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The shoulder complex is made up of several bones which include the clavicle, scapula, acromion, glenoid, and humeral head. Any fracture in one of these is considered a shoulder fractures. Patients can have fractures in more than one of these bones in case of high-intensity injuries.
Just like any other fracture, patients with fracture around the shoulder complain of pain, swelling, difficulty moving the shoulder, and sometimes numbness around the shoulder if there is an accompanying nerve injury
After a thorough clinical examination, Xrays can confirm the presence of a fracture. Sometimes there may be a need to get a CT scan and MRI exam done especially in fractures involving the joint or in case of suspicion of soft tissue injury such as rotator cuff tear
No. Minimally displaced fractures, the body of scapula fractures can be treated conservatively without surgery. Elderly patients or patients who are not fit for surgery due to medical problems can also be treated non operatively.
Grossly displaced fractures, Fractures that involve more than 2 bones of the shoulder girdle, open fractures, fractures around the joint surface in young patients, fractures associated with nerve injury are all indications for surgical intervention
Depending on the fracture geometry, different types of screws and plates are available for fracture management. Young patients with peri-articular fractures require more robust fixation for early rehabilitation and hence locking plates are useful. Elderly patients with weak bones cannot hold the screws and hence are sometimes managed with minimally invasive K-wires insertion.
A well-healed fracture that restores the normal shape of the bone can result in excellent outcomes. However, sometimes when the fracture is a result of high-intensity injury resulting in multiple fragments, it may not be possible to restore the normal anatomy. Such patients may get near-normal function if the technique of surgery is good. A bad fracture with inadequate surgical management will result in poor outcomes
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