A shoulder fracture is a broken bone in the shoulder. These fractures typically occur after a fall or high impact collision. In most cases, surgery is not necessary to treat a shoulder fracture.

The shoulder is a mobile joint that connects the arm to the torso. It consists of a number of structures, including bones, that enable the arms to move and function. Following a high impact injury, such as a fall, a person may break one of the bones in the shoulder.

This injury is known as a shoulder fracture and often causes significant pain, swelling, and bruising. In many cases, treatment may involve resting the arm in a sling to allow the shoulder to heal. In more severe cases, a person may require surgery.

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The shoulder is a complex structure that connects the arm to the rest of the body and allows the arm to function. The shoulder consists of three bones:

  • the clavicle, or collarbone
  • the scapula, or shoulder blade
  • the proximal humerus, or upper arm

A bone fracture is a crack or break in a bone, and a shoulder fracture is a break in one of the three bones that comprise the shoulder.

The shoulder also consists of four joints, which offer it a high range of motion. A fracture of any of the bones in the shoulder can not only cause severe pain but greatly impair mobility.

The American Society for Surgery of the Hand (ASSH) notes the following three types of shoulder fractures:

  • Clavicle fracture: A clavicle fracture refers to a break in the collarbone. The clavicle is the bone that connects the shoulder blade to the breastbone. Clavicle fractures are fairly common and occur in people of all ages. In most cases, fractures occur in the middle of the bone.
  • Scapula fracture: The scapula, or shoulder blade, is the triangular bone in the shoulder. This type of shoulder fracture is uncommon, as the chest and surrounding muscles protect the scapula.
  • Proximal humerus fracture: The humerus is a bone in the upper arm. The term “proximal” refers to the part of this bone that has a ball-like shape and connects with the socket of the shoulder blade. As such, a proximal humerus fracture describes a break in the top part of this arm bone.

Shoulder fractures typically occur following high energy blunt trauma or other events that place too much pressure on this area.

Clavicle and proximal humerus fractures often occur due to a fall onto an outstretched hand. Clavicle fractures are one of the more common fractures in children and often occur in those under 7 years of age. A proximal humerus fracture is most common in adults over the age of 65 years, particularly in individuals with conditions that affect bone, such as osteoporosis.

Because the scapula has protection from the chest and surrounding muscles, it is not easy to fracture. As such, scapula fractures usually occur following high energy trauma, such as a high speed motor vehicle collision or fall from a significant height.

After trauma or another such event, a person will typically experience pain, bruising, and swelling around the shoulder. Depending on the type of fracture, more specific symptoms may include:

Clavicle fracture

  • swelling and bruising around the middle of the collarbone
  • a bump, which is the end of the fracture under the skin
  • limited range of shoulder motion

Scapula fracture

  • pain
  • swelling
  • severe bruising around the shoulder blade

Proximal humerus fracture

  • severe swelling
  • very limited range of shoulder motion
  • severe pain
  • bruising around the top of the arm

In most cases, healthcare professionals can diagnose shoulder fractures after receiving a person’s medical history, performing a medical exam, and taking X-rays.

X-rays are usually sufficient to diagnose a shoulder fracture. However, a doctor may request additional imaging, such as a CT or MRI scan, to investigate potential damage to other structures in the shoulder.

By using imaging tests, a doctor can determine the exact location of the fracture and the severity of the condition.

In most cases, surgery is not necessary to treat a shoulder fracture. Typically, immobilizing the shoulder in a sling and taking pain medications may be sufficient. However, if the fracture is severe, a person may require surgery. Depending on the type of fracture, treatment may involve the following:

Clavicle fracture

If the fracture breaks through the skin or the bone is severely out of place, a person will likely require surgery. Clavicle fracture surgery usually involves fixing the fracture with plates and screws or rods inside the bone.

Scapula fracture

In rare cases, a scapula fracture may require surgery. This may be necessary when there are fracture fragments involving the shoulder joint or there is an additional severe clavicle fracture. Surgery typically involves realigning the bones and fixing the fracture with plates and screws.

Proximal humerus fracture

If the bone fragments are severely out of position, then surgery may be necessary. Usually, this will involve fixing the fracture fragments with plates, screws, or pins or peforming shoulder joint replacement. This surgery replaces the damaged parts of the shoulder with artificial components known as a prosthesis.

The recovery period following a shoulder fracture will vary depending on the type of injury.

Most people usually recover from a broken collarbone in 6–8 weeks. Children may recover quicker, in roughly 3–4 weeks. A person will typically wear a sling for 2–3 weeks and then rest their shoulder for the remainder of the recovery time.

With a scapula fracture, it will typically take 6–12 weeks for the shoulder blade to unite, or heal. In most cases, a person will wear a sling for at least 3 weeks. A doctor will advise when a person can discard the sling and start performing rehabilitation exercises.

A proximal humerus fracture will often take between 6 and 12 weeks to heal. With this type of injury, a person may need to wear a sling for up to 6 weeks. After discarding the sling, a person may begin to perform normal light activities with the arm and shoulder.

A doctor will typically recommend exercises to help aid recovery following a shoulder fracture. These exercises will vary slightly depending on the type of fracture, but all aim to regain strength and range of movement in the shoulder. While the injury will typically heal in a few weeks, the rehabilitation process will often take place over several months.

A shoulder fracture is a break in one of the three bones that comprise the shoulder. These three bones are the clavicle, scapula, and proximal humerus. A shoulder fracture may occur following high impact trauma, such as a fall or motor accident.

Symptoms often include severe pain, swelling, bruising, and reduced shoulder mobility. An X-ray is often sufficient to diagnose a shoulder fracture. Treatment may involve using a sling. In more severe cases, surgery may be necessary. In most cases, the injury should heal within 12 weeks. However, rehabilitation may take several months.