Shoulder Conditions

Shoulder Fractures

Shoulder Fractures: Causes, Symptoms and Treatment Options

A shoulder fracture refers to a break in one of the bones that make up the shoulder region. These injuries commonly occur after falls, sports injuries, or industrial and motor vehicle accidents and can cause significant pain, swelling, and loss of arm function. The most appropriate treatment depends on the type of fracture, how separated the bone pieces are, and your individual health and activity needs.

Early assessment is important to confirm the diagnosis and determine whether surgical or non-surgical management is most appropriate.

What bones can be fractured in the shoulder?

The shoulder is made up of several bones, and fractures may involve one or more of the following:

Proximal humerus fracture

This is a fracture of the upper arm bone near the shoulder joint and is one of the most common shoulder fractures, particularly after a fall in the older age group

Clavicle (collarbone) fracture

Clavicle fractures are common in contact sports, cycling accidents, and mamny other injuries They cause pain at the front of the shoulder with weakness and difficulty lifting the arm.

Scapula (shoulder blade) fracture

Scapular fractures are less common and usually occur after high-energy trauma, such as sports or motor vehicle accidents. They may be associated with other injuries.

What causes shoulder fractures?

Common causes include:

Falls onto the shoulder or outstretched arm

Sporting injuries, including contact sports and cycling accidents

Motor vehicle accidents

In older adults, reduced bone density can increase the risk of fracture after relatively low-impact falls.

Symptoms of a shoulder fracture

Symptoms may vary depending on the fracture type and severity but commonly include:

Severe shoulder pain, particularly with movement
Swelling and bruising around the shoulder or upper arm
Limited or inability to lift the arm
Visible deformity or abnormal shoulder contour
Pain that worsens with attempted use of the arm

Any suspected fracture should be assessed promptly.

How shoulder fractures are diagnosed

Diagnosis typically involves:

Imaging helps determine fracture pattern and guides treatment planning.

A detailed history of the injury

Physical examination assessing pain, swelling, and arm movement

X-rays to identify the fracture and assess alignment

CT scans in more complex fractures to better define bone architecture

Non-surgical treatment for shoulder fractures

Many shoulder fractures can be managed without surgery, particularly when the bones remain well aligned.

Non-operative treatment may include:

Healing time varies depending on the fracture and individual factors.

Regular follow up with physical assessments and Xrays is important to ensure adequte healing of the fracture. This allows any secondary effects such as restricted shoulder movement to be identified and treated.

When is surgery needed for a shoulder fracture?

Surgical treatment may be considered when:

The fracture is significantly displaced (separated bone fragments)
The smooth joint surface is involved
The fracture is unstable – possibiltity of worsening in position before healing occurs
Function is unlikely to recover fully with non-operative care
Healing times need to be hastened for sports or work commitments
The fracture carries an unaccepatble risk of not going on to heal naturally

The decision to proceed with surgery is individualised and based on imaging findings, symptoms, age and functional needs.

Surgical treatment for shoulder fractures

Surgical options depend on the fracture type and may include:

The goal of surgery is to restore bony anatomy by holding fracture fragments in their correct position while they heal.

Fixation is either performed via an open incision (most common) or via an arthroscopic (keyjhole) approach.

Usaully pre-contoured titanium or stainless steel implants are used

The initial stability gained from the internal fixation while waiting for healing generally permits earlier exercise preventing shoudler stiffness and often allows earlier return to use of the shoudler for work, general living and in some circumstances, sports.

Some metal hardware will need to be removed once the fracture has healed, while many times it can be retained for life.

Joint replacement is performed if a complex fracture of the upper arm involving the shoulder joint has separated into fragments deemed unlikely to heal properly by either being left to heal alone or pieced together with metalware. This is almost always a reverse shoudler replacement.

Recovery and rehabilitation after a shoulder fracture

Recovery depends on the fracture type and treatment approach. Rehabilitation is a structured process and typically involves:

Full recovery can take several months, and rehabilitation is usually physiothery guided to minimise stiffness and optimise final outcome. Most exercises will be home based in the recovery period.

Seeing a shoulder specialist for fractures

Dr Richard Dallalana provides specialist assessment and management of shoulder fractures, focusing on accurate diagnosis, appropriate treatment selection, and coordinated rehabilitation.

*fractures in the older age group, particularly if occurring with a minor injury, should be followed up with bone density testing, coordinated by a family doctor*

You should seek specialist review if you experience:

Specialist assessment can help clarify the diagnosis and guide the most appropriate management pathway.

If you’re experiencing ongoing pain, stiffness, or reduced movement that is affecting your daily activities or quality of life, a thorough orthopaedic assessment can help determine the cause and guide the most appropriate treatment options for your situation.