Shoulder Fractures

Falling on an outstretched arm can fracture the collarbone (clavicle) or the upper arm bone (humerus) near the shoulder. In addition to feeling pain, people with a shoulder fracture may be unable to move the arm.

Treatment

For most shoulder fractures, the shoulder is immobilized with a removable device, such as a sling. A removable device is chosen because the shoulder can become permanently stiff within a few days if it is not moved periodically.

If the shoulder is badly out of line or if structures that hold the joint together (such as ligaments, bones, or other tissue) are damaged, surgery is usually needed. Surgery (called internal fixation) often involves wires, pins, or screws inserted into the broken bone. If the shoulder joint is damaged too badly, it is replaced with an artificial joint, similar to that used for the hip.

After all shoulder fractures, the hand and wrist can and should be used immediately. If a removable device is used, range-of-motion exercises for the shoulder and elbow on the affected side are begun within about a week, sometimes sooner. A physical therapist teaches the person how to do these exercises. After 3 weeks, most people can begin exercises that involve raising the arm. However, the person may not be able to raise the arm overhead to do a task (such as comb the hair) for several months. Arthritis can make rehabilitation more difficult, and people who have it may recover more slowly. Problems such as a frozen shoulder or a tear in the muscles and tendons that hold the shoulder in place (rotator cuff) can also slow recovery.