shoulder fractures trauma

Daniel Schwartz, MD, Orthopedic Surgeon, Shoulder Specialist, Seattle, WA

Shoulder Fractures and Trauma

Shoulder fractures and trauma encompass a spectrum of conditions that can significantly impact one’s mobility and quality of life. Among the various types, Proximal Humerus Fractures, Clavicle Fractures, and Humeral Shaft Fractures are prevalent. These injuries often require surgical intervention known as Open Reduction Internal Fixation (ORIF) to realign and stabilize the fractured bones effectively. Additionally, conditions such as Shoulder Separations demand meticulous repair and reconstruction procedures, while injuries like Pectoralis Major Rupture, Distal Biceps Rupture, and Triceps Rupture necessitate specialized repair techniques to restore muscle function and structural integrity.

Diagnosis and Treatments

Accurate diagnosis is paramount in addressing shoulder fractures and trauma. Advanced imaging techniques, including X-rays, CT scans, and MRIs, aid in precisely identifying the extent and nature of the injury. Once diagnosed, the treatment approach depends on the specific condition. ORIF is commonly employed for fractures, ensuring proper alignment and stability through surgical intervention. Non-surgical approaches, such as immobilization and physiotherapy, may be recommended based on the severity

Causes of Shoulder Fractures and Trauma

Shoulder fractures and trauma can result from various incidents and activities. Common causes include:


  • Traumatic Injury:High-impact events such as falls, sports injuries, or car accidents can lead to fractures in the shoulder region.
  • Direct Impact: A forceful blow to the shoulder, whether from a fall or collision, can cause fractures, particularly in the clavicle or proximal humerus.
  • Overuse and Repetitive Strain: Certain activities that involve repetitive overhead motions, such as throwing or lifting heavy weights, may contribute to stress fractures or trauma over time.
  • Osteoporosis: Weakening of the bones due to conditions like osteoporosis can make the shoulder more susceptible to fractures even with minor trauma.
  • Age-Related Factors: Aging can affect bone density and increase the risk of fractures, especially in the elderly population.

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Shoulder Fracture Examples & Treatments

Athletes, particularly those involved in high-impact sports or activities that place significant stress on the shoulder, are at an increased risk of shoulder fractures and trauma. Sports like football, rugby, and wrestling, which involve contact and potential falls, may lead to acute injuries such as fractures or dislocations. Additionally, athletes engaged in repetitive overhead motions, such as baseball pitchers or swimmers, are prone to overuse injuries that can contribute to stress fractures or other trauma over time.

Accidental falls and slips are common causes of shoulder fractures and trauma, affecting individuals of all ages. For instance, a slip on icy surfaces or a fall from a height can result in direct impact on the shoulder, leading to fractures, dislocations, or other injuries. Elderly individuals and those with compromised balance are especially vulnerable to fractures from falls, often experiencing fractures in the proximal humerus or clavicle

Conditions like osteoporosis, characterized by the weakening of bones, significantly increase the risk of fractures, even with minor trauma. Elderly individuals, particularly postmenopausal women, are more prone to osteoporosis. When combined with a fall or other trauma, weakened bones are more likely to sustain fractures. Bone degeneration can also affect athletes or individuals with certain medical conditions that compromise bone density.

The elderly population is particularly susceptible to shoulder fractures and trauma due to a combination of factors. As people age, bone density naturally decreases, making bones more fragile and prone to fractures. Falls, often associated with factors like balance issues or environmental hazards, become more common in the elderly. Fractures in the elderly, especially in the proximal humerus or hip, can have significant implications for mobility and overall quality of life. Additionally, age-related conditions like osteoarthritis may contribute to shoulder problems.

Recovery and Rehabilitation Process

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Immediate Postoperative Care

After undergoing surgical intervention, the immediate postoperative period is crucial for managing pain and preventing complications. Patients are closely monitored in a medical facility to ensure the anesthesia wears off safely. Pain management protocols, including medications and ice therapy, are initiated to alleviate discomfort.


Immobilization and Protection

To facilitate proper healing, the shoulder is often immobilized using a sling or brace. This immobilization helps protect the surgical site and minimizes stress on the healing tissues. During this phase, patients are educated on proper sling use and provided guidelines on avoiding activities that could jeopardize the healing process.


Early Mobilization and Range of Motion Exercises

Once the initial healing has occurred, the rehabilitation process begins with gentle range of motion exercises. Physical therapists guide patients through controlled movements to prevent stiffness and promote flexibility. These exercises are tailored to the individual’s condition, gradually progressing as the shoulder gains strength and mobility.


Strengthening Exercises

As the shoulder continues to heal, the focus shifts to strengthening exercises. Targeted exercises aim to rebuild muscle strength and endurance. The physical therapist develops a customized exercise plan that challenges the shoulder progressively, promoting increased resilience and functional capacity.


Functional Activities and Return to Normalcy

The rehabilitation program advances to include activities that mimic daily tasks and job requirements. This phase focuses on restoring the shoulder’s ability to perform routine functions, emphasizing proper body mechanics and functional movements. The goal is to reintegrate individuals into their regular activities while minimizing the risk of re-injury.

Patient testimonials

Patient Testimonials

“Hello Dr. Schwartz & Melissa : ) Congratulations on your move! It sounds like your expertise is I consider you absolutely tops in your profession and your dedication. You have saved me from debilitating pain and instability from my injured shoulders. You and your team have always treated me with up most care and professionalism.. Your expertise and healing powers where evident from my first visit onward...I immediately felt GREAT and reassured that I made the right decision! I will have no problem recommending Dr. Schwartz M.D. to anyone. Thank-you.”


