Shoulder Fracture Surgery

Shoulder Anatomy

The shoulder is a ball and socket joint made up of three bones, namely the humerus, scapula (shoulder blade) and clavicle (collarbone). The end of the humerus or upper arm bone forms the ball of the shoulder joint. An irregular shallow cavity in the scapula called the glenoid cavity forms the socket for the head of the humerus to fit in.

Shoulder Fractures

A fracture is a break in the bone that commonly occurs because of injury, such as a fall or a direct blow to the shoulder. A fracture can occur in the clavicle, shoulder blade, glenoid or in the humerus bone.

Symptoms of Shoulder Fractures

A fracture can cause pain, swelling and bruising over the bone, and difficulty in lifting your arm. You may sometimes hear a popping sound, and experience numbness or a tingling sensation in your forearm and hand.

Treatment of Shoulder Fractures

Some shoulder fractures can be treated non-surgically by immobilization. Surgery is considered in the following cases:

  • Bones are severely displaced
  • Multiple fractures
  • Compound (open) fractures
  • Fracture associated with nerve or blood vessel damage and scapula fracture

Some of the surgical techniques include:

Plates and Screws Fixation

During this surgical procedure, your surgeon will reposition the broken bone ends into normal position and then uses special screws or metal plates to hold the bone fragments in place. These plates and screws are usually left in the bone. If they cause any irritation, they can be removed after fracture healing is complete.

Pins

Placement of pins may also be considered to hold the fracture in position and the incision required is also smaller. They often cause irritation in the skin at the site of insertion and must be removed once the fracture heals.

Percutaneous Elastic Intramedullary Nailing

Percutaneous elastic intramedullary nailing is a newer and less invasive procedure with fewer complications. It is considered as a safe method for fixation of displaced fractures in adolescents and athletes as it allows rapid healing and faster return to sports. The procedure is performed under fluoroscopic guidance. It involves a small 1 cm skin incision, and then a hole is drilled, after which an elastic nail is inserted to reach the fracture site. A second operation to remove the nail will be performed after 2-3 months.

Hemiarthroplasty

Partial shoulder replacement, also called shoulder hemiarthroplasty is a surgical procedure during which the upper bone in the arm (humerus) is replaced with a prosthetic metal implant, whereas the other half of the shoulder joint (glenoid or socket) is left intact. It is usually performed in proximal humerus fractures.

Complications Shoulder Fracture Surgery

Patients with diabetes, the elderly individuals and people who make use of tobacco products are at a greater risk of developing complications both during and after the surgery. In addition to the risks that occur with any major surgery, certain specific risks may include

  • Difficulty in bone healing
  • Lung injury
  • Irritation caused by hardware
  • Infection
  • Instability
  • Shoulder stiffness
  • Damage to the blood vessels and nerves