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Shoulder Fractures

Types of shoulder fractures vary. The majority of fractures in children occur in the clavicle, commonly referred to as the collarbone. In adults, fractures within the upper part of the arm (proximal humerus) occur with increasing frequency into old age.
Some of the main types of shoulder fractures include::

Clavicle (collarbone) fractures

The most common fracture of the shoulder is the clavicle, frequently the result of a fall onto the shoulder. These fractures can be very painful and cause difficulty in moving the arm.

Treatment has historically been non-operative, such as a simple sling. Once healed, there may be a bump over the fracture site which may decrease with time, but this callus may remain permanently.

Surgical treatment options for fractured clavicles may include plates and screws or even a rod placed into the bone. The consideration of these treatment options depends upon the patient’s activity level and the dominance of arm use, i.e. a right-handed athlete with injury to the right clavicle versus an older individual not engaged in “overhead” activities.

Scapula (shoulder blade) fracture

Fractures of this bone occur more rarely than those to the clavicle. Usually they result from high-energy trauma, such as motor vehicle accidents or a fall onto the back from a height. Diagnosis of the fracture is often made by X-rays. At times, more definition of the fracture may require a CT scan to assess the displacement of the fracture fragments.

Treatment of a scapula fracture can range from a simple sling to open surgery. Surgery is more often needed with an injury to the glenoid (shoulder socket) with displacement of the joint surface or the neck of the scapula.

Shoulder joint fractures

Shoulder joint fractures usually occur from a fall onto the arm. In younger people, these injuries can be simple fractures, often associated with dislocations of the shoulder joint. In those instances, the fracture is often treated by putting the shoulder joint back into place, i.e. reduced. If X-rays show that the fracture is in good position, sling immobilisation is often the treatment of choice. If the fracture is out of position, surgery may be undertaken.

Proximal humerus fractures

Fractures of the upper part of the arm (humerus) are more common in the older population. Sometimes, there may be no significant displacement of the bone fragments. In other cases, the fracture fragments may be more severely displaced. Non-displaced fractures can be treated with a sling. Recovery may require the use of physical therapy to assist in improving motion and strength. For those fractures with displacement, surgery may be required. Surgery may entail repair of the fracture with devices such as plates, screws, and wires. In some cases, the fracture is sufficiently severe that a shoulder replacement may be necessary.