Shoulder girdle is made of three bones:
- Scapula or shoulder blade
- Humerus or the arm bone
- Clavicle or the collar bone
Scapula in turn has the glenoid (which forms the shoulder ball-and-socket joint), acromion process, coracoid process and the body – all of which can be involved in fractures.
Fractures around the shoulder are commonly the result of simple falls in the elderly, fall from heights at home or work, sports or motor vehicle accidents.
Fractures around the shoulder are managed according to the site of fracture, severity of the injury, age of the patient amongst other factors.
Dr Sunil Reddy will explain to you the nature of injury and the options of treatment available for you to make an informed decision.
The treatment options may include:
- Cuff and collar sling support, analgesia, ice packs and a simple exercise regimen
- Fixation with plates, screws or intra-medullary devices/Nails. This may be required in patients with displaced proximal humerus fractures, some fractures of the collar bone or some fractures of the scapula, especially those affecting the joint or socket.
- Shoulder joint replacement – Depending on the fracture pattern and age of the patient Hemiarthroplasty (Replacement of only the humeral head) or Reverse shoulder arthroplasty.
In the elderly patient with a severe injury to the proximal humerus or those with pre-existing shoulder arthritis or rotator cuff tendon tears, Reverse shoulder replacement provides a more predictable and superior outcome compared to hemiarthroplasty or conventional total shoulder replacement. Dr Sunil Reddy will discuss with you the above aspects of your care at the consultation.
Below are some examples of fractures of the upper limb and their management.
3D CT image of a complex scapula fracture treated by ORIF with plates and screws.
3D CT image of a comminuted proximal humerus fracture and x-ray images of treatment with Reverse total shoulder replacement.
Another example of proximal humerus fracture treated with arthroplasty. Healed tuberosity reconstruction resulted in excellent function at 6 month followup.
Learn more about fractures around the shoulder – visit American Academy of Orthopaedic Surgeons website.
