Treatment of Shoulder Fractures – Leichhardt Physio

Humeral fractures are relatively usual accounting for up to 5% of all fractures, with 80% of humeral broken bones becoming minimally affected or undisplaced. Many of these fractures are caused by osteoporosis, and a fracture of the forearm on the same side is a common occurrence. The possibility of nerve or arterial injury as a result of the fracture is a serious concern, although it is uncommon. The top of the arm (humerus neck – “shoulder crack”) and the center of the shaft of the humerus are common fracture locations and need physiotherapy sessions by Leichhardt Physio for the treatment. Get detailed here –

 A straightforward fall on the arm, either on the elbow, wrist or directly onto the shoulder, is the most common source of a humeral fracture. There can be a lot of physical tension at the time due to all the tissues that bind to the top humerus, trying to dictate how far the bones are forced into a displaced location. Humeral fractures are more popular in the aged with an average age of fracture of about 65 years, and youths are more likely to have a background of forceful trauma, such as automotive vehicle accidents or sports.

A pathological origin, such as cancer, must be assumed if the rupture occurs through massive force. On physio review, the discomfort will arise when turning the shoulder or elbow, there will be substantial bruising and swelling, the arm will seem small if the crack is displaced in shaft broken bones, and shoulder mobility may be extremely limited. Radial nerve injury is unusual in top humeral broken bones, but it is more prevalent in shaft fractures, resulting in “wrist drop,” weakness of the finger and wrist extensors, and reduced thumb mobility.

Management of Humeral Fractures

Following the injury, the patient’s motions are limited and appropriate analgesia is administered to hold them relaxed. If there is minimal to no displacement, non-operative care is recommended, but if the larger tuberosity is broken, rotator cuff damage should be assumed. This is more popular in strong accidents, when the patient is elderly, or when the tuberosity is greatly displaced. Shaft fractures are challenging to treat however can be braced. Humeral neck ruptures can be held in line with a cuff and collar, forcing the elbow to hang free.

Open reduction internal fixation (ORIF) is typically used for fractured bones of three or four components in youthful patients whereas humeral head reconstruction is used in elderly patients to avoid shoulder pain and stiffness. Shaft fractures may require nailing or plating, but they normally heal without surgery. Complications of humeral broken bones include radial nerve damage in shaft broken bones, frozen shoulder, and collapse of the humeral head due to a lack of blood supply. While the average recovery period is 6-8 weeks, older patients can never regain the full range of motion in their shoulders.

Conclusion

The physiotherapist will advise the patient in auto-assisted exercises using the other arm three weeks after the fracture to help relieve stress on the injury. As the arm strengthens, unassisted movements are used to perform lateral and medial rotation and flexion. The bones will be medically sound after six weeks, allowing the physiotherapist to advance to more aggressive resistance exercises and gentle end-range stretching. Joint mobilizations can help to free up the joint’s slipping and gliding movements while strengthening and joint range of motion work can be achieved with physio treatment.