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The shoulder comprises a group of bones that work together to allow the shoulder and arm to function. The bones in the shoulder consist of the upper arm bone, called the humerus, the collarbone, which is called the clavicle, and the shoulder blade, referred to as the scapula.
The shoulder joint comprises the glenohumeral joint, commonly known as the ball and socket joint, as well as the acromioclavicular joint and the sternoclavicular joint. A fracture occurring in any of the bones within the shoulder can significantly hinder your mobility and create intense pain. Shoulder fractures typically happen due to trauma or injury to the shoulder resulting from a fall, sports injury, car accident, or any direct impact on the shoulder.
We treat every type of shoulder fracture using the latest diagnostic and treatment techniques, including surgery for a shoulder fracture injury, to offer the best possible outcomes.
The upper arm bone, the humerus, is a long bone that extends from the shoulder area and the scapula (commonly known as the shoulder blade) to the elbow joint. Fractures of the humerus can be categorized into one of two different types: a proximal humerus fracture or a humerus shaft fracture.
A proximal humerus fracture typically happens near the shoulder joint and can be found at various levels, presenting different fracture patterns, such as simple or comminuted. In contrast, a humerus shaft fracture is specifically found at the midsection of the upper arm area.
Shoulder fractures may be classified as non-displaced (when the bone pieces remain in the correct position) or displaced (when parts of the bone are fractured and fragments have shifted out of their normal position).
Non-displaced fractures are the most common and account for about 80 percent of shoulder fractures. Nonsurgical methods often treat these fractures, while displaced fractures may require surgery to realign the bones.
Types of shoulder fractures include:
The clavicle, also known as the collarbone, is a long, narrow bone that starts at the bottom of the neck and extends outward toward the shoulder. Clavicle fractures can happen at any stage of life, impacting individuals from newborn infants to elderly adults.
These fractures generally happen due to a fall, a direct impact, involvement in contact sports such as hockey or football, or even a motor vehicle accident. Symptoms commonly include bruising, swelling, and pain in the area around the clavicle. Furthermore, a bump might develop over the injury site due to hematoma, which is localized swelling confined to a specific area or due to a deformity of the bone. When a person suffers from a fractured clavicle, they typically find it challenging to raise the arm.
The humerus is a lengthy bone that extends from the elbow to the shoulder. A break that occurs at the upper part of the humerus bone, either at the humeral head or just slightly beneath it, is the proximal humerus fracture. The humeral head is frequently called the ball that sits within the shoulder's socket.
Proximal humerus fractures are very common occurrences. They can happen at any age, but the risk of these fractures increases with older age and osteoporosis.
There exist two additional types of humerus fractures. These specific fractures do not impact the shoulder joint as significantly as a proximal humerus fracture.
A humeral shaft fracture impacts the middle section of the humerus bone.
A distal humerus fracture influences the lower end of the humerus, which is close to the elbow joint.
A humeral fracture can frequently be treated without surgery. However, factors that can affect the necessity for surgery include the degree of displacement, involvement of the cartilage at the joint, and the patient's age and activity level.
The scapula is a flat, triangular bone located in the upper part of the back. It serves as the main connection between the chest and the arm. Scapula fractures are uncommon, making up less than 1% of all fractures and only 3% to 5% of all shoulder fractures.1 These fractures are usually observed in men aged 25 to 45 years.
A scapula fracture can occur during a contact sport, such as football, or a traumatic incident, like an automobile accident. Considering the force needed for the scapula to break, an individual with this kind of injury typically has also experienced other injuries, such as nerve damage, rib fractures, or lung injuries.
The glenoid is the socket structure that creates the shoulder's ball-and-socket joint. While glenoid fractures are uncommon, they can happen as a result of significant trauma or during high-energy sports activities and events.
Signs of a glenoid fracture include:
Your doctor will do a detailed physical examination and may order X-rays or a CT scan to examine the extent of the fracture and any joint displacement.
Non-displaced fractures need to be immobilized in a supportive sling for approximately six weeks. If the fracture has resulted in the displacement of the bones, then surgical intervention may be necessary to correct and securely fix them using pins, plates, or screws. Physical therapy might be suggested to assist in recovery and enhance the arm's overall range of motion and strength.