Wondering if someone could tell Dr. Schwartz that the Deltoid muscle lift exercises are definitely helping. It seems to be getting a little stronger already. I can’t lift my arm by itself yet, but, I can easily lower my arm slowly now, and my reach is a little better, too. I was even able to easily reach down to lace and tie my own hiking boots today! . I really appreciate him, so didn’t want to wait to tell him till my next appointment in January.”


“Dr Schwartz, You performed should surgery on my shoulder two years ago and I have had a great outcome! I am from Alaska and flew down to have you fix my shoulder so that I could resume my life as a massage therapist. Everything is going great!! I so appreciate your help in my recovery. The reason I am writing is that I have a client with a reverse shoulder surgery and I am trying to help him recover but I am not able to really figure out how the muscles all work to move the shoulder...I find that the deltoid is the main mover now but I was wondering if you had any resources to help my understand how all the muscles attach now so that I can help my client. His surgery was in California in January so not done in your office. I realize that this may be a lot to ask but if you could help I'd appreciate it. Thanks! ~wendy hooker PS We had our first big Aurora show last night and it was spectacular!! :)”


“I was put at ease from my 1st visit with Dr. Schwartz. He and Joy, his nurse, and surgery schedulers were very professional and thorough. Most of all, I felt very comfortable on the day of surgery, and afterwards. Dr. Schwartz was very thorough in his explanations. It was so nice to see my surgeon and nurse the morning of surgery smiling at me. Overall a very positive experience!”


“I’ve had very positive experiences with my treatment and the staff. I’ve been really happy with the results of my shoulder surgery (rotator cuff repair) and am more than happy to make referrals of my friends to see Dr. Schwartz and Joy in clinic! If I had to do it all over again, I no doubt would return to see Dr. Schwartz at The Sports Medicine Clinic.”


“I had my shoulder replaced with Dr. S and my shoulder has not felt this good in years! I can finally sleep peacefully at night, and move my arm in ways I could have only dreamed off preop! If you have questions ask Dr. S to send you my way, I’ll be more than happy to talk to you about getting you shoulder replaced with him.tions ask Dr. S to send you my way, I’ll be more than happy to talk to you about getting you shoulder replaced with him.”


“I suffered from multiple shoulder dislocations, and was treated surgically by Dr. Dan Schwartz and was impressed by his thoroughness from the start. He listened very well, and I felt at ease with him from the start. He explained all of the surgical options, and we proceeded with the right option that was right for me. Since surgery, I have been so happy and have strongly recommended him to anyone that will listen! Thanks Dr. Schwartz!”


Thank you so much Dr. Daniel Schwartz for your great work! As a Physical Therapist I did a lot of research to find a shoulder surgeon highly qualified to carry out my Mother's reverse shoulder replacement. I appreciated your taking the time to explain the procedure to my parents, and the surgery turned out better than my mom ever expected. Your staff was kind, professional, and competent. It was well worth the drive from Eastern Washington and I will recommend you to all my patients in need of a shoulder surgery.”


This is the first online comment that I have ever left for a person, product or service, however I was so impressed by Dr. Schwartz as a human being and a surgeon that I felt compelled to share my story. I had a bone chip in my elbow that intermittently (depending where it floated) rendered my elbow immobile. Despite a fairly lengthy procedure, within two days I had minimal swelling and near full mobility. I should note that I was the last patient of the week on Friday afternoon (most medical advisers would recommend against this time slot), and Dr. Schwartz"s previous operation had been particularly challenging. Yet he was kind, caring, and focused in our pre-operative meeting and he performed flawlessly. I might also note that I'm a guy who tries to avoid hospitals and doctors whenever possible, in fact I didn't even go to my primary care doctor until months after the ski accident that caused my injury. I would give kudos to Dr. Schwartz and special mention of his nurse, Joy, during my exams and surgery for allaying my fears and phobias and making the whole episode as good as one could ever expect.”

Gary P Ballard

Dr. Schwartz and Joy are the best!!”


“Greetings: I am an attorney who represents Ms. Laura Kent, a former patient of Dr. Schwartz in 2018. This case is coming up for arbitration in a couple weeks and I would like to get an opinion from Dr. Schwartz as to whether the diagnosis he made oflateral epicondylitis of the right elbow was causally connected to the motor vehicle collision in this matter. Please call or email at your earliest convenience.”

Joe Baker

Just a note to say thank you for the thorough and well-composed information about rotator cuff and sleep. It was really the best I could find. Much gratitude.”


“Was referred by a past patient of yours. Would like to see how quickly I could get in for a Grade 3 AC tear.”

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Recovery timelines vary, but most patients can expect several weeks to months for significant improvement. Full recovery may take longer.

Patients are typically advised to avoid heavy lifting, overhead activities, and strenuous exercises during the initial stages of recovery.

Not always. Some fractures may heal with non-surgical methods like immobilization and physiotherapy. However, surgical intervention is often required for severe cases.

Without proper treatment and rehabilitation, shoulder fractures can lead to chronic pain, limited range of motion, and functional impairment.

The timing varies, but return to normal activities is typically gradual. Patients are guided by their healthcare team based on individual progress and healing milestones.

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