Abstract
Subscapular hematomas are rare entities that pose diagnostic and therapeutic challenges due to their deep anatomical location and nonspecific presentation. Delayed recognition may lead to abscess formation and long-term functional impairment. We report the case of an 18-year-old male who presented with progressive pain, swelling, and restricted range of motion of the right shoulder following blunt trauma. Imaging revealed a large subscapularis hematoma with an associated smaller intramuscular deltoid hematoma. The patient underwent expedited surgical evacuation using a modified dorsal scapular approach with two incisions, allowing safe and effective drainage while preserving surrounding neurovascular structures. A total of 450 ml of hematoma was evacuated. Postoperatively, inflammatory markers declined, pain resolved, and shoulder range of motion improved substantially with physiotherapy. No complications were observed during follow-up. This case highlights the importance of early diagnosis and supports the dorsal scapular approach as a safe and effective option for managing deep periscapular hematomas.