Shoulder Fractures

Background

Trauma to the shoulder can result in a fracture or broken bone. This can involve several bones that make up the shoulder joint, most commonly the proximal humerus, clavicle, and scapula. These fractures often result from trauma such as falls, motor vehicle accidents, or high-impact sports injuries, and are particularly common in older adults with osteoporosis.

Proximal humerus fractures are the most frequently seen shoulder fractures, especially in elderly patients, while clavicle fractures are more common in younger, active individuals. The severity of the fracture can vary from nondisplaced cracks to complex, comminuted, or displaced fractures involving joint surfaces.

Symptoms

Shoulder fractures typically present with:

• • Sudden, severe pain following trauma
• • Swelling and bruising around the affected area
• • Visible deformity or bump over the fracture site
• • Limited range of motion
• • Inability to lift the arm or move the shoulder
• • Occasional numbness or tingling due to nerve involvement

Pain is usually localized to the fracture site depending on the bone involved.

Diagnosis

Diagnosis of shoulder fractures begins with a physical examination to assess for deformity, swelling, neurovascular status, and range of motion. Imaging is essential and typically starts with standard X-rays to identify the location, pattern, and displacement of the fracture.

In complex cases or when joint involvement is suspected, CT scans may be ordered to provide detailed visualization of the bony anatomy and assist in surgical planning.

Treatment Options

Treatment of shoulder fractures depends on several factors:

• • Type, location, and severity of the fracture
• • Patient's age and activity level
• • Bone quality
• • Presence of joint surface involvement