Pneumothorax complicating fracture of the scapula

We evaluated thirty patients with a fracture of the scapula in a prospective study over a seven-year period. Sixteen patients were found to have an associated pneumothorax, of which more than two-thirds were associated with a fracture of the left scapula. Ten of the pneumothoraces were delayed for one to three days. All of the scapular fractures were treated using a shoulder immobilizer, and early range-of-motion exercises of the involved extremity were instituted as tolerated. Information obtained from pulmonary auscultation and percussion, determination of initial values for arterial blood gases, and daily chest radiographs for three days after injury confirmed the diagnosis. Closed suction drainage using anteriorly or laterally placed thoracostomy tubes was performed successfully in all patients and avoided the potential sequelae of shock, respiratory failure, and pneumonia, as well as recurrence.