Shoulder Fractures

What can fracture around the shoulder?

The shoulder is formed of three bones. The shoulder blade (scapula), collarbone (clavicle) & the top of the arm bone (proximal humerus). These three bones articulate together forming two joints, one between the collarbone & shoulder blade called the acromioclavicular joint (AC joint) and one between the shoulder blade & the top of the arm bone called the glenohumeral joint (shoulder joint).

All of these bones can break (fracture) & all the joints can dislocate. Fractures of the collarbone (clavicle) are discussed under AC joint-collar bone . Dislocation of the AC joint is discussed under AC joint-collar bone & dislocation of the shoulder joint is discussed under Instability & Dislocation .

What can fracture around the shoulder blade (scapula)?

The shoulder blade is formed of several parts. These are the body of the scapula, coracoid process, acromion & glenoid. The acromion is the part that articulates with the collarbone to form the AC joint & the glenoid is the part that articulates with the top of the arm bone (proximal humerus) to form the shoulder joint.

In general, fractures around the shoulder blade are treated in a sling for a few weeks to allow the fracture to heal and early physiotherapy to avoid shoulder stiffness. The exception to this is displaced fractures that involve a joint. i.e. displaced fractures of the glenoid and acromion, which may be best, treated with operative fixation.

What can fracture around the top of the arm bone (proximal humerus)?

The proximal humerus is formed of several parts. These are the head, greater tuberosity, lesser tuberosity & neck. The head is the part that articulates with the glenoid to form the shoulder joint. The greater tuberosity & lesser tuberosity are the parts where the rotator cuff tendons attach. The neck is the part that connects the other three parts of the proximal humerus to the rest of the arm bone.

In general, undisplaced fractures are treated in a sling and physiotherapy within one to two weeks. Displaced fractures will require operative fixation that depends on the number of broken fragments and the degree of displacement.

I have a fracture and I am not sure what is the best treatment for me!

This depends on several factors. One is the fracture assessed by x-rays and computerised tomography (CT) scans. Other factors, are the condition of your bones in general and your level of activity.

Taking these factors into account, your doctor will discuss the options for treatment with you and a decision can be made. If operative treatment is considered, the earlier this is performed, the better the result of the treatment would be.

I had a fracture and the pain is not settling down.

Fractures around the shoulder are painful for a period of six weeks. During this period the pain settles down gradually. If the pain is not settling after six weeks, the fracture may not be healing (non-union) or healing in an abnormal position (mal-union). Your doctor will discuss the options for treatment with you in these situations.

I had a fracture and my shoulder is stiff.

This may be due to joint contracture as the shoulder was in a sling for a period of time or the fracture has healed in an abnormal position (mal-union). Your doctor will discuss the options for treatment with you in these situations.

I had a fracture, my arm moves but I have no control over it.

This may be due to tendon detachment or the fracture may not have healed (non-union). Your doctor will discuss the options for treatment with you in these situations.

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