Shoulder Fracture Q&A

What are the common types of shoulder fractures and how do they happen?

The most common types of fractures seen around the shoulder are clavicle (collarbone) fractures and proximal humerus fractures (ball of the ball and socket joint).  Clavicle fractures are frequently the result of high energy trauma such as going “over the bars” on your bike.  Proximal humerus fractures can also be the result of significant trauma, but they can also happen to older patients with poor bone who fall on their outstretched hand. 

How are these fractures diagnosed?

In most cases, these fractures can be diagnosed with a regular x-ray.  In some cases, a CT scan may be needed to better define the fracture, or to plan for surgery.

Does a shoulder fracture need surgery?

The need for surgery is based on the severity of the fracture.  Some fractures in which the bones are well aligned can be treated non-surgically. In these cases, you will often wear a sling for a few weeks, and then start physical therapy.  Your pain can often be managed with anti-inflammatory medication and ice.  You will need to follow-up with your doctor intermittently for x-rays and to review your progress.  However, if there is poor alignment of the bones, or many pieces to the fracture, then surgery may be required. 

What does shoulder fracture surgery entail?

Surgery typically involves a procedure called open reduction and internal fixation.  During this procedure, the bone fragments are first repositioned into their normal alignment. The pieces of bone are then held in place with smetal hardware such as plates and screws.  Following surgery, the shoulder is typically in a sling for a short period of time prior to starting rehabilitation.   In some cases of severe proximal humerus fractures, shoulder replacement may be required.

How long is the recovery for shoulder fracture repair?

You start passive exercises with a physical therapist right away. About a month after surgery, you can start on more active exercises. Two to three months after surgery, you begin doing strengthening exercises to regain muscle mass. Most men and women have adequate strength and range of motion about 3-6 months after surgery. You continue to improve from there for up to a year.

Author

Frank Petrigliano, MD Dr. Petrigliano s a highly skilled orthopaedic surgeon and a specialist in sports medicine and shoulder surgery at the USC Epstein Family Center for Sports Medicine in Los Angeles, California. Dr. Petrigliano is the chief of sports medicine at USC and head team physician for the LA Kings professional hockey team.