Overview
Fractures are broken bones. Shoulder fractures commonly involve the collarbone (clavicle), top of the upper arm bone (proximal humerus), and shoulder blade (scapula). Fractures of the clavicle and proximal humerus are usually caused by a direct blow to area from a fall, collision, or motor vehicle accident. Scapula fractures are less common because the scapula is protected by the chest and surrounding muscles. When they do occur, shoulder blade fractures are usually caused by high-energy trauma and often associated with injuries to the chest.
Shoulder Diagram
This illustration highlights the bones and other major components of the shoulder.
Fracture Symptoms
Symptoms of shoulder fractions are related to the specific type of fracture, but general symptoms include pain, swelling and bruising, inability to move shoulder, a grinding sensation when moving the shoulder, and a noticeable deformity.
Collarbone fractures typically swell about the middle of the collarbone area. There may be a “bump” that is immediately noticeable. The bump is the prominent ends of the fracture under the skin. Range of motion is very limited in the shoulder.
Proximal humerus fractures typically show a severely swollen shoulder with significant pain. There is very limited movement of the shoulder with this type of fracture.
Treatment
Most collarbone fractures can be treated without surgery. Dr. Stowell may recommend surgery if there is a compound fracture that has broken through the skin or the bone is severely out of place. During surgery, Dr. Stowell may fix the fracture with plates and screws or rods inside the bone.
Proximal humerus fractures are commonly treated without surgery if the bone fragments are not shifted out of position. If the bone fragments are displaced, Dr. Stowell may suggest surgery. During surgery, the fractured bone fragments are fixated with plates, screws, or pins. In some cases, shoulder replacement may be necessary.
Scapula fractures are mostly treated without surgery. Dr. Stowell may immobilize your shoulder with a sling or shoulder immobilizer, icing, and pain medications. About 10-20% of scapula fractures require surgery. Scapula fractures that Dr. Stowell needs to treat surgically usually have fracture fragments involving the shoulder joint or there is an additional fracture of the clavicle. Plates and screws are used to fixate the fracture fragments.
Most shoulder fractures whether treated surgically or nonsurgically need a period of immobilization followed by rehabilitation. It may take several weeks or even months to recover. Shoulder exercises are usually necessary and help with increased range of motion and decreased stiffness. A regimented physical therapy routine may also help with more rapid return of function by helping to regain muscle strength.