A shoulder fracture can cause severe pain, swelling, weakness, and difficulty moving the arm. These injuries most commonly involve the upper portion of the humerus or the scapula, including the glenoid socket. The clavicle is also part of the shoulder girdle, although collarbone fractures are addressed separately.
Dr. Brian Cohen is a board-certified orthopedic surgeon who provides individualized shoulder fracture treatment in Columbus, OH. He evaluates the location and severity of the break, bone alignment, joint involvement, and surrounding soft tissues before recommending nonsurgical care or surgery.
About Shoulder Fractures
The shoulder is formed by three bones:
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The humerus, or upper arm bone
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The scapula, or shoulder blade
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The clavicle, or collarbone
The rounded head of the humerus fits into a shallow socket in the scapula called the glenoid. A shoulder fracture may involve the proximal humerus, the body or other portion of the scapula, or the glenoid joint surface. These injuries range from stable, nondisplaced breaks to complex fractures involving multiple fragments or disruption of the joint.
Shoulder Fracture Causes
Shoulder fractures may result from:
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Falling directly onto the shoulder
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Falling onto an outstretched hand
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Motor vehicle or bicycle collisions
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Contact sports injuries
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A direct blow to the shoulder or upper arm
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Falls from standing height in older adults with osteoporosis
The type of injury often influences the fracture pattern. Proximal humerus fractures may occur after either a significant impact or a lower-energy fall in someone with weakened bones.
Because the scapula is protected by surrounding muscles and the chest, scapular fractures usually result from high-energy trauma. These injuries may occur along with damage to the ribs, lungs, nerves, blood vessels, or other nearby structures.
Shoulder Fracture Symptoms
Symptoms vary according to the bone involved and the severity of the fracture. They may include:
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Sudden or severe shoulder pain
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Swelling and tenderness
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Swelling around the shoulder
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Difficulty or inability to lift the arm
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Pain with shoulder movement
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A visible bump, deformity, or abnormal shoulder position
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A grinding sensation when the arm moves
Swelling and bruising may gradually extend down the arm toward the elbow, wrist, or hand.
An open wound, visible bone, numbness, weakness, difficulty breathing, or a hand that becomes pale or cold requires immediate medical attention. Call 911 or go to the nearest emergency department when the injury follows major trauma or includes signs of impaired circulation or chest injury.
Shoulder Fracture Diagnosis
Diagnosis begins with a discussion of how the injury occurred and the symptoms that followed. Dr. Cohen or one of his orthopedic colleagues will examine the shoulder, upper arm, chest, and hand for tenderness, swelling, bruising, wounds, deformity, circulation, sensation, and movement.
X-rays are typically used to identify the fracture and assess bone alignment. A CT scan may be ordered when the fracture is complex, extends into the glenoid, or requires more detailed surgical planning. Additional testing may be needed when significant trauma could have injured the ribs, lungs, nerves, blood vessels, or other parts of the body.
Shoulder Fracture Treatment Options
Treatment depends on several factors, including:
Depending on the severity of the condition and the patient’s functional needs, nonsurgical treatment may include:
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The bone and portion of the shoulder involved
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The fracture pattern and degree of displacement
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Whether the joint surface is affected
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The condition of the surrounding skin and soft tissues
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Bone quality and overall health
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The patient’s age and activity needs
Many stable fractures can be treated without surgery. Displaced, unstable, open, or highly fragmented fractures may require internal fixation or shoulder replacement.
Nonsurgical Treatment
Nonsurgical treatment may be appropriate when the fracture fragments remain in an acceptable position, and the shoulder joint is stable.
Care may include:
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A sling to support the arm
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Ice and pain-relieving medication
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Temporary activity restrictions
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Follow-up examinations and X-rays
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Gentle elbow, wrist, and hand movement
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Gradual shoulder exercises as healing progresses
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Physical therapy to restore motion and strength
Dr. Cohen determines when shoulder movement can safely begin based on the location and stability of the fracture.
Open Reduction and Internal Fixation for Shoulder Fractures
While many proximal humerus fractures can be treated with a supportive sling if they are not displaced, larger and more complex fractures will require surgery to align and secure the bones. Open reduction and internal fixation (ORIF) is a surgical technique that can help those who suffer from fractures to the humerus. It involves reducing the fracture and securing the bones in proper alignment so the patient can heal. This can be accomplished with a plate and screw or with an intramedullary fixation device with locking screws.
Total Shoulder Replacement
Also called total shoulder arthroplasty, this procedure includes the removal of part of the shoulder joint. The part that is removed will be replaced with artificial components that match the shoulder’s natural anatomy. A plastic cup device is attached inside the shoulder socket (glenoid), and a metal ball is attached to the top of the upper arm bone (humerus). This helps reduce the amount of pain the patient is feeling while also improving range of motion and mobility. Total shoulder replacement is often used to help treat severe pain and stiffness that occurs with arthritis, but may be utilized to treat complex fractures of the proximal humerus.
Reverse Total Shoulder Replacement
This type of surgical treatment differs from total shoulder replacement in where the components are situated. For a reverse total shoulder replacement, the metal ball is positioned on the glenoid, where the socket used to be, and the plastic cup is on top of the proximal humerus, where the shoulder ball used to be.
The indications for treatment with a reverse total shoulder replacement are much more extensive than those for an anatomic total shoulder replacement, and performing an anatomic total shoulder replacement for the wrong indications could result in an unsuccessful outcome.
Recovery and Rehabilitation
Recovery from a shoulder fracture may take several months. The rehabilitation plan depends on the bone involved, fracture stability, treatment performed, and condition of the surrounding muscles and tendons.
Early care may focus on protecting the fracture while maintaining movement in the elbow, wrist, and hand. Shoulder motion is introduced gradually as healing progresses. Physical therapy may then focus on:
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Restoring range of motion
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Reducing stiffness
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Rebuilding shoulder and arm strength
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Improving coordination and function
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Preparing for a safe return to work or recreation
Follow-up examinations and X-rays help Dr. Cohen determine when activity can safely increase.
Why Choose Dr. Cohen?
OVER 25+ YEARS OF EXPERIENCE
One of the first orthopedic surgeons employed by a large hospital. Dr. Cohen spent 20 years.
TRUSTED BY OVER 100,000+ PATIENTS WORLDWIDE
Over his distinguished career, Dr. Cohen has cultivated a reputation of excellence and trust among his patients and his peers.
UTILIZING THE LATEST TECHNOLOGY
To achieve the best surgical outcomes, Dr. Cohen uses the most advanced technologies and techniques, keeping his practice state-of-the-art.
PATIENT SAFETY IS TOP PRIORITY
An individualized, patient-focused process coupled with decades of training and experience helps ensure maximum safety for all of Dr. Cohen’s patients.
Shoulder Fracture Care in Columbus, OH
Shoulder fractures vary considerably in location, severity, and effect on arm function. Dr. Cohen evaluates the fracture pattern, bone alignment, joint surface, and surrounding soft tissues before recommending a sling, rehabilitation, internal fixation, or shoulder replacement when appropriate. To schedule a consultation with Dr. Brian Cohen, call (614) 788-0375.
