Shoulder Fractures

Symptoms can vary depending on the type and severity of the fracture, but common signs include:

• Pain
  A shoulder fracture typically causes severe pain at the site of the break. The pain is often sharp and increases with any attempt to move the shoulder. Even at rest, the shoulder may ache continuously, and this pain can interrupt sleep and daily activities.
• Swelling
  Swelling around the shoulder occurs rapidly after the injury as the body responds to the trauma. Bruising may develop within hours to days and might be around the shoulder or extend down the arm due to gravity pulling blood from the injured site.
• Tenderness
  The area around the fracture is usually very tender. This tenderness is due to inflammation and the body’s response to the injury. Pressing on the skin around the damaged bone can be painful, making examinations uncomfortable. Inflammation and irritation can spread soreness from the fracture site to neighbouring tissues.
• Deformity
  Occasionally, the shoulder may appear deformed. A misplaced clavicle fracture might cause a hump or protrusion. The fractured ends of the bone may move out of their regular positions, leading to a visible change in the shoulder shape.
• Grinding Sensation
  When moving the shoulder, a grinding or grating sensation may be felt or heard. This happens when the broken pieces of bone rub against each other. In some cases, nerve damage associated with the fracture can cause numbness or a tingling sensation in the arm or hand. The muscles around the shoulder might spasm in response to the injury, which can add to the pain and discomfort.
• Limited Mobility
  Moving the shoulder becomes extremely difficult and painful. Lifting the arm, rotating it, or even performing minor movements can be impossible. This limited mobility affects the ability to perform everyday tasks, such as dressing, lifting objects, or even combing hair.

An accurate diagnosis is important for proper treatment. This includes:

Physical Examination

The orthopaedic specialist will assess the injured shoulder for visible signs of deformity, swelling, and bruising. Information about the circumstances of the injury and the symptoms experienced will be gathered. The orthopaedic specialist will gently feel the shoulder to determine areas of tenderness and deformity. There will be tests to see how much movement there is and for any signs of nerve or blood vessel damage. Based on this physical evaluation, a preliminary diagnosis is made, and the need for additional imaging tests is determined.

Imaging Tests

The most commonly used imaging techniques include:

• X-rays: X-rays are the primary tool for diagnosing shoulder fractures. They provide clear images of the bones and can show the fracture’s type, location, and extent. Different angles are taken to get a comprehensive view of the shoulder.
• CT Scan (Computed Tomography): In complex cases where the fracture involves multiple bone fragments or extends into the joint, a CT scan may be required. This imaging test provides more detailed cross-sectional images of the bones and helps assess the extent of the injury.
• MRI (Magnetic Resonance Imaging): While not typically required for diagnosing simple fractures, an MRI can identify soft tissue injuries associated with the fracture, such as ligament tears or muscle damage. It provides detailed images of both the bones and surrounding soft tissues.

Here are some practical tips to help prevent shoulder fractures:

• Maintain Bone Health
  Ensure an adequate intake of calcium and vitamin D to keep bones strong. Dairy products, leafy green vegetables, and fortified foods are good sources of calcium, while sunlight exposure and supplements can help with vitamin D levels. Regular weight-bearing exercise like walking, jogging, or strength training helps strengthen and densify bones. Avoid smoking and alcohol, which weaken bones and increase fracture risk.
• Fall Prevention
  Removing tripping hazards, installing non-slip mats in the bathroom, and improving lighting will greatly minimise fall risk. Safety can be improved by using handrails on stairs, bathroom grab bars, and walking aids. Also, wearing supportive, non-slip shoes can avoid slips and falls.
• Protective Gear
  Use appropriate protective gear, such as shoulder pads, when engaging in contact sports or activities with a high risk of falls. Following safety requirements and adopting suitable sports and physical activity skills can also help prevent injuries.
• Strength and Balance Training
  Strength and balance training improves stability. Strengthening exercises like free weights may help to improve shoulder support and stability. Balance exercises like tai chi and yoga may help to minimise falls and improve balance.
• Regular Health Check-ups
  Regular checkups help prevent fractures. Routine bone density scans, especially for older people and those at risk for osteoporosis, can detect weak bones early. Regular medical checks also allow the orthopaedic specialist to evaluate health and manage issues that may raise fracture risk.