Shoulder Fracture

What is a shoulder fracture?

A shoulder fracture is a broken bone in your shoulder joint. A bone fracture is the medical definition for a broken bone.

You might need surgery to repair a fractured shoulder. Some people only need a cast, brace or sling for the bone to heal. How long it takes to recover fully depends on which of your bones are fractured and what caused it.

Never try to force your shoulder joint back into place on your own or use it if you’ve experienced trauma. Go to the emergency room if you think you have a broken bone or another shoulder injury.

What are the types of shoulder fractures?

The most common way healthcare providers classify shoulder fractures is by which bone is broken. There are three bones in your shoulder joint:

• The top (proximal) part of your humerus (your upper arm bone).
• Scapula (your shoulder blade).
• Clavicle (your collarbone).

Breaking any of these bones is a shoulder fracture.

How common are shoulder fractures?

Shoulder fractures aren’t as common as other injuries like dislocations or separated shoulders.

Clavicle fractures are common, especially in teens. Proximal humerus fractures are more common in people older than 65 or those who have bone density issues. Scapula fractures are rare because your shoulder blades are so well protected by muscles and other tissue in your chest and back.

What are fractured shoulder symptoms?

Symptoms of a shoulder fracture include:

• Shoulder pain.
• Swelling.
• Bruising or discoloration.
• Not being able to move or use your shoulder.
• A deformity or bump that’s not usually on your body.

What causes shoulder fractures?

Shoulder fractures are almost always caused by traumas that suddenly impact your shoulder with a lot of force. Some of the most common causes include:

• Sports injuries.
• Falls.
• Car accidents.

What are shoulder fracture risk factors?

Anyone can experience shoulder fractures, but they’re most common in kids and teens who experience traumas and adults older than 65 who experience falls.

People with osteoporosis or osteopenia are much more likely to experience a bone fracture, especially from falls. Osteoporosis weakens bones, making them more susceptible to sudden and unexpected fractures. Many people don’t know they have osteoporosis until after it causes them to break a bone. There usually aren’t obvious symptoms.

What are the complications of shoulder fractures?

Lots of people who experience a fractured shoulder have permanent stiffness in their joint, even after it’s healed. A shoulder fracture can also increase your risk of developing arthritis in that shoulder.

If you experience an open fracture (the bone breaks through your skin), you have an increased risk of bone infections (osteomyelitis).

It’s rare, but there’s a chance the injury that caused a fracture could damage other parts of your shoulder, too, including your:

• Muscles.
• Ligaments.
• Tendons.
• Nerves.
• Blood vessels.

How are shoulder fractures diagnosed?

A healthcare provider will diagnose a shoulder with a physical exam and imaging tests. Providers in the emergency room might diagnose the fracture if you’re taken to the ER after a trauma like a car accident.

Which tests do providers use to diagnose shoulder fractures?

You’ll need at least one of a few imaging tests to take pictures of the fracture:

• X-rays: A shoulder X-ray will confirm any fractures and show how damaged your bones are.
• Magnetic resonance imaging (MRI): Your provider might use an MRI to get a complete picture of the damage to your bones and the area around them. An MRI will show tissue like cartilage and ligaments around your bones, too.
• Computed tomography (CT) scan: A CT scan will give your provider or surgeon a more detailed picture of your bones and the surrounding tissue than an X-ray.

Displaced vs. non-displaced shoulder fractures

Your provider will describe the fracture as displaced or non-displaced.

A displaced fracture means the pieces of your bone moved so much that a gap formed around the fracture when your bone broke.

Non-displaced fractures are still broken bones, but the pieces weren’t moved far enough during the break to be out of alignment.

Open vs. closed shoulder fractures

Your provider will classify the fracture as either open or closed. If you have an open fracture, the broken bone breaks through your skin. Open fractures are sometimes referred to as compound fractures. Open fractures have an increased risk of infections and other complications. Closed fractures are still serious, but your bone doesn’t push through your skin.

How are shoulder fractures treated?

How your provider treats a fractured shoulder depends on which bone is broken and if you have any other injuries.

