his upper limb involving both his shoulder and elbow and it was difficult to locate the exact area of pain. The obvious step to take was to repeat the x-rays but include the shoulder area with 2 different views.

Fortunately, the anterior/posterior view was able to demonstrate the injury - "Marshall" had fractured his scapula or shoulder blade, a very rare fracture. Usually, the scapular fragments will displace to conform to the body wall and remain relatively stable in this position because of the action of the surrounding musculature. Consequently, the bone fragments will heal without any surgical intervention.

The main concern relates to soft tissue adhesions and scar formation. The shoulder should be returned to normal function within 4 to 6 weeks or serious contracture of the triceps muscle or loss of range of motion may occur. Providing this can be achieved then the prognosis for complete return to normal function is very good.

 

X-ray: View showing fracture line

Marshall's x-ray

The key to success therefore is to maintain movement of the affected area. This is contrary to most healing fractures where stability and immobilisation of the bone fragments are paramount. Fortunately, "Marshall" is a regular at the Bosworth Water Park where his routine swimming has helped his "convalescence" tremendously.

Terry Dunne BVMS, Cert SAO, MRCVS

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