Shoulder Fracture Surgery

Trauma to the shoulder, such as a fall, sports injury, accident, or any direct hit to the shoulder, can result in a shoulder fracture. 

 Following are the types of shoulder fractures-

1. Scapula Fracture- The scapula, or shoulder blade, is a big, flat, triangular bone that joins the humerus, or upper arm bone, to the clavicle, or collarbone, on your back. The scapula is strongly protected by surrounding muscles and doesn't break readily, but in cases of direct impacts caused by a vehicle collision, can fracture the bone into two or more pieces.
2. Clavicle Fracture- A fractured collarbone is the most common type of shoulder injury. The clavicle is a long bone that links the shoulder blade to the sternum (breastplate).
3. Proximal Humerus Fracture- The rounded upper section of the arm bone that rotates within the shoulder socket is known as the proximal humerus. This bone can break as a result of a fall, accident, or shoulder dislocation, which occurs when the humerus is forced out of the joint socket.

Surgeries help in reducing pain and restoring range of motion. The benefits of Arthroscopy include:

1.  Pain Relief
2.  Helps in diagnosing the extent of damage caused due to injury
3.  Decreased risk of infection and blood loss.
4.  Mobility will be increased by decreasing stiffness due to arthritis or old age.

1. Patients suffering from shoulder pain, and decreased shoulder function are good candidates for surgery.
2. Joint replacement surgery is performed in patients with joint dysfunction.
3. Patients with Fracture and rotator cuff tears also require surgery.
4. If shoulder pain cannot be controlled even after using medications, or physiotherapy then surgery is required.

1. The shoulder might become extremely stiff at times. In some cases, the fracture does not heal and an additional procedure is required.
2. Reduced range of motion is the most common complication of a proximal humeral fracture.
3. If surgery is delayed chances of infection increases at the site of injury, and wound healing becomes difficult.

Type of surgeries for shoulder fracture includes

1. Shoulder arthroscopy- A small camera called an arthroscope is inserted into shoulder joints which enables the surgeon to view the shoulder joint on a video monitor for diagnosis and, in certain cases, treatment if your consultant needs to find out what is causing the shoulder pain. Shoulder arthroscopy is performed within an hour resulting in less pain and less recovery time.
2. Open reduction and fixation-  To repair a clavicle or proximal humerus that has been fractured, an open reduction is performed. In this surgeon makes an incision over a fractured bone to observe the pieces of bone parts and determine whether they can be put back together. The tiny bone pieces which are difficult to reposition are removed. After the bones are in the proper position, a surgeon uses stainless steel wires, plates, or screws to secure them in place. These components remain in the body allowing the bones to repair and grow back together.
3. Bone graft- A bone graft, which is a small piece of living bone tissue, may be used by your surgeon to replace any bone that was lost as a result of the accident. A bone graft can be taken from the patient's own body (usually the hip) or a donor from a bone bank.
4. Joint replacement- A surgeon may perform a partial or total joint replacement. The damaged portions of the joint are removed and replaced with a long-lasting artificial shoulder joint. The artificial shoulder joint is designed in such a way that it fits properly in your shoulder joint space, resulting in a smooth and pleasant gliding motion when used together.
5. Reverse total shoulder replacement- A serious shoulder fracture may need a reverse total shoulder replacement in some situations. The placement of the socket and metal ball are reversed. People who have a reverse complete shoulder replacement have less pain and better function and range of motion.
6. Internal fixation- The procedure of physically joining the bones is internal fixation. To align the bones appropriately, this procedure requires special screws, plates, wires, or nails. This keeps the bones from developing unusually.
7. Rotator cuff surgery- The rotator cuff connects your arm to your shoulder blade by a group of muscles and tendons. Any damage to the rotator cuff requires surgery. During the surgery, injured tendons and muscles are repaired or replaced with a graft tendon.

Other treatment options for shoulder fracture-

Cold Compression: While the bones recover, immobilisation with an arm sling or wrap is recommended, pain relievers that are taken orally and physical therapy.

1. Avoid using medications the day before the surgery. One week before surgery, aspirin and other non-steroidal anti-inflammatory medicines should be avoided (NSAIDs).
2. Follow your doctor's instructions for any pre-operative testing or lab work which also includes pre-anaesthetic checkups. Make arrangements for someone to pick you up from the hospital.
3. After midnight the night before surgery, don't eat or drink anything.

1. Wearing jewellery, body piercings, makeup, nail paint, and hairpins is not permitted. Money and valuables are not allowed at the time of surgery.
2. Take the medication prescribed by the doctor which is required on the day of surgery with a little sip of water.
3. The doctor may advise not to drink or eat after midnight before the surgery.

Throughout the treatment, your surgical team will monitor your health. They'll most likely use:

1. A finger clip that measures your oxygen levels
2. A blood pressure cuff is worn on the arm
3. Keep track of your heart rate using chest pads.

The recovery process in the hospital

1. The patient will be shifted to the recovery room after the surgery.
2. The patient’s vitals along with anaesthesia’s effect will be monitored.
3. Depending on the patient's condition, the discharge will be finalised.

The recovery process after hospital discharge:

1. The length of your recovery depends on the severity of your injury and the type of surgery you have.
2. The success of shoulder fracture surgery depends on a good rehabilitation programme.
3. The majority of patients need to wear a brace for three to four weeks.
4. The total recovery time is usually several months, although as with any surgical surgery, the particular recovery time varies depending on the patient and condition.
5. To determine your progress, your doctor examines and analyzes your X-rays.
6. To maximise healing and improve success, physical therapy is frequently required to improve motion and strength.
7.  Patients can perform easy exercises for increasing flexibility, strengthening muscles, and restoring the range of motion in their shoulders.

First, follow up appointment

Your follow up will be scheduled by a doctor after surgery for 1 week, 2 weeks, 6 weeks, 3 months and 12 months after the procedure.

Consult the doctor in case of:

1. Infection at the site of surgery.
2. Fever
3. Discolouration, or any other complications.