Indications/ContraindicationsIn 1938, Wilson recorded a 1% incidence of scapula fractures in a comprehensive review of 4,390 broken bones. It is estimated that scapula fractures account for 3% to 5% of all fractures about the shoulder girdle. The well-endowed parascapular musculature, the oblique plane mobility of the scapula on the thorax, and the surrounding skeletal structures (which usually yield first) explain the relative rarity of scapula fractures. However, increased recognition of shoulder morbidity after high-energy trauma as well as improving familiarity with surgical approaches to the scapula have clarified the indications for nonoperative versus surgical treatment.Fractures of the scapula follow a bimodal pattern of injuries based on the vector and mechanism of force to the shoulder. Low-energy and sporting accidents often lead to partial articular fractures that usually involve the anterior glenoid process and are commonly associated with anterior shoulder dislocations. These fractures are often referred to as bony Bankart lesions and may be characterized by anterior shoulder instability. If shoulder instability is present either clinically or on radiographic examination, then operative intervention in an appropriate surgical candidate is recommended. These criteria are usually present with fractures involving more than 20% of the articular surface.