Traumatic injuries of the scapula and the scapulothoracic articulation have received little attention in the literature, since they are uncommon. Scapular fractures constitute only 1% of fractures in general, and scapulothoracic dissociations and dislocations are extremely rare. The vast majority can and should be managed nonoperatively. However, recent experience has shown that injuries that involve significant displacement can have long-term adverse functional consequences for both the shoulder complex and the upper extremity as a whole. In these situations, surgery should at least be considered. Various scapular fractures and dislocations are discussed, with particular emphasis on those requiring operative care.