Fractures of the shoulder

The shoulder is a complex vital joint connecting the arm to the body. Shoulder bones include the proximal humerus (upper arm), clavicle (collarbone) and scapula (shoulder blade). These bones can be fractured as a result of a trauma such as a fall, contact sports or road accident.

Causes

There are several types of shoulder fractures and the type of fractures that patients suffer from can vary by age. Most children’s fractures are to the collarbone (see Fractures of the collarbone). In adults, the most common fractures are to the proximal humerus.

A fracture to the scapula (shoulder blade) is fairly uncommon as it is protected by the chest and surrounding muscles, so a fracture tends to occur when there is a very high impact trauma. Proximal humerus fractures are more common in older people, and the severity of the fracture can vary.

Symptoms

General symptoms of a shoulder fracture are pain, swelling, bruising, stiffness, immobility and an appearance that differs to the other shoulder. Symptoms of a proximal humerus fracture are severe swelling, limited movement and severe pain.

For patients with a scapula fracture, symptoms include pain, severe swelling around the shoulder blade and pain.

Treatment

Most fractures of the proximal humerus do not require surgery if the bone fragments haven’t been displaced. However, if they have been shifted then surgery may be required. This involves fixation of the fracture fragments using pins, plates or screws.

Only about 10-20% of fractures of the scapula require surgery, and rest using a sling and pain relief will usually suffice. However, if surgery is required it will involve fixation of the fracture fragments with screws and plates.

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