Broken Shoulders
A fractured neck of humerus is a common injury of the upper limb. There is a wide range of potentially suitable treatments for a fractured neck of humerus, which depend on the type of fracture and the activity level of the patient.
Most fractures of the neck of humerus can be treated non-operatively, with a supportive sling for 3 to 6 weeks. During the time that the patient wears the sling, it is important that (s)he comes out of the sling to practice hand, wrist and elbow exercises to prevent stiffness.
From 3 to 6 weeks the patient can usually commence some shoulder exercises, ranging from gentle pendular exercises to assisted forward elevation. The bleeding from the fracture causes thickening of the shoulder ligaments that can restrict movement (post-traumatic frozen shoulder).
Fractures that may need an operation include:
- Where the head fragment is split, not facing or touching the socket
- If the bony attachments for the tendons (that help move the shoulder) are displaced these may also need reduction
- Where the blood supply to the joint surface has been jeopardised (4 part fracture)
The most common operation performed for a fractured neck of humerus is fixing the bones with plates, screws and sutures.
If the articular surface is split or has lost all blood supply a humeral head replacement may be required.
Regardless of the form of treatment, stiffness is a very common problem after a fractured neck of humerus, especially if an operation is also performed. A prolonged course of physiotherapy is usually required to assist in regaining a functional range of motion. Maximal range of motion is achieved 12-18 months post fracture +/- surgery. Rarely if stiffness persists and is disabling, keyhole releasing surgery can be performed.
A low energy fall that results in a fractured neck of humerus may be an osteoporotic fracture. On recovery from this fracture it is recommended you have your bone mineral density assessed, if this had not been performed recently, with your general practitioner. If you had previous borderline osteoporosis the fracture may make you eligible for treatments that reduce fracture risk.
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