Shoulder Fractures
What Are the Most Common Types of Shoulder Fractures?
Shoulder fractures most often involve the proximal humerus (the upper end of the arm bone, near the shoulder joint) and typically result from a fall, direct trauma, or in older adults with weaker bone, sometimes from a relatively low-energy fall. Treatment ranges from simple sling immobilization to surgical fixation or shoulder replacement, depending on the fracture pattern and the patient's age and bone quality.
Common patterns & causes
Proximal humerus fractures are especially common in older adults after a fall onto an outstretched arm or directly onto the shoulder, often related to osteoporosis. In younger patients, shoulder fractures more often result from higher-energy trauma like motor vehicle accidents or sports injuries. The fracture pattern — how many pieces the bone breaks into and how displaced they are — is the main factor guiding treatment.
Diagnosis and Treatment:
X-rays confirm the fracture pattern; CT scans are often used for more complex fractures to fully understand the pieces involved before planning treatment. Many proximal humerus fractures, particularly those that are minimally displaced, heal well with sling immobilization and progressive physical therapy. More displaced or complex fracture patterns may require surgical fixation with plates and screws, and in select older patients with severely comminuted fractures or poor bone quality, shoulder replacement (including reverse shoulder replacement) may provide a better functional outcome than attempting to repair the fracture.
Frequently Asked Questions:
Do all shoulder fractures need surgery?
No, many proximal humerus fractures, especially those with minimal displacement, heal well with sling immobilization and therapy alone.
Why would a shoulder fracture be treated with a joint replacement instead of fixation?
In certain severely comminuted fractures or in patients with poor bone quality, attempting to repair the fracture pieces may not heal reliably, making joint replacement a more predictable option for restoring function.