Shoulder Fractures: Everything You Need To Know

You are busy preparing a dinner worthy of a five-star restaurant for your family. Everything is going to plan, but the fate of your pasta sauce rests in your ability to quickly get to the basil! As you turn to reach for it, you slip on the rug. Pasta sauce goes flying and your shoulder strikes the edge of your countertop during the fall. There is immediate pain in your shoulder and you are unable to move it. The biggest concern here isn’t the pasta sauce, it’s your broken shoulder! Let’s take a closer look at shoulder fractures and why we want to prevent them!

A broken shoulder refers to any fracture involving the ball-and-socket joint that forms the shoulder. Most often, it refers to a broken humerus bone (the humerus is the upper arm bone that forms the “ball” of the shoulder joint). These fractures can occur in one of two ways– by falling onto an outstretched arm that you use to brace for impact, or during a fall directly onto the shoulder.

How common are shoulder fractures?
In the United States alone, shoulder fractures account for more than 370,000 emergency room visits each year. This number is estimated to reach over 490,000 by the year 2030 as baby boomers continue to age. Statistics documenting the economic burden that these fractures place on the individual and on society are not readily available, but the cost is likely in the 100s of millions each year!

What are symptoms of shoulder fractures?
Like most broken bones, shoulder fractures tend to be quite obvious. You are likely to experience shoulder pain, swelling, bruising, and may be unable to move your arm/shoulder as a result. Severely displaced fractures and shoulder dislocations are associated with painful muscle spasms, and occasionally injury to nearby nerves and blood vessels.

How are shoulder fractures treated?
Treatment of shoulder fractures depends on the severity of the fracture and your pre-injury level of function. The vast majority (nearly 85%) of shoulder fractures can be treated without surgery. You will be placed in a shoulder sling for 4-6 weeks, followed by a physical therapy program designed to regain shoulder motion and strength. Severe fractures will require surgery, which may consist of a plate and screws to hold the fractured bone fragments in place, or with a shoulder replacement in instances where the bone cannot be pieced back together. Total recovery following a shoulder fracture often takes 4-6 months.

What are complications of shoulder fractures?
Shoulder fractures are associated with several possible complications which can impact your quality of life and ability to perform everyday tasks. Fortunately, most studies show 60-85% of people will have a “good” or “excellent” outcome following a shoulder fracture. When complications occur, the most common is permanent shoulder stiffness. Injury to nerves around the shoulder have been reported in up to 67% of people, but these injuries are usually temporary and rarely lead to permanent impairment. Other possible side effects include injury to the rotator cuff tendons, development of arthritis, and loss of blood supply to the humerus bone (called avascular necrosis) which requires surgical treatment.

The bottom line on shoulder fractures…
Shoulder fractures are common in those with osteoporosis and are caused by a fall onto an outstretched arm or a direct impact to the shoulder region. The majority of shoulder fractures (85%) can be treated without surgery and most people will regain shoulder function over a 4-6 month period. More severe shoulder fractures are treated with surgery, and long term consequences include permanent stiffness, rotator cuff tears, shoulder arthritis, and the inability to perform normal daily activities as a result of the injury.