Scapular malunion in a Vietnam War veteran: Superior medial angle of the scapula impinging on the clavicle

Case: Scapular malunion can be overlooked as a source of substantial upper-extremity pain and dysfunction and can generate unnecessary studies or treatments. We present the case of a Vietnam War veteran who sustained a projectile injury in the left shoulder and had persistent symptoms limiting his activity and quality of life for a number of years until surgical resection was performed. Conclusion: Scapular malunion should be considered in the differential diagnosis of a patient presenting with persistent upper-extremity pain and weakness following scapular fracture. Making the correct diagnosis based on the history, examination, and imaging will prevent unnecessary studies and invasive procedures.