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Shoulder Fractures

Traumatic injuries may cause a fracture of the humerus (ball), scapula (shoulder blade), or clavicle (collarbone) of the shoulder.

The majority of these injuries can be treated without surgery and heal well. Some fractures are better treated with surgery because they may carry a high risk of arthritis if left alone. 

Fractures are either described as being displaced or non-displaced. Fortunately, nearly 80 percent of all shoulder fractures are non-displaced. “Non-displaced” means that the broken pieces remain near their normal position and can heal if immobilized in a sling. Most shoulder fractures heal in about six weeks.

The remaining 20 percent of shoulder fractures are displaced and may require some type of surgery.  Surgery is used to bring widely displaced fracture pieces back together and lock them in place so they can heal well.  Surgery doesn’t usually help non-displaced fractures heal faster.

What are my treatment options?

Conservative care for shoulder fractures

Most non-displaced fractures require immobilization in a sling until the fracture heals enough to be permit motion without risk of dislodging the fracture fragments. X-rays are used to determine if sufficient healing has occurred to permit motion exercises.

If the arm is moved too early, this can delay healing, but too little movement will result in stiffness.  So you need to work with your doctor and therapist to move the shoulder at the right time.  It is vital to maintain flexibility of the elbow, wrist and fingers while resting the shoulder. So you will often be allowed to stretch the hand, wrist, and elbow while still protecting the shoulder.

Surgical

ORIF – If the fracture fragments are displaced, surgical procedures may be necessary to bring the pieces together and fix them with wires, pins, plates or screws.  This is called an “Open Reduction and Internal Fixation (ORIF).”

Shoulder Replacement – If the ball portion of the upper arm is broken, split or crushed, a shoulder replacement may become necessary. 

Reverse Shoulder Replacement – If the ball is badly damaged and the rotator cuff is also torn, a reverse total shoulder may be your best option to return to normal and re3duce risk of further surgeries.

Shoulder Anatomy

The Shoulder is a complex joint between the arm bone, shoulder blade, and collar bone.  Fractures can occur at any of these three bones.  They can happen after major injuries when younger, or after simple falls as we age.

What is the recovery time after shoulder fracture?

Most shoulder fractures can be treated without surgery.  It usually takes about 6-8 weeks for enough healing to occur and allow for full motion.  Rehab can take several months to return you to normal strength and motion.

Surgical recovery can vary.  Some treatments, like shoulder replacement and ORIF can take just as long as non-surgical care.  Reverse shoulder replacement allows for earlier motion, but almost the same time to return to normal strength.

What are the long-term problems after shoulder fractures?

The biggest problem after shoulder fractures is stiffness.  This seems to depend more on the severity of the injury than how they are treated.  If the injury is bad enough to require surgery, you will likely have some loss of motion after healing has completed.

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