Shoulder Fracture
Expert care for shoulder and upper arm bone fractures
What is a Shoulder Fracture?
A shoulder fracture refers to a break in one or more of the bones that make up the shoulder: the clavicle (collarbone), scapula (shoulder blade), or proximal humerus (upper arm bone near the shoulder). These injuries can range from simple cracks to complex fractures involving multiple bone fragments.
Proximal humerus fractures are the most common type of shoulder fracture, particularly in older adults with osteoporosis. The severity and treatment depend on the number of bone fragments, their displacement, and involvement of the joint surface.
Common Causes
• Motor vehicle accidents
• Falls from height
• Sports injuries (rugby, cycling)
• Direct blow to shoulder
• Falls from standing height (common in elderly)
• Minor trauma in osteoporotic bone
• Twist or sudden movement
Symptoms
• Severe pain at the time of injury
• Swelling and bruising around the shoulder
• Inability to move the arm
• Visible deformity or abnormal shoulder shape
• Grinding or crunching sensation with movement
• Numbness or tingling (if nerves affected)
Diagnosis
Clinical Examination: Assessment of pain, deformity, neurovascular status (nerve and blood vessel function).
X-rays: Multiple views to identify fracture location, displacement, and number of fragments.
CT Scan: Detailed 3D images for complex fractures, surgical planning, and assessment of joint involvement.
Treatment Options
Appropriate for: Non-displaced or minimally displaced fractures, elderly patients with low activity demands, patients unfit for surgery.
• Sling immobilization for 3-6 weeks
• Pain management with medications
• Early gentle exercises to prevent stiffness
• Progressive physiotherapy as healing occurs
Indications: Displaced fractures, multiple fragments, joint surface involvement, open fractures, neurovascular injury.
Surgical Options:
• ORIF (Open Reduction Internal Fixation): Plates and screws to stabilize bone
• Intramedullary Nailing: Rod inserted into bone for support
• Shoulder Replacement: For severe fractures in elderly patients
Recovery Expectations
Bone Healing: 6-8 weeks for initial healing, 3-4 months for complete bone union.
Rehabilitation: Begins early with gentle pendulum exercises. Progressive strengthening starts at 6-8 weeks. Full recovery takes 3-6 months.
Outcomes: Most patients regain good shoulder function. Older patients may have some residual stiffness. Younger patients typically return to full activities.
