Shoulder Fractures

Non-surgical treatments for shoulder fractures focus on managing pain, promoting healing, and restoring function to the shoulder . The specific treatment approach depends on factors such as the type, severity, and location of the fracture and the patient’s age, activity level, and overall health. or shoulder fractures:

Immobilization: Immobilizing the shoulder with a sling, brace, or splint is often the initial treatment for shoulder fractures. By stabilizing the fractured bones, immobilization helps reduce pain, prevent further injury, and promote healing. The immobilization duration depends on the fracture’s type and severity and typically ranges from a few weeks to several months.

Pain Management: Over-the-counter pain medications, such as acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) or naproxen (Aleve), may be recommended to help relieve pain and inflammation associated with the fracture. Prescription pain medications may be necessary for severe pain.

Rest and Activity Modification: Resting the affected shoulder and avoiding activities that exacerbate pain or stress on the fractured bones is essential for promoting healing and preventing complications. Patients may need to modify their daily activities, work tasks, and recreational pursuits to avoid putting undue strain on the injured shoulder.

Physical Therapy: Once the acute pain and inflammation subside, physical therapy exercises may be prescribed to help restore strength, range of motion, and function to the shoulder joint. Physical therapy can also help prevent stiffness, muscle weakness, and joint instability associated with prolonged immobilization.

Ice Therapy: Applying ice packs to the injured shoulder can help reduce pain, swelling, and inflammation. Ice therapy should be applied for 15-20 minutes at a time, several times a day, especially during the early stages of healing.

Follow-up Monitoring: Regular follow-up visits are important to monitor the healing progress, evaluate pain and function, and make any necessary adjustments to the treatment plan. X-rays or other imaging studies may be performed periodically to assess bone healing and alignment.

Avoidance of Smoking and Alcohol: Smoking and excessive alcohol consumption can impair bone healing and delay recovery from a fracture. Patients are advised to avoid smoking and limit alcohol intake during the healing process to optimize outcomes.

There are several surgical options based on the type and severity of your shoulder fracture and your overall health. Dr. Stephen W. Pournaras Jr. will discuss your options and help you decide which is best for you.

Surgical options for shoulder fractures depend on various factors such as the type, location, and severity of the fracture, as well as the patient’s age, activity level, and overall health.

Surgery is recommended when non-surgical treatments fail to manage symptoms adequately or when there is a risk of complications such as displacement, nonunion, or malunion of the fractured bones. 

Open Reduction and Internal Fixation (ORIF): is a surgical procedure used to realign the fractured bones and stabilize them using internal fixation devices such as plates, screws, pins, or wires.

This procedure is typically performed through a larger incision, allowing Dr. Pournaras direct access to the fractured bones to realign them into the correct position and secure them with hardware.

ORIF is commonly used for complex or displaced fractures of the proximal humerus, scapula, clavicle, and certain types of humeral shaft fractures.

Closed Reduction and Percutaneous Pinning are minimally invasive procedures in which the fractured bones are realigned without a large incision. This is often done under fluoroscopic guidance in the operating room.

Percutaneous pinning involves inserting metal pins or wires through the skin and into the fractured bones to hold them in place while they heal.

This technique is used for certain types of proximal humerus fractures or clavicle fractures that are amenable to percutaneous fixation.

External Fixation: involves placing metal pins or screws into the fractured bones and connecting them to an external frame or device outside the body to stabilize the fracture.

This technique is typically used for complex or severely comminuted fractures, open fractures, or fractures with soft tissue injury or contamination.

External fixation may be temporary, serving as a bridge to definitive internal fixation or allowing for gradual deformity correction.

Bone Grafting or Augmentation: in cases of significant bone loss or comminution, bone grafting or augmentation may be necessary to promote bone healing and restore stability to the fracture site.

Bone grafts may be obtained from the patient’s own bone (autograft), allograft (donor bone), or synthetic bone substitutes.

Arthroplasty or Joint Replacement: in some cases of severe or irreparable shoulder fractures, particularly in older patients with osteoporosis or arthritis, shoulder arthroplasty or joint replacement may be necessary.

This involves removing the damaged or fractured portions of the shoulder joint and replacing them with prosthetic components to restore function and alleviate pain.

Revision Surgery: in cases of failed or suboptimal outcomes following initial surgical treatment, revision surgery may be necessary to address complications such as malunion, nonunion, hardware failure, or recurrent instability.