A fracture is a broken bone. Fractures to the shoulder could result from a fall onto the shoulder or could be as a result of a car accident.
There are three main bones in the shoulder which includes scapula (shoulder blade), clavicle (collar bone) and humerus (arm bone). They are supported by multiple layers of soft tissues including ligaments and muscles. A fracture of the shoulder could happen in any of these bones however in older adults it is more common to have a fracture in the upper part of the arm, mainly due to osteoporosis. However, following high energy force younger patients can sustain a fracture.
Fractures of the upper arm bone can happen in different areas, but the most common one is a fracture in the neck of the humerus, mostly seen elderly patients with osteoporosis. The number of fragments and the degree of displacement of the fracture dictates whether surgery is required or not.
If there is a fracture in the upper arm bone, the patient would generally be in a lot of pain, and have swelling and bruising which might extend to the lower arm and even to the chest. Also, it is common to have a restriction of movement following a fracture. Sleeping is also disturbed.
In most cases, a non-displaced fracture can be treated without surgery by using an arm sling and having a period of rest. This is often followed up by a period of physical therapy to improve movement and muscle function. However, in a fracture where there are big chunks of bone moved from their normal place, then surgery would be necessary and may even require plates, screws or in severe cases, a joint replacement.
Having osteoporosis is a significant risk factor for fractures, especially in the elderly population. Unfortunately, most people do not release they have osteoporosis until a fracture happens. This is why it is called a silent disease. But the good news is there is a specific scan that can measure bone density.
There is high risk of osteoporosis if you have a low level of calcium, vitamin D, smoke cigarettes, have a high alcohol intake of more than two standard drinks per day, lack of physical activity and some hormonal changes. A lot of these factors can be corrected, so it is advisable to check with your GP to see if you need to be tested to help prevent a fracture.
Whether the treatment of choice is a period of immobilisation by a sling or surgery to fix the bones, it is often recommended to have a period of physiotherapy. Physiotherapy can help to reduce pain, improve range of movement and restore muscle function around the shoulder blade.