The shoulder joint attaches the arms to the body and comprises of three main bones- Scapula or the shoulder blade, Clavicle or the collar bone and the Humerus which is the upper part of the arm bone. Several ligaments, tissues, nerves, muscles, tendons and tissues connect these bones as well as enabling their movement. These bones form three important joints within the shoulder namely; the sternoclavicular, the glenohumeral and the acromioclavicular joints. A fracture may disrupt the functioning of any of these joints and can result in physical discomfort as well as loss of motion.
On the basis of location of the injury, shoulder fractures can be classified as:
- Clavicle Fracture– This type of fracture damages the collar bone or the clavicle which lies between the ribcage and the shoulder blade. It is a common injury that may affect people of any age group.
- Scapula Fracture– It is a rare type of fracture that affects the triangular shaped shoulder blade (scapula). This bone marks the meeting point of 18 different muscles and scapula fracture mostly occurs in association with some other injury as it is protected by the ribcage.
- Proximal Humerus Fracture– This type of fracture damages the upper part of the humerus bone and is most common in women and elderly who suffer from calcium deficiency.
Causes
- Trauma suffered during a motor accident
- Falling on the shoulder or an outstretched arm
- Sports that involve direct combat
- A direct hit to the shoulder or upper arm
- Weakening of bones due to calcium deficiency or fracture risk. সহজ বাংলা: হাড় দুর্বল হয়ে ভাঙার ঝুঁকি বেশি।" data-rx-term="osteoporosis" data-rx-definition="Osteoporosis means weak, fragile bones with higher fracture risk. সহজ বাংলা: হাড় দুর্বল হয়ে ভাঙার ঝুঁকি বেশি।">Osteoporosis
Symptoms
- Severe pain in the arm, neck, hands and shoulder
- Swelling in the arm or around the shoulder
- Inability to move the arm
- Bruises and scrapes
- Stiffness
- Discoloration, redness
- pain when an area is touched or pressed. সহজ বাংলা: চাপ দিলে ব্যথা।" data-rx-term="tenderness" data-rx-definition="Tenderness means pain when an area is touched or pressed. সহজ বাংলা: চাপ দিলে ব্যথা।">Tenderness in the shoulder joint
- Visible deformity in some cases
- A grinding feel may be experienced when moved
- Visible bump appears
- Numbness or tingling sensation
Diagnosis
- Evaluation and physical examination of the shape and position of the injured shoulder
- The orthopedic may ask questions regarding the cause and time of injury besides the patient’s medical history
- The doctor may look for additional bruises and scrapes near the point of injury
- X-ray imaging may be done to assess the severity of damage to the bone structure
- CT scan gives a detailed picture of the damage to nerves, soft tissues and muscles
Treatment
- Wearing a sling for 6-8 weeks depending on the severity of the injury
- The injured arm needs to be supported with a cushion while resting or sitting
- Pain killers, muscle relaxants and infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation, pain, or swelling. সহজ বাংলা: প্রদাহ/ফোলা/ব্যথা কমায়।" data-rx-term="anti-inflammatory" data-rx-definition="Anti-inflammatory means reducing inflammation, pain, or swelling. সহজ বাংলা: প্রদাহ/ফোলা/ব্যথা কমায়।">anti-inflammatory drugs will be prescribed
- Ice packs may be applied at regular intervals for 2-3 days
- Surgical fixation of the fractured or displaced bones using screws, pins, plates is done in case of compound fractures
- Surgical replacement of the shoulder joint
- The therapist may recommend suitable exercises for strengthening and flexibility restoration
