What so Humerous about a Shoulder Fracture?

What is a Shoulder Fracture?

A fracture is the medical term for a broken bone.

When your humerus (arm bone) is fractured near or at the ball of your shoulder joint, it is commonly known as a shoulder fracture.

Your humerus can be broken in many places and the fracture is normally described by its location eg a fractured neck of humerus.

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Broken Shoulder

Please Note: "fractured" is the medical term for a "broken bone". Despite what your friends say, there is no difference in severity between a fractured bone and a broken bone.

Other Shoulder Fractures

Due to the main reason for shoulder fractures being falls, often a second shoulder fracture will occur at the same time.

The location of these fractures can have an impact on your treatment because of the attachment of important shoulder muscles. If you use a muscle that is attached to a broken section this can be very painful or can cause a deformity when your fracture eventually heals.

Below is a list of muscles that attach to different parts of the shoulder. Your physiotherapist or doctor will be able to explain what you should and shouldn't do if you have a fracture of the following regions:

Greater tuberosity - supraspinatus, infraspinatus & teres minor
Lesser tuberosity - subscapularis
Humeral Head
Shaft of Humerus - pec major (displaces shaft medially & internal rotation)

How is Your Shoulder Fracture Treated?

After your shoulder fracture has been diagnosed via an X-ray, your arm will most likely be supported at the wrist in a "collar and cuff" sling. This allows the weight of the arm to pull the humerus downwards. The downward pull helps the bones to heal in the correct position.

You must not put anything under your elbow in an attempt to support the weight of your arm. This would push your humerus upwards and move the bones into the wrong position. This is why you are not given a triangular sling. You must not rest your arm on a pillow when sitting or lying. You will need to wear the collar and cuff for at least six weeks depending on what your doctor recommends. You may wear it outside your clothes. You may remove it to wash.

Surgery is sometimes required to stabilise your fracture. This surgery is undertaken by an Orthopaedic Surgeon who specialises in fractures.

Does a Shoulder Fracture Hurt?

Yes! Your shoulder will be quite painful for the first two weeks. Pain relieving tablets may help to reduce your pain. Ask your doctor for advice.

Physiotherapy & Exercises for Shoulder Fracture

Your arm will usually be in a collar and cuff for six weeks. You must move your fingers and wrist whilst in the collar and cuff to prevent stiffness and swelling.

Your doctor or physiotherapist will advise you when it is safe to recommend range of motion, active-assisted , active and then progressive strengthening exercises. DO NOT attempt to do too much too soon or you may disturb your fracture.

While it is important to move your shoulder to prevent stiffness, your priority is the allow fracture healing and weakness stiff. Be guided by your health professionals. They are the experts in getting your shoulder back moving again as soon as possible.

Even with diligent exercising your shoulder may become stiffer than normal. Your physiotherapist is the best person to advise you which exercises to do, how often and when?

Seek the advice of your physiotherapist early (within the first week after injury is ideal) to attain your best outcome.

Will Your Shoulder Fracture Fully Recover?

In most cases, Yes! Your shoulder will continue to improve for up to twelve months. However, your best results will occur early.

Washing

You may remove the collar and cuff to wash. Wash under your arm using a hanging pendulum position.

Driving

You cannot drive whilst your arm is in a collar and cuff. You will not have free movement of your arm for several weeks after the sling has been removed. Therefore you will not be able to drive for at least eight weeks.

Work

This depends on your job. If you can work one handed, you may be able to return to work two weeks after your injury. This also depends on you being able to get to work. If your job is manual you will be unable to work for at least three months.

Sport

In most cases, you may participate in light non-contact sports about six weeks after your injury. When you start playing, you will not be able to play for as long as normal. Your shoulder will ache at the end of exercises.

Smoking

You should not smoke whilst your fracture is healing. Research confirms that smoking slows down bone healing.

Complications

Your fracture may not heal. If this happens an operation might be necessary. If the fracture heals in the wrong position an operation to correct the position or to insert an artificial shoulder might be necessary.

General Advice for Shoulder Fracture

You will have dramatic bruising down your arm as far as the elbow. This is normal. The bruising will take many days to disappear. This is a common injury in older patients. As a result the shoulder usually ends up stiffer than normal following this injury. If you have any problems or queries, please ask your physiotherapist or doctor.