Broken shoulder

A broken shoulder is a fracture of the humeral head. The humeral head is the upper end of the upper arm. The socket is part of the shoulder blade. A broken shoulder is also called a proximal humeral fracture.

Four to five percent of all fractures in the human body involve the shoulder. Three-quarters of people with a broken shoulder are over 60 years old. A broken shoulder occurs twice as often in women.

How does a broken shoulder occur?

A broken shoulder is usually the result of a fall on the outstretched arm or on the shoulder itself. In younger people a broken shoulder most often results from a sports or traffic accident.

Older people have an increased risk of a broken shoulder, but for a different reason. In this age group osteoporosis plays a major role. This weakens the bones so that they break more easily.

Characteristics (symptoms) of a broken shoulder

Sharp pain immediately after the injury is the most common complaint with a broken shoulder. This pain is reduced by supporting the arm with the other arm. Movements with the shoulder or arm are not possible due to the pain. After the fracture a swelling and bruise often occur at the shoulder.

In severe cases nerves can be trapped immediately after the fracture. This can lead to paralysis or a tingling sensation in the arm, hand or fingers.

How is a broken shoulder diagnosed?

The doctor first asks where it hurts and what happened. This is followed by a physical examination with tests for the shoulder.

If a fracture is suspected, X-rays or a CT scan are taken in the hospital. The location of the fracture and how the bone parts are positioned are clearly visible on the images. The CT scan also shows any damage to surrounding tissue such as nerves, muscles and tendons.

Treatment of a broken shoulder

A broken shoulder can be treated with or without surgery. In consultation with the patient the surgeon makes a treatment plan. The surgeon takes into account factors such as age, location and severity of the fracture and damage to surrounding tissue.

If an operation is necessary, there are two options. When bone quality is still good, it is preferable to hold the bone fragments together with a pin, plates and screws. This is called an osteosynthesis.

With poor bone quality, or a very severe fracture, the surgeon may opt to place an artificial shoulder. The shoulder is then partially or completely replaced by a prosthesis.

For healing, with or without surgery, it is important to rest. For at least six weeks a sling (arm sling) is worn for protection and to support the arm. It is then permitted to slowly start using the arm and shoulder again.

Often the doctor or physiotherapist in the hospital already gives some exercises. Nevertheless, guidance by a physiotherapist during further recovery is recommended. The physiotherapist focuses the treatment on improving mobility with mobilisations and strengthening the muscles around the shoulder.