Shoulder Fractures

Selected Features of Our Program

Evaluation and Diagnosis

Two patterns of shoulder fractures occur. In weaker bone, the upper part of the shoulder near the ball and socket joint will separate from the long arm bone. Major injuries such as auto accidents cause the long bone of the upper arm to fracture in the middle of the arm, leaving the arm unstable. The first pattern happens in older patients, the second usually in younger patients. X-rays show the break, its location and pattern. A physical examination is important to check for injuries to other structures, such as muscles or nerves.

Treatment and Recovery

Fractures at the upper end of the bone begin to heal quickly and usually do not require surgery. Immobilization in a sling for the first several weeks is followed by a gradual increase in the use of the arm as healing progresses. Therapists can help with exercises to improve motion and eventually strength. Meanwhile, the doctor will monitor x-rays to be sure the bone is healing in the correct position. Fractures in the middle of the arm bone are naturally unstable. They can be treated in a special arm brace, but healing is slower and less guaranteed to end up in the proper position when all finished. Most patients prefer to be stabilized to ensure the final position is correct and to allow early use of the arm, even before the fracture is finished healing. This used to be done with long incisions and plates and screws. Now special slender metal rods can be placed inside the bone through small incisions. Once the fracture is healed, most patients are able to return to their usual activities.