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Fractured Shoulder (Broken)

You've Broken Your Shoulder

What is the Problem?

Your arm bone (humerus) is broken. It is broken just below the top of the bone where it forms the part of the shoulder. This the neck of the humerus.

Broken Shoulder

Please Note: "fractured" is the medical term for a "broken bone". Despite what your friends say, there is no difference in severity between a fractured bone and a broken bone.

Other Fractures

Often a second fracture will occur at the same time. These can have an impact on your treatment because of the attachment of important shoulder muscles. If you use a muscle that is attached to a broken section this can be very painful or can cause a deformity when your fracture eventually heals. Below is a list of muscles that attach to different parts of the shoulder. Your physiotherapist or doctor will be able to explain what you should and shouldn't do if you have a fracture of the following regions:

Greater tuberosity - supraspinatus, infraspinatus & teres minor
Lesser tuberosity - subscapularis
Humeral Head
Shaft of Humerus - pec major (displaces shaft medially & internal rotation)

How is Your Shoulder Treated?

After your fracture has diagnosed via an X-ray, your arm will be supported at the wrist in a "collar and cuff" sling. This allows the weight of the arm to pull the humerus downwards. The downward pull helps the bones to heal in the correct position.

You must not put anything under your elbow in an attempt to support the weight of your arm. This would push your humerus upwards and move the bones into the wrong position. This is why you are not given a triangular sling. You must not rest your arm on a pillow when sitting or lying. You will need to wear the collar and cuff for six weeks. You may wear it outside your clothes. You may remove it to wash.

Will it Hurt?

Your shoulder will be quite painful for the first two weeks. Pain relieving tablets may help to reduce your pain.

Physiotherapy & Exercises

Your arm will usually be in a collar and cuff for six weeks. You must move your fingers and wrist whilst in the collar and cuff. You must then begin to move your shoulder as the pain subsides. If you do not move your shoulder it will end up very stiff. Even with diligent exercising your shoulder may become stiffer than normal.

Your physiotherapist is the best person to advise you which exercises to do, how often and when? Generally, for the first three weeks you may not want to move the shoulder itself. You should straighten and bend your elbow out of the sling at least once an hour.

After three weeks, until six weeks after your injury you may increase shoulder movement until you can move your elbow up to shoulder level with your hand hanging down. You may rotate your hand and forearm outwards whilst your elbow is tucked into your side. Your physiotherapist may suggest you do exercises in the pool. The weight of the arm is supported better by water and will allow for less painful movement.

After six weeks you may increase your shoulder movements.

Seek the advise of your physiotherapist early (within the first week after injury is ideal) to attain your best outcome.
Will your shoulder fully recover?

Your shoulder will continue to improve for up to twelve months. However, your best results will occur early.

Washing

You may remove the collar and cuff to wash. Wash under your arm using a hanging pendulum position.

Driving

You cannot drive whilst your arm is in a collar and cuff. You will not have free movement of your arm for several weeks after the sling has been removed. Therefore you will not be able to drive for at least eight weeks.

Work

This depends on your job. If you can work one handed, you may be able to return to work two weeks after your injury. This also depends on you being able to get to work. If your job is manual you will be unable to work for at least three months.

Sport

In most cases, you may participate in light non-contact sports about six weeks after your injury. When you start playing, you will not be able to play for as long as normal. Your shoulder will ache at the end of exercises.

Smoking

You should not smoke whilst your fracture is healing. Research confirms that smoking slows down bone healing.

Complications

Your fracture may not heal. If this happens an operation might be necessary. If the fracture heals in the wrong position an operation to correct the position or to insert an artificial shoulder might be necessary.

General Advice

You will have dramatic bruising down your arm as far as the elbow. This is normal. The bruising will take many days to disappear. This is a common injury in older patients. As a result the shoulder usually ends up stiffer than normal following this injury. If you have any problems or queries, please ask your physiotherapist or doctor.