Shoulder fractures are very common. They occur most commonly in the young and active population and in the elderly. The most common types of shoulder fractures are proximal humerus fractures and clavicle fractures. Most of these types of fractures can be treated without surgery. However, in more severe cases patients do benefit from surgical procedures.
Proximal Humerus Fractures
Proximal humerus fractures occur right below or involve the ball part of the shoulder joint. These fractures can either include one or two fractured pieces of the shoulder and be nondisplaced, or the shoulder may be fractured into many pieces that are widely displaced.
The recommended treatment varies depending on the fracture as well as patient age, activity level, and bone quality. Nondisplaced and minimally displaced fractures can usually be treated without surgery. Displaced fractures often require surgical fixation with screws and/or a plate and screws. This allows the fracture fragments to be placed back in the appropriate position and be held in place while they heal. Very displaced fractures, especially in older patients, may even be treated with partial shoulder replacement.
Regardless of the treatment method a sling is usually worn for 4 to 6 weeks, and physical therapy is utilized to prevent stiffness and aid in the return of full function to the shoulder.
Clavicle Fractures, or collarbone fractures, are extremely common. These fractures may occur anywhere along the collarbone. However, they most commonly occur in the mid-portion of the bone. Historically these fractures were almost never treated surgically. In recent years it has been recognized that some of these fractures may not heal as well as we once thought, and may become associated with some long term pain and functional deficits. Due to these findings we now operate on clavicle factures more frequently.
Clavicle fractures that are most often considered for operative treatment are those that are displaced and occur near the end of the bone toward the shoulder, as well as those that occur in the middle of the bone and are significantly displaced.