The scapula is a complex flat bone providing the glenohumeral socket, multiple muscle attachments, and the mechanical platform for the rotator cuff. Its 17 muscle attachments and three projections (acromion, coracoid, glenoid) make it the most complex bone of the upper limb girdle. The scapular body is predominantly covered by the subscapularis anteriorly and the serratus anterior medially, with the posterior surface bearing the supraspinous and infraspinous fossae.
Scapular fractures from high-energy trauma are associated with brachial plexus injuries, pneumothorax, and aortic injury in 60-80% of cases — the so-called 'floating shoulder' (ipsilateral clavicle + scapular neck fracture) risks glenohumeral instability. Glenoid fractures involving more than 25% of the articular surface require ORIF to prevent glenohumeral subluxation.
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