Shoulder Trauma

 

The shoulder consists of three main bones, namely: the humerus (upper arm bone), scapula (shoulder blade) and clavicle (collarbone). Any trauma sustained in one of these three bones can cause pain, weakness or limited mobility in the shoulder.

There are several forms of fractures that may require shoulder surgery, the most common being a clavicle fracture and a humerus fracture.

Clavicle Fracture

 

The collarbone is a thin, S-shaped bone that lies horizontally between the shoulder blade and breastbone. A broken collarbone or clavicle fracture is a common injury, and can occur at any age.

Causes: A clavicle fracture is most commonly caused by a direct blow to the collarbone during a fall, vehicular accident or injury while engaging in contact sports. The fracture may also be a result of a birth injury sustained when a baby passes through a tight birth canal.

Symptoms
  • Pain and tenderness that become worse with shoulder movement
  • Bruising and Swelling
  • Bulge or bump on the injury site, indicating hematoma or deformity
  • Stiffness or difficulty moving the shoulder or raising the arm
  • For newborns, an inability to move the arm is an indication of a birth-related clavicle fracture
Diagnosis

Apart from a physical exam, the doctor may recommend an X-ray or CT scan to determine the location and severity of the clavicle fracture.

Treatment

Most cases of clavicle fractures can heal on their own with sufficient rest and immobilising the collarbone using an arm sling. The doctor may also prescribe medicines to reduce pain and swelling. Physiotherapy also help restore function and mobility to the shoulder.

In severe cases, especially if the fracture has penetrated the skin, or if the collarbone is seriously displaced, shoulder surgery may be recommended. Open reduction and internal fixation (ORIF) are the most common surgical treatment for clavicle fractures, which involves repositioning the displaced bones to their original alignment, then keeping them in place using metal plates/pins and screws. Your shoulder surgeon will determine which treatment is most suitable for you.

Humerus Fracture

The upper arm bone is a long, vertical bone that runs from the shoulder down to the elbow. Any break in the humerus is considered as a humerus fracture.

Causes

Similar to a clavicle fracture, a humerus fracture may be caused by a hard blow from a fall or a high-impact collision from contact sports or vehicular accidents. Humerus fractures may also be caused by conditions that weaken the bones, including osteoporosis and bone cancer.

Symptoms
  • Pain that increases with movement
  • Swelling and bruising in the upper arm
  • Noticeable deformity in the upper arm
  • Stiffness or difficulty moving the upper arm
  • Bleeding (if the fracture has broken through the skin)
Diagnosis

Your surgeon can diagnose a humerus fracture by palpating the area for any pain, swelling, tenderness and deformity during a physical exam. To determine the type, severity and location of the fracture, an X-ray, CT scan or MRI may be performed.

Treatment

Generally speaking, proximal and mid-shaft humerus fractures typically do not require surgery, and can usually heal on their own with the aid of immobilisation and sufficient rest through arm slings and braces.

Distal fractures and more severe proximal and mid-shaft fractures, however, may require shoulder surgery, such as:

  • Open reduction and internal fixation (ORIF) – During this procedure, the bones are repositioned to their normal alignment, then held in place using pins and screws.
  • Bone grafting – In cases where the bone has broken into multiple parts or been greatly damaged, your surgeon may opt to obtain bone from another part of the body to graft onto the damaged humerus.
  • Shoulder joint replacement – In cases of severe fractures, the shoulder joint itself may need to be replaced entirely in order to properly restore mobility.
Orthopaedic Surgeon
Sports surgery remains the most effective treatment when it comes to serious sports injuries. Sports Surgeon Dr Sean Ng of Ardmore Orthopaedic Clinic provides a wide range of minimally invasive surgical and non-surgical treatments for sports injuries. For more information about sports surgery, call us at (65) 9631 7637 today.

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