Fractures

Shoulder fractures can be located in a number of different places; the clavicle, the upper arm and the shoulder blade.

For more information on shoulder fractures and possible treatment options, call +44 (0) 203 195 2442 to arrange a consultation with the London Shoulder Specialists.

Fracture of the clavicle

The clavicle, or collarbone, is the connecting bone between the arm and body and you can feel it lying along the front of the shoulder. A collarbone is a common fracture, usually in the middle of the bone, and are often caused by a fall or a blow to the shoulder. It is commonly seen in contact sports such as rugby and potentially high impact sports such as horse riding.

Patients tend to have problems raising their arm and this can be a very a painful injury. You may see a swelling, bump or bruising where it has been broken. At your consultation at London Shoulder Specialists, we will examine the shoulder and then usually perform an X-ray to confirm the diagnosis. A CT scan can also be ordered.

A collarbone should heal well if rested and supported in a sling, followed by physiotherapy. However, if the damage is more extensive and the bones have become displaced, you may require surgery to realign the collarbone and screws and plates to keep it in position. About 15% of collarbone fractures will also fail to heal properly, known as ‘non-union’ and will then require fixation.

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Fracture of the upper arm

The top of the humerus or upper arm bone forms the ball part of the shoulder joint and a fracture to this part of the bone is commonly called a broken shoulder. Fractures here can be caused by a collision or breaking a fall with a straightened arm and often occur in older patients suffering from osteoporosis.

Patients typically present with pain and limited movement of the shoulder and there is usually bruising and swelling. Your range of movement and amount of discomfort will be assessed and then your London Shoulder Specialist consultant will order investigative tests.

Most fractures will heal without surgery and you will be prescribed anti-inflammatories and advised to wear a sling or a clavicle brace to support the shoulder until you can begin gentle stretching exercises. However, bone displacement may require surgery to realign the bones or they will heal out of alignment, potentially causing further problems in the future. Complex fractures may require CT or MRI scans to determine the extent of the problem.

The surgical option does mean an extensive recovery period, so the patient must be committed to following a lengthy physiotherapy programme afterwards and be realistic about what the procedure entails.

Fracture of the shoulder blade

The shoulder blade, technically known as the scapula, is the bony plate that protects the chest. It is surrounded by muscle so is rarely fractured. Typically, it requires a high-impact injury, although it is possible to develop stress fractures over time.

It is usually marked by extreme pain and swelling, particularly in the back of the shoulder. An X-ray or CT scan will show the extent of the damage. Your London Shoulder Specialists consultant will then advise you on the appropriate treatment.

Often this fracture will resolve itself with rest followed by physiotherapy, however, scans may reveal that there are loose bone fragments that may require surgical intervention. It also may be necessary to realign the bones in the shoulder and hold them in place with screws and plates.

If you have more questions about possible treatment options or whether surgery is the best option for you, please arrange a consultation with the London Shoulder Specialists.

Frequently Asked Questions on Shoulder Fractures

A shoulder fracture involves either the scapula, clavicle or humerus and is described as either displaced or non-displaced. Most fractures are non-displaced, which means the bones remain in their correct anatomical position. In contrast, in a displaced fracture, the broken bones are separated and usually require manipulation to restore normal anatomy.

The typical symptoms of a shoulder fracture are pain, swelling and tenderness. There also may be a deformity at the site of the fracture in the form of a bump or discolouration of the skin. You will likely have difficulty moving your arm.

Our London Shoulder Specialists will diagnose a shoulder fracture by asking about your symptoms and performing a physical examination of the shoulder joint. They can order an X-ray to examine the joint and may also arrange a CT or MRI scan to provide images of the rotator cuff tendons and glenoid labrum in case they have also been injured.

If a fracture is displaced, then surgery may be required to realign the bones, so they heal in the correct position. Sometimes the rotator cuff muscles / tendons are torn simultaneously as the fracture, which may require surgical repair.

Risks of shoulder fracture surgery include bleeding, infection, issues with wound healing, and injury to the nerves in the shoulder. Post-surgery there can be stiffness, weakness, instability, pain, or the fracture fails to heal.