Medication Summary
Nonsteroidal anti-inflammatory agents and opioid analgesics are typically required for scapular fractures.
Nonsteroidal anti-inflammatory agents (NSAIDs)
Class Summary
These agents are most commonly used for the relief of mild to moderate pain. Effects of NSAIDs in the treatment of pain tend to be patient specific, yet ibuprofen is usually the DOC for initial therapy. Other options include naproxen, flurbiprofen, and ketoprofen.
Ibuprofen (Ibuprin, Advil, Motrin)
Usually DOC for the treatment of mild to moderate pain, if no contraindications exist; inhibits inflammatory reactions and pain, probably by decreasing cyclooxygenase activity, which results in prostaglandin synthesis.
Ketoprofen (Oruvail, Orudis, Actron)
Used for the relief of mild to moderate pain and inflammation. Administer small doses initially to smaller patients and older persons. Doses of >75 mg do not increase therapeutic effects. Administer high doses with caution and closely observe patient.
Naproxen (Anaprox, Naprelan, Naprosyn)
Used for relief of mild to moderate pain; inhibits inflammatory reactions and pain by decreasing cyclooxygenase activity, which decreases prostaglandin synthesis.
Flurbiprofen (Ansaid)
Has analgesic, antipyretic, and anti-inflammatory effects; may inhibit cyclooxygenase, causing inhibition of prostaglandin biosynthesis that may result in analgesic and anti-inflammatory activities.
Analgesics
Class Summary
Pain control is essential to quality patient care. It ensures patient comfort, promotes pulmonary toilet, and aids physical therapy regimens. Many analgesics have sedating properties that benefit patients who have fractures.
Acetaminophen (Tylenol, Panadol, Aspirin-Free Anacin)
DOC for treatment of pain in patients with documented hypersensitivity to aspirin or NSAIDs or in those with upper GI disease or taking oral anticoagulants.
Acetaminophen and codeine (Tylenol #3)
Drug combination indicated for the treatment of mild to moderate pain.
Hydrocodone bitartrate and acetaminophen (Vicodin ES)
Drug combination indicated for the relief of moderate-to-severe pain.
Oxycodone and acetaminophen (Percocet)
Drug combination indicated for the relief of moderate to severe pain; DOC for aspirin-hypersensitive patients.
Oxycodone and aspirin (Percodan)
Drug combination indicated for relief of moderate to severe pain.
Morphine sulfate (Duramorph, Astramorph, MS Contin)
DOC for narcotic analgesia because of its reliable and predictable effects, safety, and ease of reversibility with naloxone. IV doses vary and commonly are titrated until desired effect is obtained.
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Classification of glenoid cavity fractures: IA - Anterior rim fracture; IB - Posterior rim fracture; II - Fracture line through the glenoid fossa exiting at the lateral border of the scapula; III - Fracture line through the glenoid fossa exiting at the superior border of the scapula; IV - Fracture line through the glenoid fossa exiting at the medial border of the scapula; VA - Combination of types II and IV; VB - Combination of types III and IV; VC - Combination of types II, III, and IV; VI - Comminuted fracture
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Classification of glenoid neck fractures. Type I includes all minimally displaced fractures. Type II includes all significantly displaced fractures (translational displacement greater than or equal to 1 cm; angulatory displacement greater than or equal to 40°)
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Superior shoulder suspensory complex. (A) anteroposterior view of the bony/soft tissue ring and the superior and inferior bony struts; and (B) lateral view of the bony/soft tissue ring.
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Fixation of acromion fractures. (A) tension band construct; and (B) plate-screw fixation (most appropriate for proximal fractures).
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Scapular anatomy. Muscle origin and insertion.
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Scapula fracture on Y view.