If you experience any of the following symptoms, please book an appointment with us to determine if you have fractured your shoulder:
To accurately diagnose a shoulder fracture, an orthopedic specialist will order advanced imaging tests to determine the precise location of your fracture and assess the severity of your medical condition. We offer the latest advancements in imaging tests and diagnostic tools to evaluate for shoulder fractures, including:
We at Sunnyvale Sports Medicine and Orthopedic Center treat non-displaced and displaced shoulder fractures using the latest nonsurgical and surgical techniques. Some shoulder fractures can be treated with noninvasive methods, while others may require more complex surgical treatments to repair the fractured bone(s). Your treatment plan may require both conservative and surgical techniques.
Most non-displaced shoulder fractures can be treated with conservative techniques, such as:
Use an arm sling or wrap for immobilization while the bones properly heal.
Taking oral medications that help alleviate and reduce pain
Engaging in physical therapy along with range-of-motion exercises (to commence once the bones have begun to heal and under the careful supervision of a qualified physical therapist)
We have the expertise to treat complex surgical cases, including fracture non-union or malunions (broken bones that haven't healed or haven't healed in proper alignment) and other serious traumatic shoulder fractures.
We regularly treat injuries that require multiple surgeries simultaneously. Our orthopedic shoulder surgeons are experts in bone-grafting procedures and muscle and ligament reconstruction or repair.
For certain shoulder fractures with extensive damage to the surrounding skin and muscles, we collaborate with plastic surgeons with specialized training to help reconstruct soft tissues in the shoulder. We continuously integrate highly advanced surgical specialties that guarantee the best possible outcome for more serious shoulder fractures. Our surgeons are actively working on techniques and technologies to make shoulder surgeries faster and easier for patients.
Because there are many types of shoulder bones, treatment for shoulder fractures will vary depending on which area of the shoulder has been injured and the severity of the fracture.
Types of shoulder fracture surgeries include:
If the bones are displaced or there is an open fracture (where the bone has come through the skin), surgery is necessary to repair the fracture and any damaged ligaments, tendons, and muscles. To lock the bones back into the correct position, orthopedic surgeons will use specialized hardware such as plates, screws, or pins. Surgeons sometimes perform bone grafting and repair soft tissues such as ligaments and tendons. In some severe fracture cases, the shoulder will require a joint replacement.
If you suffer from a severe shoulder fracture, you may require a partial shoulder replacement. In this specific procedure, a traditional shoulder replacement device that includes a metal ball and stem replaces the damaged ball and the upper section of the arm bone. People who undergo a partial shoulder replacement typically experience reduced pain, enhanced function, and a greater range of motion, which results in an improved quality of life.
In some cases, a severe shoulder fracture will require a reverse total shoulder replacement. During this procedure, the socket and the metal ball are exchanged: The metal ball is securely attached to the socket, and the plastic cup is firmly fixed to the humerus bone. Individuals who undergo a reverse total shoulder replacement experience reduced pain and improved function and range of motion.
Following your surgery, a pain management specialist will make sure that you receive the necessary medication to keep you comfortable as the fracture heals properly. The duration of your hospital stay is determined by how severe the injury is and the specific type of surgery that was carried out. Some individuals can go home the same day, while others might need to stay overnight for careful observation.
Before you are discharged from the hospital, your doctor may put a plaster cast on your arm and elbow or provide a splint or sling. These supportive devices help to immobilize the injured shoulder or elbow while the bones undergo the healing process.
Your surgeon decides how long you need to wear a sling or cast based on several important factors, including where the fracture is located and how severe it is, the type of surgery performed, and whether there is any soft tissue or blood vessel damage along with the fracture. Your age is also taken into account during this process. Younger individuals typically heal much faster than older individuals because their bones regenerate quicker.
Your surgeon schedules a follow-up appointment for you about one week after your surgery to check if the bone is healing properly and effectively. During this appointment, your doctor assesses when you should start physical therapy sessions.
Initially, a physical therapist demonstrates simple exercises to maintain the range of motion in the nearby joints unaffected by the injury. For instance, if you have a fractured collarbone, doctors recommend beginning early range of motion exercises for the elbow and wrist of that arm. Physical therapy appointments usually occur twice weekly as you gradually build strength.
In the upcoming weeks, your surgeon may arrange periodic appointments to monitor the bone's healing closely. They might utilize X-rays to ensure the bone fragments stay in place and confirm that the bone is healing effectively. As your pain decreases and you regain the ability to move the affected arm, your physical therapist assists you in restoring your range of motion, enhancing flexibility, and building muscle strength.