Shoulder Fractures & Trauma
Breaks in the Shoulder Bones and Other Traumatic Injuries Leading to Pain, Swelling, and Impaired Function
Shoulder fractures occur when one or more of the bones in the shoulder joint break due to trauma. These bones include the clavicle (collarbone), scapula (shoulder blade), and humerus (upper arm bone). Trauma, such as a fall, a direct blow, or a high-impact accident, can result in fractures and other shoulder injuries, leading to significant pain, swelling, and loss of function. Depending on the severity of the injury, treatment may involve non-surgical management or surgery to realign and stabilise the bones or repair other damaged tissues.
CAUSES OF SHOULDER FRACTURES
Shoulder fractures and other shoulder injuries are commonly caused by traumatic events.
These include:
- Falls: Falling onto an outstretched arm or directly onto the shoulder is one of the most common causes, particularly among older adults who may have weaker bones.
- Sports Injuries: High-impact sports like rugby, football, or cycling can lead to fractures or shoulder trauma from collisions or falls.
- Motor Vehicle Accidents: Car or motorcycle accidents can exert significant force on the shoulder, resulting in fractures or additional injuries such as ligament tears.
- Osteoporosis: Weakened bones due to osteoporosis make individuals more susceptible to fractures, even from minor trauma or impact.
- Blunt Trauma: Shoulder injuries can occur from blunt trauma, such as being struck by an object or during a high-impact collision, potentially causing fractures, dislocations, or soft tissue injuries.
TYPES OF SHOULDER FRACTURES
There are several types of shoulder fractures depending on which bone is affected and the nature of the break:
The clavicle connects your arm to your body and is a common site of fractures, especially in children and athletes. Clavicle fractures typically occur from a direct blow to the shoulder or a fall onto an outstretched arm.
This fracture occurs near the top of the humerus, where it fits into the shoulder socket. Proximal humerus fractures are more common in older adults, particularly those with osteoporosis, and often result from falls.
Fractures of the scapula are relatively rare because the shoulder blade is protected by muscles. These fractures are usually the result of high-impact trauma, such as a motor vehicle accident or a fall from a height.
In addition to fractures, trauma can cause other significant shoulder injuries, including:
A dislocated shoulder occurs when the upper arm bone pops out of its socket, often caused by trauma or a fall. This injury can lead to ligament damage.
A traumatic injury can tear the rotator cuff, a group of muscles and tendons that stabilise the shoulder joint. This can occur alongside fractures or dislocations.
The labrum is a ring of cartilage that helps stabilise the shoulder joint. Trauma can cause this cartilage to tear, leading to shoulder instability and pain.
SYMPTOMS OF SHOULDER FRACTURES & TRAUMA
The symptoms of a shoulder fracture can vary depending on the severity of the break but often include:
- Severe Pain: Pain in the shoulder, particularly with movement, is a common symptom. The pain may be immediate and intense following the injury.
- Swelling and Bruising: The area around the fracture will typically swell and may bruise, leading to visible discoloration.
- Deformity: In some cases, you may notice a bump, abnormal shape, or deformity in the shoulder or collarbone.
- Inability to Move the Shoulder: Movement of the shoulder or arm may be restricted or impossible due to pain and the disruption of the bones.
- Grinding Sensation: You may feel or hear a grinding or popping sensation when trying to move the arm or shoulder.
DIAGNOSIS OF SHOULDER FRACTURES & TRAUMA
Dr Liddell will begin by conducting a thorough physical examination of your shoulder, assessing for tenderness, swelling, deformity, and range of motion.
Imaging tests will then confirm the diagnosis and determine the extent of the injury:
- X-Rays: X-rays are the primary diagnostic tool for shoulder fractures. They provide detailed images of the bones and help Dr Liddell determine the type and location of the fracture.
- CT Scan: In some cases, a CT scan may be needed to get a more detailed view of the fracture, especially if the break is complex or involves multiple bones.
- MRI: If soft tissue injuries are suspected in addition to the fracture, an MRI may be recommended to assess the surrounding ligaments, tendons, and muscles.
TREATMENT OPTIONS FOR SHOULDER FRACTURES & TRAUMA
Treatment for shoulder fractures depends on the type and severity of the fracture, as well as your overall health and activity level.
Non-Surgical Treatments
Many shoulder fractures can heal without surgery, particularly if the bones are properly aligned or only minimally displaced.
Non-surgical treatment options can include:
- Immobilisation: The use of a sling or shoulder immobiliser to keep the shoulder in place and allow the bones to heal naturally. The length of immobilisation will depend on the severity of the fracture, but it typically ranges from 3 to 6 weeks.
- Pain Management: Medications, including over-the-counter pain relievers and anti-inflammatories, can help manage pain and reduce swelling during the healing process.
- Physiotherapy: After the initial healing period, physiotherapy will be essential to restore shoulder mobility and strength. A tailored rehabilitation program will focus on gradually increasing range of motion, followed by strengthening exercises.
Surgical Treatments
If the fracture is severe or the bones are displaced, surgery may be required to realign and stabilise the shoulder.
Surgical options might include:
- Open Reduction and Internal Fixation (ORIF): In this procedure, Dr Liddell will make an incision to access the fractured bones and realign them. The bones are then stabilised using metal plates, screws, or rods to ensure proper healing.
- Shoulder Replacement Surgery: In cases where the fracture is complex or the shoulder joint is damaged beyond repair, a shoulder replacement may be necessary. This involves replacing part or all of the damaged shoulder joint with an artificial implant.
- Minimally Invasive Techniques: In certain cases, Dr Liddell may use minimally invasive surgical techniques, such as arthroscopy, to treat the fracture while reducing recovery time and scarring.
Recovery from a shoulder fracture can take several months, and the timeline will vary depending on the severity of the fracture and whether surgery was required. Dr Liddell will provide a personalised recovery plan to ensure the best outcome.