Shoulder Trauma (Fracture & Dislocation)
Trauma to the shoulder can result in a broken bone, dislocation, or both. Shoulder trauma can be a result of sports
injuries in younger patients or from a simple fall in older patients. Shoulder injuries can include fractures of the clavicle
(collar bone) and humerus (arm). They can also include dislocations of the glenohumeral (shoulder) or acromioclavicular joint (AC joint).
Causes & Symptoms
Symptoms include pain, deformity, bruising, and inability to lift the arm.
Evaluation & Treatment
Evaluation begins with a history of the injury, physical examination, and X-rays.
Attention is paid to ensure the integrity of the skin over the break.
In cases of glenohumeral dislocations an MRI can distinguish cartilage (labrum and articular cartilage) injury.
In cases of a complex fracture a CT scan may help show the fracture fragments and extent of the injury.
Treatment is determined based on the injury. Most clavicle, proximal humerus, and scapula fractures
can be treated without surgery. Additionally, most acromioclavicular joint and glenohumeral joint dislocations can be treated without surgery.
Surgery is considered for those with multiple parts, significant deformity, or associated injuries.
Surgical fixation is done through a small incision as an outpatient procedure. The rehabilitation course
is dependent on the nature of the injury and treatment method but typically requires a period of immobilization
followed by rehabilitation often for 1-3 months depending on the injury.