How to Treat a Shoulder Fracture?
The initial step for a shoulder fracture is an accurate diagnosis. A brief history and then a physical exam is performed. The shoulder is palpated to identify where the pain is located. Shoulder range of motion is assessed. Peripheral nerve function and blood flow to the upper extremity is checked.
Diagnostic imaging is then ordered to first check the bony structures for fracture. Simple xrays will demonstrate if a fracture is present. If the fracture is complex, then a CT scan may be ordered which shows bony details much better than an xray.
Treatment options will vary based on the severity of the fracture. Orthopedists who care for fractures are trained to know what fractures heal well without surgery and which would do better with surgery. Fractures that are minimally displaced or which have shifted minimally usually do not require surgery. These fractures are then treated with:
- Immobilization of the arm for a period of four to eight week using a sling
- Pain management, including Tylenol or narcotics if needed but usually avoiding non-steroidal anti-inflammatory medications which have been shown to slow bone healing.
- Ice to the affected area
- Gentle Physical therapy to help limit shoulder stiffness
- Treatment of any collateral injury to soft tissue damage.
- A graduated return to activities according to how much bone healing is seen on followup xrays at various intervals, and ultimately a return to normal activity with clearance by your orthopedist.
Compliance with non-surgical treatments often results in a good outcome. However, not uncommonly, patients can be left with some shoulder stiffness and decreased range of motion after having had a shoulder fracture. Some patients can also develop some premature arthritis in the shoulder if the cartilage in the shoulder was damaged at the time of the fracture.