The initial stage of treatment of a shoulder fracture is to make an accurate diagnosis.
A short interview will be conducted first, followed by a clinical trial. The arm will be palpated to determine where the pain is located. Its mobility will then be assessed. Peripheral nerve function and blood supply to the upper limb will be checked.
Imaging tests will then be recommended to check whether a fracture has occurred or not. A simple x-ray will show it . If the fracture is complex, a CT scan will be required, which will show the bones in more detail and much better than an X-ray.
Treatment options will vary depending on the severity of the fracture. Orthopedic surgeons usually know which fractures will heal well without surgery and which will develop better after surgery.
Fractures that are minimally displaced usually do not require surgery. These fractures are treated:
- immobilize the limb for a period of 4-8 weeks using a scarf.
- treatment of pain, especially including acetaminophen and avoiding nonsteroidal anti
- inflammatory drugs that slow bone healing.
- cold applications on the affected area.
- gentle physical therapy to reduce the reduced mobility of the arms.
- treatment of associated soft tissue lesions.
- a gradual return to activity, depending on the progress of bone healing, monitored on X-ray images taken at regular intervals.
Patients who strictly follow the recommendations usually get very good results after conservative treatment. However, some patients may be left with limited mobility of the shoulder after a shoulder fracture. Some may also develop osteoarthritis of the shoulder if the articular cartilage has been damaged at the time of fracture.
What fracture should require surgery?
Although many shoulder fractures can be treated conservatively, there are several types of fractures that can progress better after surgery: Clavicle fracture: surgery is indicated if bone fragments are displaced by more than 2 cm or if the skin has been bitten by a broken bone. A fracture of the clavicle is usually set and maintained in an anatomical position by means of a special metal plate, perfectly shaped to the curvature of the bone and fixed to it with small screws.
Shoulder fracture: shoulder fractures usually heal without surgery. However, if the fracture of the scapula reaches the joint (the surface of the joint pan ) and moves, then surgery is indicated to reduce the area of the joint and prevent the appearance of osteoarthritis.
Proximal fractures of the humerus: fractures located just below the head of the humerus, in which the head is separated from the shaft, are usually treated without surgery, provided that movement is minimal. However, if these fractures include nodules (in which the tendons of the rotator cuff are inserted), surgery is recommended to replace the bone fragments and reduce them with a special plate with locked screws.
Shoulder-clavicle dysjones: a rupture of the ligaments causes the end of the clavicle to move in different directions and with varying degrees of severity. Moderate shoulder-clavicle dysfunctions are treated without surgery, and the ligaments will heal. The most serious will require intervention to get a good result. After surgery, followed by a period of immobilization and recovery, most patients with shoulder fractures after surgery return to normal activity within a few months with good results.