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Shoulder Fractures

A fracture is a broken bone. Fractures can range in severity from a crack (known as a hairline or greenstick fracture), to a complete break and separation of a bone that may protrude through your skin (known as an open or compound fracture).

Fractures can occur in any bone in the body, but the most common fractures are of bones in the extremities and of the ribs. Fractures are most common in young adults who are adventurous in nature, and in the older population as bones become fragile.

A closed fracture is one in which the bones do not break the skin, while in an open (also known as compound) fracture, one or more bone fragments protrudes through the skin. Open fractures are more difficult to treat and have a greater risk of infection. Stress fractures are tiny cracks that develop in bone due to repeated force, such as overuse injuries.

Because we have three major bones in our shoulders, there can also be three different types of shoulder fractures.

Clavicle fractures are the most usual of all the fractures of the shoulder and fracture can happen when something heavy and hard fall on the shoulder. These kinds of fractures are very painful and there would be difficulty in moving the arm.

  • Scapula-Shoulder blade fractures are the result from high-impact trauma such as accidents or fall from certain heights. Because the shoulder blade is a delicate bone, a CT scan may be required to have an overall analysis of the fracture.
  • Shoulder Joint fractures or the proximal humerus fractures are the result from falling that landed on the arm first resulting in shoulder dislocation. Dislocations of the ball sockets are the usual characteristics of these kinds of fractures.

What causes shoulder fractures?

A number of factors increase the risk of developing fractures. Not all people with risk factors will get fractures. Risk factors for fractures include:

  • Advanced age
  • Certain genetic disorders
  • Excessive tobacco or alcohol consumption
  • Female gender
  • Lack of physical activity on a regular basis
  • Lack of proper nutrition, especially calcium
  • Osteoporosis (thinning and weakening of the bones)
  • Participation in sports
  • Thyroid or endocrine disorders
  • Vitamin deficiencies

What are the symptoms of a shoulder fracture?

  • Shoulder Pain
  • Swelling
  • Tenderness
  • Deformity or "bump" at the site of the fracture
  • Discoloration around the upper arm
  • Inability to normally move the arm without pain

Diagnosing a shoulder fracture:

The medical history will be inquired by the doctor and other condition that might be contributing to the pain. Physical examination will be conducted as well. The doctor will feel the injury and will ask the patient to move his arms if there are limits to their movements. Moreover, a more systematic review will be relevant to find any information that might be related to the shoulder injury. First, an x-ray will be taken to confirm shoulder fracture and then an injection of contrast fluid will be injected into the shoulder to outline structures of the bone. This process is called an arthrogram. MRI may also be needed to produce series of cross-sectional images and other diagnostics might follow.

Shoulder fracture surgery:

There are different options for the treatment of shoulder fractures depending on which bone is damaged. For clavicle fractures, a ‘figure 8” treatment is most recommended. This is a strap that will be worn on the shoulder for around 2 months. Range of motion will be administered after the pain subsides but the person may not be allowed to use his shoulder for a long time until completely healed. For shoulder blade fractures simple slinging of the shoulder, which may last for two weeks or a month will be needed. However, when there is a severe displacement of the glenoid or shoulder socket surgery may be needed.

For those events when the shoulder joint must be positioned back into place, sling can be an option but if the fracture is a displaced bone, surgery will be the option in line. Non-displaced fractures are oftentimes treated with the use of slings but fractures with displaced or fragmented bones will require surgery as well and then going back to the sling and therapy thereafter.

 

   

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