Shoulder fractures involve at least one of three bones in the shoulder: the scapula (shoulder blade), clavicle (collarbone), or humerus (upper arm bone). The upper end of the humerus has a ball-like shape that connects with the socket of the scapula, called the glenoid. All three types of fractures can cause shoulder pain, swelling, tenderness, and limit the shoulder’s range of motion.
Most fractures in children occur in the clavicle bone. In adults, the most common shoulder fracture is of the top part of the humerus (proximal humerus).
Some types include:
Clavicle Fractures: This is the most common shoulder fracture, frequently the result of a fall
Scapula Fractures: Fractures of this bone rarely occur. They usually result from high-energy trauma such as motor vehicle accidents or a high fall
Proximal Humerus Fractures: Fractures of the upper part of the arm are more common in the older (over 65 years of age) population. Sometimes, there are just cracks in the bones, but they have not moved very far out of their normal position.
Some shoulder fractures are diagnosed using x-rays. Sometimes, a CT scan is needed to see more detail.
After your broken shoulder 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 into the correct position to heal.
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 broken shoulder. This surgery is undertaken by an Orthopaedic Surgeon who specialises in shoulder fractures.
The shoulder is a very movable joint and when it is immobilised it becomes very stiff quite quickly. Coupled with trauma from a broken bone the risk of developing a problem secondary to the broken bone is high.
Secondary problems include:
The treatment available to you depends on whether your fracture was managed surgically or non-surgically. If it was managed surgically you may have had pins, plates or screws inserted to hold the broken bone together while it heals. In this case the exercises you are able to perform will be different to those if your fracture were managed non-surgically in a collar and cuff sling. Your Hospital therapist will advise you which exercises are appropriate for you.
While wearing the sling it is important to stretch the elbow and wrist several times a day to prevent them from becoming stiff. You should not attempt to move your arm at the shoulder until your doctor says it is safe to do so.
If however, your hand became swollen this can be treated at Hand Kinetics with taping and massage to help improve drainage and we can go over your exercises to be sure you are performing them correctly.
Gradually gentle exercises can be introduced for the shoulder after 2-3 weeks as instructed by your hospital therapist. If you require additional help with these, feel nervous about moving your arm or just need reassurance about how well you are progressing, Hand Kinetics can help you.
Please talk to our principal therapist at Hand Kinetics to discuss your specific needs and shoulder problem before making an appointment and we will be happy to discuss treatment options with you.
Hand Kinetics Telephone: 0044 28 417 72301
www.handkinetics.com
contactus@handkinetics.com
