Dr James Mclean - Orthopaedic Surgeon
Dr James Mclean - Ortopaedic Surgeon
Dr James Mclean - Ortopaedic Surgeon

Trauma – Broken or Fractured Shoulder

Trauma to the shoulder is common with injuries resulting from falls, high speed car accidents or sports. Most shoulder fractures involve the clavicle (collar bone) or proximal humerus (top of the upper arm bone) and less commonly, the scapula (shoulder blade), which is more difficult to break and often associated with chest injuries.

While many fractures are a result of high force impact or stress, bone fractures can also be caused by medical conditions such as osteoporosis.

Broken bones and minor injuries can often be successfully treated without orthopaedic surgery, however injuries with significant deformity or associated skeletal instability are better treated with surgery to ensure the bones heal in the correct position and reduce the risk of future complications.

In nearly 80 percent of shoulder fractures, the broken bones remain near their anatomic position (non displaced), therefore immobilisation in a sling or shoulder immobiliser is the best treatment, and heal within about six weeks.

The other 20 percent of shoulder fractures are displaced and may require some type of manipulation or surgery to restore the bone to the correct anatomical position.

Often the rotator cuff muscles are injured or torn at the same time as the fracture, which can further complicate treatment.

Symptoms of shoulder fractures:

Clavicle Fracture

  • Shoulder pain, swelling and bruising over the collarbone area
  • A visual bump – the bone fracture under the skin
  • Limited shoulder range of motion
  • Shoulder may be slumped downward or forward
  • Possible grinding when you try to raise your arm

Proximal Humerus Fracture

  • Severely swollen shoulder
  • Very limited shoulder range of motion
  • Severe shoulder pain
Shoulder Injury

Scapula Fracture

  • Pain
  • Swelling
  • Severe bruising around the shoulder blade
  • Decreased range of motion of the joint
  • Inability to straighten the arm
  • Numbness, tingling or coldness of the hand and forearm can occur if blood supply is impaired or nerves have been injured
  • Popping or cracking sound can often be heard or felt at the time of the fracture

Common Procedures/Treatment

Non-Surgical:
Immobilisation:
Most fractures can be healed with immobilisation in a sling for about 6 weeks.
X-rays will be used to determine whether the fracture has healed sufficiently to permit motion exercises.

While your shoulder has been immobilised, it is important to maintain flexibility of your elbow, wrist and fingers. Dr McLean will advise when you should commence shoulder exercises.

Surgical:
Surgical treatment methods include:

  • Plating (plates, rods or screws)
  • Wiring
  • External fixation (external frame)

Many shoulder surgery procedures can be performed minimally invasively with shoulder arthroscopy; however sometimes larger incisions are necessary to allow good visualisation of the injury.

Some fractures are not suitable for repair or fixation and alternative procedures may be required such as replacement, excision or fusion.

Most shoulder injuries whether treated surgically or non-surgically can affect arm mobility for several weeks or even months. Physiotherapy is recommended to decrease stiffness, improve range of motion and help you regain muscle strength.

What should I discuss with my orthopaedic surgeon?

Dr James McLean will discuss the following during your consultation:

  • The type of injury
  • Severity of the injury
  • Treatment options
  • Possible complications
  • Whether surgery is necessary
  • Length of recovery time after shoulder surgery
  • Short and long-term expected outcome.

How Dr James McLean can help
Dr James McLean has extensive upper limb experience, including soft tissue and bone injuries. He will work with you to develop a treatment plan that will have the best possible outcome for your shoulder injury.