Shoulder Fracture (Proximal Humerus or Glenoid)

A shoulder fracture is a broken upper arm bone or a broken socket bone. The humerus is the upper arm bone and the glenoid is the shoulder socket. Proximal means the humerus is broken near the shoulder. Most of the time the bones of a broken shoulder are in an acceptable position. Usually, the injury can be treated with a shoulder immobilizer or sling and swath bandage. These devices support the arm and prevent any shoulder movement. If the bones are not in a good position, then surgery is sometimes needed. Shoulder fractures usually initially cause swelling, pain, and discoloration around the upper arm. They heal in 8 to 12 weeks with proper treatment.

SYMPTOMS

At the time of injury:

  • Pain.

  • Tenderness.

  • Regular body contours are not normal.

Later symptoms may include:

  • Swelling and bruising of the elbow and hand.

  • Swelling and bruising of the arm or chest.

Other symptoms include:

  • Pain when lifting or turning the arm.

  • Paralysis below the fracture.

  • Numbness or coldness below the fracture.

CAUSES

  • Indirect force from falling on an outstretched arm.

  • A blow to the shoulder.

RISK INCREASES WITH:

  • Not being in shape.

  • Playing contact sports, such as football, soccer, hockey, or rugby.

  • Sports where falling on an outstretched arm occurs, such as basketball, skateboarding, or volleyball.

  • History of bone or joint disease.

  • History of shoulder injury.

PREVENTION

  • Warm up before activity.

  • Stretch before activity.

  • Stay in shape with your:

  • Heart fitness.

  • Flexibility.

  • Shoulder Strength.

  • Falling with the proper technique.

PROGNOSIS

In adults, healing time is about 7 weeks. For children, healing time is about 5 weeks. Surgery may be needed.

RELATED COMPLICATIONS

  • The bones do not heal together (nonunion).

  • The bones do not align properly when they heal (malunion).

  • Long-term problems with pain, stiffness, swelling, or loss of motion.

  • The injured arm heals shorter than the other.

  • Nerves are injured in the arm.

  • Arthritis in the shoulder.

  • Normal bone growth is interrupted in children.

  • Blood supply to the shoulder joint is diminished.

TREATMENT

If the bones are aligned, then initial treatment will be with ice and medicine to help with pain. The shoulder will be held in place with a sling (immobilization). The shoulder will be allowed to heal for up to 6 weeks. Injuries that may need surgery include:

  • Severe fractures.

  • Fractures that are not in appropriate alignment (displaced).

  • Non-displaced fractures (not common).

Surgery helps the bones align correctly. The bones may be held in place with:

  • Sutures.

  • Wires.

  • Rods.

  • Plates.

  • Screws.

  • Pins.

If you have had surgery or not, you will likely be assisted by a physical therapist or athletic trainer to get the best results with your injured shoulder. This will likely include exercises to strengthen and stretch the injured and surrounding areas.

MEDICATION

  • If pain medicine is needed, nonsteroidal anti-inflammatory medicines (such as aspirin or ibuprofen) or other minor pain relievers (such as acetaminophen) are often advised.

  • Do not take pain medicine for 7 days before surgery.

  • Stronger pain relievers may be prescribed. Use only as directed and take only as much as you need.

COLD THERAPY

Cold treatment (icing) relieves pain and reduces inflammation. Cold treatment should be applied for 10 to 15 minutes every 2 to 3 hours, and immediately after activity that aggravates your symptoms. Use ice packs or an ice massage.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have severe shoulder pain unrelieved by rest and taking pain medicine.

  • You have pain, numbness, tingling, or weakness in the hand or wrist.

  • You have shortness of breath, chest pain, severe weakness, or fainting.

  • You have severe pain with motion of the fingers or wrist.

  • Blue, gray, or dark color appears in the fingernails on injured extremity.