When evaluating a patient with a suspected scapular fracture, what is a primary concern?

• A. Chest pain only.
• B. Breathing problems.
• C. Heart rhythm disturbance.
• D. Arm numbness.

Answer: (B)

Breathing is the main concern because a scapular fracture from high‑energy trauma often signals accompanying thoracic injury. The force that breaks the scapula can also injure the lungs, pleura, or mediastinal structures, leading to pneumothorax, hemothorax, or pulmonary contusion. These problems can quickly compromise ventilation, so assessing and securing breathing takes priority. Look for signs like shortness of breath, rapid or shallow breathing, decreased breath sounds, or chest wall tenderness with respiration. Other issues such as chest pain, heart rhythm disturbances, or arm numbness may occur, but they are not the immediate threats to ventilation in this scenario.