Post-Traumatic Subcutaneous Emphysema of the Upper Extremity Associated with an Open Scapular Fracture: A Case Report...

Subcutaneous emphysema (SE) of the upper extremity is a rare condition, typically associated with penetrating trauma, infections, or chest injuries. Its occurrence following blunt trauma with an isolated scapular fracture is exceedingly uncommon and may mimic more serious conditions such as necrotizing fasciitis. We present a rare case of upper-limb SE associated with an open scapular fracture and propose a diagnostic approach to distinguish benign SE from limb-threatening infections.

A 65-year-old male presented with pain and swelling in the right upper limb following a fall from a two-wheeler. Clinical examination revealed a laceration over the posterior axillary fold and extensive crepitus extending to the elbow. Radiographs and computed tomography imaging confirmed SE without intrathoracic involvement and revealed an extra-articular scapular body fracture. The patient underwent wound debridement and was treated with antibiotics. The scapular fracture was managed conservatively. The patient had an uneventful recovery, and follow-up showed complete resolution of symptoms.

Post-traumatic SE of the upper limb can present similarly to necrotizing soft tissue infections but is often benign. Careful clinical assessment, appropriate imaging, and close monitoring are essential. Awareness of this rare presentation in the context of scapular fractures helps prevent overtreatment and unnecessary surgical intervention.