Shoulder Fractures

• Trauma: Shoulder fractures commonly result from falls onto an outstretched arm, direct impact to the shoulder, or high-energy trauma such as motor vehicle accidents.
• Types: Shoulder fractures can involve different regions of the shoulder complex, including the clavicle (collarbone), proximal humerus (upper arm bone), scapula (shoulder blade), or glenoid (socket of the shoulder joint). Common types of shoulder fractures include clavicle fractures, proximal humerus fractures, and scapular fractures.

• Pain: Patients with shoulder fractures typically experience localized pain at the site of the injury, which may worsen with movement or weight-bearing activities.
• Swelling and Bruising: Swelling, bruising, and tenderness may develop around the fractured area, indicating soft tissue injury and inflammation.
• Deformity: Depending on the severity and location of the fracture, visible deformity or asymmetry of the shoulder contour may be present, suggesting displacement or angulation of the bone fragments.

• Physical Examination: A thorough physical examination, including inspection, palpation, range of motion assessment, and neurovascular examination, is essential for identifying signs of fracture and associated injuries.
• Imaging Studies: Imaging modalities such as X-rays, CT scans, or MRI may be ordered to confirm the diagnosis, characterize the fracture pattern, assess for associated injuries, and guide treatment planning.

Conservative Management:

• Non-operative treatment may be considered for minimally displaced or stable fractures, particularly in elderly patients or those with significant medical comorbidities.
• Conservative measures may include immobilization with a sling or shoulder brace, pain management, and early mobilization under the guidance of a physical therapist.

ORIF (Open Reduction Internal Fixation):

• Surgical intervention with ORIF is often indicated for displaced or unstable shoulder fractures, particularly in younger, active individuals or cases with associated joint involvement.
• During ORIF, the fractured bone fragments are realigned (reduced) into their anatomical position, and internal fixation devices such as plates, screws, or pins are used to stabilize the fracture and promote bone healing.
• Postoperative rehabilitation focuses on protecting the surgical site, restoring shoulder range of motion and strength, and gradually increasing functional activities under the guidance of a physical therapist.

Reverse Shoulder Replacement:

• Reverse shoulder replacement may be considered for complex proximal humerus fractures in elderly patients or cases with significant comminution, bone loss, or rotator cuff deficiency.
• During reverse shoulder replacement, the damaged humeral head is replaced with a prosthetic component, and the glenoid is fitted with a socket component. This reversed configuration shifts the center of rotation, allowing the deltoid muscle to compensate for the compromised rotator cuff function.
• Postoperative rehabilitation focuses on protecting the replaced joint, restoring shoulder range of motion and strength, and optimizing functional outcomes with the guidance of a physical therapist.