What is a Shoulder Fracture?
A break in the bone that makes up the shoulder joint is called a shoulder fracture. The clavicle (collarbone) and end of the humerus (upper arm bone) closest to the shoulder are the bones that usually are fractured. The scapula, or shoulder blade, is not easily fractured because of its protective cover of surrounding muscles and chest tissue.
Causes
Clavicle and humerus fractures can occur by a direct hit from a motor vehicle accident, collision or fall. A fracture of the scapula can occur by high-energy trauma during an accident from a high-speed motor vehicle.
Signs and Symptoms
The common signs and symptoms may include:
- Pain
- Swelling
- Bruising
- Difficulty in lifting the arm
- Numbness, tingling or coldness of the hand and forearm
- A popping sound also referred to as crepitus, heard or felt at the time of the fracture
Diagnosis
A shoulder fracture is usually diagnosed based on a thorough physical examination, and imaging studies such as X-rays and CT scans.
Treatment
The treatment for a shoulder fracture is based on the type of fracture. Treatment can include either non-surgical or surgical methods.
Clavicle Fracture Care
A broken clavicle usually heals without surgery, but if the bone ends have shifted out of place (displaced), surgery is recommended to align the bone ends and hold them stable during healing.
Surgery for clavicle fractures may be considered in the following circumstances:
- Multiple fractures
- Compound (open) fractures
- Fractures associated with nerve or blood vessel damage and/or scapula fracture
- Overlapping of the broken ends of bone (shortened clavicle)
Plates and Screws
During this procedure, your surgeon will reposition the broken bone ends into their normal position and then use special screws or metal plates to hold the bone fragments in place. These plates and screws are usually left in the bone. If they cause irritation, they can be removed after the fracture heals.
Pins
Placement of pins may also be considered to hold the fracture in position, and the incision required is also smaller. They often cause irritation in the skin at the site of insertion and must be removed once the fracture heals.
Percutaneous Elastic Intramedullary Nailing
This is a newer and less invasive procedure with fewer complications. It is considered a safe method for fixation of displaced clavicle fractures in adolescents and athletes, as it allows rapid healing and a faster return to sports. The procedure is performed under fluoroscopic guidance (live x-ray). It involves a 1-cm incision near the sternoclavicular joint (where the collarbone meets the breastbone), after which an elastic nail is inserted inside the canal of the clavicle. Then the nail is manipulated to reach the fracture site. A second operation to remove the nail will be performed after 2-3 months.
Scapular Fracture Care
Most scapular fractures are not significantly displaced due to the strong supporting soft tissue structures surrounding it. Therefore, most scapular fractures are treated conservatively and with early motion to reduce the risk of stiffness. They usually heal without affecting shoulder movement.
Conservative Treatment
Conservative treatment options for scapula fractures include:
- Immobilization: A sling is used for comfort and to support the shoulder to allow healing to take place. This is usually worn for about 3-6 weeks depending on the type of fracture and how well you heal.
- Prescription Medications: Pain medications will be prescribed for your comfort during the healing process.
- Physical Therapy: Early progressive range-of-motion exercises are essential in restoring full shoulder function. Your physician will most likely refer you to a physical therapist for instruction on proper exercises and early motion of the shoulder to prevent complications.
Surgical Treatment for Scapula Fracture
Fractures of the scapula involving the neck or glenoid (cavity) or with severe displacement have been associated with poor outcomes when treated non-operatively and usually require surgical intervention to realign the bones properly to restore function and pain-free range of motion.
Scapular fracture repair surgery has historically been performed through a large, open incision. Newer, minimally invasive techniques have evolved and surgery to repair scapular fractures can now be performed through arthroscopy.
Proximal Humerus Fracture Care
Most proximal humerus fractures are minimally displaced and can be treated with conservative approaches such as the use of a sling to immobilize and early physical therapy to improve the functional outcome. Surgery may be necessary for displaced fractures. The multiple fragments are fixed with plates, screws or pins, and in severe cases, shoulder replacement surgery is performed.
Why Choose Dr. Acevedo for Shoulder Fracture Care
Patients trust Daniel C. Acevedo for shoulder fracture care because of his focused expertise in treating complex shoulder injuries and fractures with both surgical and non-surgical approaches.
Reasons to choose Dr. Acevedo include:
- Fellowship-trained specialist dedicated exclusively to shoulder and elbow conditions
- Extensive experience treating clavicle, scapula, and proximal humerus fractures
- Expertise in both non-surgical management and advanced surgical fixation techniques
- Focus on restoring proper bone alignment, stability, and long-term shoulder function
- Use of minimally invasive and modern fixation methods when appropriate
- Personalized treatment plans based on fracture type, severity, and patient goals
- Emphasis on early motion and rehabilitation to reduce stiffness and improve outcomes
- Careful evaluation of nerves, blood vessels, and surrounding structures after injury
- Experience managing both simple and complex, high-energy fracture injuries
- Commitment to helping patients safely return to daily activities, work, and sports
Shoulder Fracture Care - FAQs
How do I know if I have a shoulder fracture?
Common symptoms of a shoulder fracture include severe pain, swelling, bruising, and difficulty moving the shoulder or arm. Some patients may also notice deformity or weakness in the arm. Imaging tests such as X-rays are usually needed to confirm the diagnosis.
Do all shoulder fractures require surgery?
No, many shoulder fractures can be treated without surgery using a sling, rest, and physical therapy. Surgery may be recommended if the bones are displaced, the joint is involved, or the fracture is severe.
How long does it take to recover from a shoulder fracture?
Recovery time depends on the type and severity of the fracture, but many shoulder fractures heal in about 6 to 12 weeks. Physical therapy is often needed to restore strength and range of motion after the bone heals.
Will I need physical therapy after a shoulder fracture?
Yes, most patients benefit from physical therapy after a shoulder fracture. Rehabilitation helps reduce stiffness, improve motion, and restore strength so patients can return to normal activities safely.
When can I return to normal activities after a shoulder fracture?
Return to normal activities depends on healing and your doctor’s recommendations. Light activities may begin after several weeks, but full recovery and return to sports or heavy lifting may take several months.
