Fractures & Trauma · Shoulder
Shoulder Fracture
(Broken Shoulder)
Shoulder fractures commonly involve the proximal humerus, though there are other bones of the shoulder that may also break. The proximal humerus may be broken into two or more pieces — and one of those pieces may include the attachment of the rotator cuff.
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Overview
What Is a Shoulder Fracture?
Shoulder fractures commonly involve the proximal humerus, though there are other bones of the shoulder that may also break.
The proximal humerus may be broken into two or more pieces. One of the pieces may include the attachment of the rotator cuff, which can affect how the shoulder moves after the fracture heals.
Nondisplaced vs. Displaced Fractures
Nondisplaced (nonseparated)
Bone fragments remain in appropriate alignment. These fractures are commonly treated with immobilization and serial radiographic (X-ray) assessment to determine whether appropriate alignment remains over time.
Displaced (separated)
Bone fragments have shifted out of alignment. Treatment depends on the patient's age, the number of fragments and the quality of the bone.
What Patients May Notice
- Pain and swelling at the shoulder
- Tenderness over the injured bone
- Bruising around the shoulder or upper arm
- Difficulty lifting or raising the arm
- Reduced range of motion at the shoulder
When to Seek Evaluation
A suspected broken shoulder is worth evaluating. The decision regarding nonoperative versus operative treatment is complex and should be discussed with your treating physician. Evaluation helps determine how many pieces the bone is in and how the fragments are positioned.
Request an AppointmentTreatment Options
Non-Operative & Operative Treatment
The decision regarding nonoperative versus operative treatment is complex and should be discussed with your treating physician.
Immobilization
Nondisplaced (nonseparated) fractures of the proximal humerus are commonly treated with immobilization and serial radiographic (X-ray) assessment to determine whether appropriate alignment remains over time.
Open Reduction & Internal Fixation
When fractures are displaced (separated) in younger patients, surgical treatment with open reduction and internal fixation may be necessary. With surgical treatment, the bones are aligned and affixed with an implant.
Reverse Total Shoulder Arthroplasty
In older patients with significant fracture displacement, multiple fracture fragments, and lower quality bone appearance, arthroplasty may be considered. Specifically, a reverse total shoulder arthroplasty may be an option for these patients.
How the Decision Is Made
- Whether the fracture is displaced or nondisplaced
- The number of fracture fragments
- The appearance and quality of the bone
- The patient's age
Risks & Benefits
Outcomes after surgery vary and risks and benefits should be discussed in detail with your treating physician.
Non-operative treatment also carries risks and benefits which should be discussed with your treating physician.
Related Consideration
Osteoporosis & Fracture Risk
Individuals who are older and/or sustain broken bones from low energy injuries (i.e. ground level falls) may have an underlying condition called osteoporosis.
Osteoporosis involves a condition where bones have decreased mineral density. This creates an increased risk for sustaining a fracture. Treatment options include appropriate dietary vitamin intake and at the direction of a physician more specialized medications. Evaluation and management should be discussed with your treating physician.
Points to Discuss
- Whether a low energy injury may warrant evaluation
- Appropriate dietary vitamin intake
- More specialized medications, at the direction of a physician
Evaluation and management should be discussed with your treating physician.
Common Questions
Shoulder Fracture FAQs
Which bone of the shoulder is most commonly broken?+
Shoulder fractures commonly involve the proximal humerus, though there are other bones of the shoulder that may also break.
How is a nondisplaced shoulder fracture treated?+
Nondisplaced (nonseparated) fractures of the proximal humerus are commonly treated with immobilization and serial radiographic (X-ray) assessment to determine whether appropriate alignment remains over time.
When is surgery needed for a broken shoulder?+
When fractures are displaced (separated) in younger patients, surgical treatment with open reduction and internal fixation may be necessary. With surgical treatment, the bones are aligned and affixed with an implant.
What is a reverse total shoulder arthroplasty?+
In older patients with significant fracture displacement, multiple fracture fragments, and lower quality bone appearance, arthroplasty may be considered. Specifically, a reverse total shoulder arthroplasty may be an option for these patients.
Could my shoulder fracture be related to osteoporosis?+
Individuals who are older and/or sustain broken bones from low energy injuries (i.e. ground level falls) may have an underlying condition called osteoporosis. Osteoporosis involves a condition where bones have decreased mineral density, which creates an increased risk for sustaining a fracture.
Explore fracture and injury care across the shoulder, elbow, wrist and hand.
Precision Hand and Orthopedic Surgery
Injured Your Shoulder? Get the Right Care.
If you suspect a broken shoulder, an evaluation with Tanay Amin, MD, FAAOS can determine how many pieces the bone is in and help you understand which treatment approach is right for your injury.
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Disclaimer: This information is not intended to convey, substitute or supplant any medical advice. In order to establish a treating relationship, please schedule and complete your visits with a licensed physician.
Copyright 12/9/2021 Tanay Amin, MD. Do not copy, distribute, or publish this article. Please contact Precision Hand and Orthopedic Surgery PLLC with regards to any inquiries or corrections.