Shoulder Fracture

Overview

Shoulder fractures may result from high-energy blunt trauma (such as a motorcycle or car crash), from falling on your own outstretched arm (trying to break your fall), or from another event that puts too much pressure on the area. These breaks most often occur at the top of the upper arm bone (proximal humerus) or in the shoulder blade (scapula).

Our approach to shoulder fracture

UCSF offers the best possible care for both simple and complex injuries of the shoulder bones. Most shoulder fractures can be treated with a sling to immobilize the bone while it heals. Other cases are best treated with surgery to realign and stabilize the bones. For all patients, our goal is to relieve pain and restore mobility, enabling a speedy return to normal life and favorite activities.

Signs & symptoms

Signs of a shoulder fracture after a specific event include:

• Extreme pain when moving the arm
• Swelling around the shoulder
• Skin abrasions

Diagnosis

Doctors diagnose shoulder fractures by getting the patient's medical history, performing a physical exam and taking X-rays. CT scans can be helpful in some instances, as can an MRI, which provides images of the rotator cuff, labrum and other shoulder structures that might also be injured.

Treatments

A simple sling allows most fractures to heal by holding the shoulder in place. You'll likely return to the office periodically for follow-up X-rays to check that the bone is knitting together properly. Most patients also benefit from starting a physical therapy program after healing has begun. This program focuses first on regaining motion in the joint and then on rebuilding strength.

If, however, the fractured bone moved significantly out of place during your injury, you may benefit from surgery. Sometimes plates and screws are placed to hold the bone together, and the surgery is performed under general anesthesia. Depending on your injury and the procedure required to repair it, you may be able to go home the same day, but it's possible you'll need to stay in the hospital for a day or so of monitoring.

Patients generally wear a sling for six to eight weeks post-op. During this time, you won't be able to drive; you'll have X-rays periodically to ensure the bone is healing well; and you'll begin physical therapy, which is essential for regaining motion and strength. The time for full recovery depends on your exact injury, but for most patients, it takes six to nine months.