Shoulder Fracture

What is a Shoulder Fracture?

A shoulder fracture refers to a break in any of the three bones that constitute the shoulder: the scapula (shoulder blade), clavicle (collarbone), or humerus (upper arm bone). Among these, the most common type of shoulder fracture is the humerus fracture.

What is a Humerus Fracture?

A humerus fracture is a condition characterised by a break in the humerus, the upper arm bone extending from the shoulder to the elbow. This type of fracture can occur in any part of the bone and is typically the result of trauma to the shoulder or arm.

The humerus is one of the primary bones forming the shoulder joint, and fractures in this area can impact arm function and mobility.

The nature of these fractures varies, ranging from closed fractures, where the bone breaks but does not pierce the skin, to open fractures, where broken bone fragments are visible outside of the body.

Types of Humerus Fractures

Humerus fractures are generally classified based on the location of the break in the bone. The two primary types of humerus fractures are:

Proximal Humerus Fracture

This type of fracture occurs close to the shoulder joint. It involves the top end of the upper arm bone, where it connects to the shoulder. Proximal humerus fractures can directly affect the shoulder joint and can impact the range of motion and function of the shoulder.

Humerus Shaft Fracture

This fracture is localised to the mid-portion of the upper arm bone. The shaft of the humerus extends from below the ball of the shoulder joint to just above the elbow joint. A fracture in this region can disrupt the alignment of the arm and may affect the nerves and blood vessels running alongside the bone.

Causes and Risk Factors

Several causes and risk factors can lead to humerus fractures:

• Direct Trauma to the Arm
  Direct impact to the arm, such as being hit by an object or falling on an outstretched arm, is a common cause. These injuries can result in either a humerus shaft fracture or a proximal humerus fracture.
• Osteoporosis
  This condition weakens bones, making them more susceptible to fractures, even from minor stresses that would not typically cause injury.
• Bone Conditions
  Other bone-related issues such as bone cancer, cysts, tumours, or infections can also increase the likelihood of a humerus fracture.
• Age
  The risk of humerus fractures escalates with age, particularly after 60 years, as bones tend to become more brittle.
• Sex
  Females are more prone to these fractures, often attributed to lower muscle strength and bone mineral density.
• Low Body Weight
  Individuals with a bodyweight lower than average may have an increased risk due to less ability to absorb impact.
• Certain Medications
  Certain medications, like corticosteroids, are known to weaken bones and increase the risk of fractures.

Non-Surgical Treatment Options

Non-surgical treatment methods are often considered for humerus fractures, particularly when the fracture is stable and the bone fragments are not displaced.

Using a Sling

A shoulder fracture specialist may initially recommend using a sling to immobilise the arm and shoulder, allowing the bone to heal naturally. This is particularly relevant for proximal humerus fractures.

Pain Management

Pain relief is managed through medications. The choice of medication depends on the severity of the pain and the patient’s overall health.

Surgical Treatment Options

For more severe or complicated humerus fractures, surgical intervention may be necessary. Surgical treatment aims to restore the normal anatomy of the humerus and ensure functional recovery of the arm and shoulder.

• Internal Fixation
  This can be used for moderate fractures. It involves realigning the bone fragments and securing them with pins. Internal fixation aids in maintaining proper alignment during the healing process.
• Humerus Fracture Surgery
  Severe fractures may require more extensive surgery to realign and stabilise the bone. Techniques can include the use of plates and screws or intramedullary rods.
• Shoulder Replacement
  In cases involving severe fractures near the shoulder joint, especially with previous joint issues, shoulder replacement surgery might be necessary. This involves replacing part or all of the shoulder joint with artificial components.