My name is Uma Srikumaran. I'm an orthopedic surgeon with Johns Hopkins
and Howard County General Hospital.
I specialize in shoulder surgery.
A fracture involving a shoulder usually involves a significant trauma such as
falling onto your outstretched arm
or maybe being involved in a car accident.
These injuries are extremely painful and can limit your function immediately after
the injury and can be confirmed with an x-ray.
If you're diagnosed with a fracture by an emergency room on an urgent care center,
you should see an orthopedic specialist as soon as possible
so the appropriate treatment can be started in a timely fashion.
Some fractures may only require a sling and physical therapy while others may
require surgical intervention.
Fractures can involve different portions of the shoulder. Fractures can involve the
proximal part of your arm or your proximal humerus
or can involve the socket of the shoulder, called the glenoid.
Fractures can also vary in severity. Some are simple breaks where the
two bone pieces do not move relative to each other - these are called
or non-displaced fractures.
Other fractures can be more severe
and the bone can be broken into several pieces.
To ensure the best possible recovery after a shoulder fracture you should see
an orthopedic specialist to be evaluated.
They'll perform a physical examination and order the necessary imaging studies to
confirm the diagnosis and determine the fracture severity.
After diagnosis has been made you can have a discussion with your orthopedic surgeon
regarding treatment options and
discuss the relative risks and benefits of each approach.
The surgical repair for a shoulder fracture involves an open surgery generally
under general anesthesia,
also with the nerve block.
The surgery is an open surgery and is a ten to twelve centimeter incision
in the front of your shoulder. The pieces of bone are carefully realigned
and fixed with a metal plate and screws. In some cases the fracture may be so
severe or the bone quality so poor that
the metal fixation can not hold. In these cases a metal prosthesis will be used to
reconstruct the shoulder.
Recovery from surgery for a shoulder fracture involves a 1-2 day
hospital admission followed by outpatient physical therapy.
Depending on the type of surgery you've had, physical therapy will start with gentle
range of motion exercises initially performed by the therapist, or passive
range of motion, followed by
active range of motion exercises performed by the patient. When range of
motion is restored, strengthening exercises will begin.
This typically occurs after the bone has healed in three to four months.