Section 5. Bone, Joint, and Muscle Disorders

Chapter 62. Fractures

Topics: Introduction | Foot Fractures | Leg Fractures | Hip Fractures | Fractures of the Pelvis | Fractures of the Spinal Column | Shoulder Fractures | Arm Fractures | Hand Fractures

Shoulder Fractures

Shoulder fractures include fractures of the clavicle (collar bone), scapula (shoulder blade) and proximal humerus (upper arm bone). Trauma can also produce disruptions of the joints connecting these bones.

Clavicle fractures occur commonly after a fall, such as from a bicycle or jungle gym. Because the clavicle lies just under the skin with little muscle covering, swelling and deformity are easily visible after a fracture. Fractures of the inner and middle part of the clavicle are usually treated with a brace that helps to align the clavicle by pulling the shoulders backward. Fractures of the outer clavicle are treated with a regular sling. A strap passing around behind the back can be added to keep the arm from swinging outward, especially at night. Surgery is rarely needed.

Fractures of the proximal humerus (upper arm bone) are common after a fall on an outstretched arm. Symptoms include pain and an inability to raise the arm. Most breaks can be treated with a sling. Surgery is needed if the fracture pieces are widely separated. If the joint fragment is badly damaged, a prosthetic implant (or a partial shoulder replacement) may be needed.

Fractures of the shaft of the humerus occur with high-energy injuries, such as high-speed motor vehicle accidents, including when pedestrians are struck by a car, falls during skiing, and falls from buildings. Most are treated with a sling and bracing.