Immobilization

If the fracture is mild and your bones didn’t move far out of place (a non-displaced fracture), you might only need a sling or brace. How long you’ll need to wear one depends on what caused the fracture and what type it is. You’ll need follow-up X-rays to make sure your bones are healing correctly.

Most clavicle and scapula fractures need only immobilization and physical therapy to help you regain your shoulder mobility.

Shoulder fracture surgery

Some shoulder fractures require surgery. You might need surgery if the fracture damaged the socket in your scapula that holds your humerus in place (the glenoid).

The most common shoulder fracture surgeries include:

Open reduction and internal fixation

Your surgeon will realign (set) your bones to their correct position and then secure them in place so they can heal and grow back together. They usually perform what’s called an internal fixation, which means your surgeon inserts metal plates, screws or pins into your bone to hold it in place while it heals.

You might live with these pieces inserted in your bone forever. Some people need follow-up surgery to remove them.

Arthroplasty

Arthroplasty is joint replacement surgery. If the fracture severely damaged your shoulder joint, you may need shoulder replacement surgery. Your surgeon will remove the damaged joint and replace it with an artificial joint (a prosthesis).

Complications of shoulder fracture surgery

Shoulder fracture surgery complications are rare, but can include:

• Acute compartment syndrome (ACS): A buildup of pressure in your muscles may stop blood from getting to tissue, which can cause permanent muscle and nerve damage.
• Malunion: This happens when your broken bones don’t line up correctly while they heal.
• Nonunion: Your bones may not grow back together fully or at all.

How can I prevent shoulder fractures?

Follow these general safety tips to reduce your risk of an injury:

• Always wear your seatbelt.
• Wear the right protective equipment for all activities and sports.
• Make sure your home and workspace are free of clutter that could trip you or others.
• Always use the proper tools or equipment at home to reach things. Never stand on chairs, tables or countertops.
• Follow a diet and exercise plan that’ll help you maintain good bone health.
• Talk to your provider about a bone density test if you’re older than 65 or if you have a family history of osteoporosis.
• Use a cane or walker if you have difficulty walking or have an increased risk of falls.

What can I expect if I have a shoulder fracture?

Most people who experience a shoulder fracture need several months of physical therapy while they’re recovering. A physical therapist will help you regain your strength and range of motion (how far you can move your shoulder).

Severe shoulder fractures can cause permanent stiffness or reduced range of motion in your shoulder. Your provider or surgeon will tell you what to expect.

What is the recovery time from a fractured shoulder?

How long it takes your shoulder to heal depends on a few factors:

• Which bone was broken.
• What caused the fracture.
• Which treatments you need.
• Any other injuries you experienced.

It might take between a few weeks and a few months to recover fully. Talk to your provider or surgeon about a timeline that fits your specific situation.

Ask your provider when you can resume physical activities. You’ll need to move your shoulder to prevent stiffness as you heal, but don’t start playing sports, working out or lifting using your fractured shoulder before your provider says it’s safe.

When should I go to the emergency room?

Go to the emergency room right away if you think you have a fractured shoulder (or any other type of broken bone). Go to the ER if you experience any of the following symptoms:

• Intense pain.
• You can’t move your shoulder like you usually can.
• Your shoulder or arm is noticeably different-looking or out of its usual place.
• You can see your bone through your skin.
• Swelling.
• New bruising that appears at the same time as any of these other symptoms.

What questions should I ask my provider?

• Which of my bones are broken?
• Will I need surgery?
• How long will I need to wear a brace or sling?
• When can I resume physical activities?
• Can I still move my elbow, wrist and hand to prevent stiffness?

Can you move your shoulder if it’s fractured?

You might be able to move your shoulder if it’s fractured, but it’ll probably be painful. It might be hard (or impossible) to move it as far as you usually can. Never force yourself to use your shoulder after an injury. Go to the emergency room right away if you’ve experienced trauma or think you might have a broken bone.

Your provider or surgeon will tell you when it’s safe to start moving your arm and shoulder again after the fracture is treated. Your physical therapist will give you exercises and movements that strengthen the muscles around your shoulder while you’re healing. You may still be able to move other parts of your arm, including your elbow, wrist and hands to prevent stiffness while you’re recovering.