Broken shoulder

A broken shoulder is a fracture of the humeral head. The humeral head is the upper end of the upper arm. The socket is part of the shoulder blade. A broken shoulder is also called a proximal humerus fracture.

In four to five percent of all fractures in the human body, it concerns the shoulder. Three-quarters of people with a broken shoulder are over 60 years old. A broken shoulder occurs twice as often in women.

How does a broken shoulder occur?

A broken shoulder is usually the result of a fall on the outstretched arm or on the shoulder itself. In younger people, a broken shoulder most often occurs due to a sports or traffic accident.

Older adults have an increased risk of a broken shoulder, but for a different reason. In this age group, bone loss (osteoporosis) plays a major role. This weakens the bones, making them more likely to break.

Characteristics (symptoms) of a broken shoulder

Sharp pain immediately after the injury is the most common symptom of a broken shoulder. This pain is reduced by supporting the arm with the other arm. Moving the shoulder or arm is not possible due to the pain. After the fracture, a swelling and bruise often develop at the level of the shoulder.

In severe cases, nerves are pinched immediately after the fracture. This can lead to paralysis or a tingling sensation in the arm, hand, or fingers.

How is a broken shoulder diagnosed?

The doctor first asks where it hurts and what happened. This is followed by a physical examination with tests for the shoulder.

If a fracture is suspected, röntgenfoto’s or a CT scan are taken in the hospital. The location of the fracture and the position of the bone fragments are clearly visible on the images. The CT scan also shows any damage to surrounding tissue such as nerves, muscles, and tendons.

Treatment of a broken shoulder

A broken shoulder can be treated with or without surgery. In consultation with the patient, the surgeon makes a treatment plan. The surgeon takes into account factors such as age, location and severity of the fracture, and damage to surrounding tissue.

If surgery is needed, there are two options. When the quality of the bone is still good, the preferred option is to hold the bone fragments together with a pin, plates, and screws. This is called an osteosynthesis.

With poor bone quality, or a very severe fracture, the surgeon may choose to place an artificial shoulder. In this procedure the shoulder is partially or completely replaced with a prosthesis.

For healing, with or without surgery, it is important to rest. For protection and to support the arm, a sling (draagdoek) is worn for at least six weeks. After this, you may gradually start using the arm and shoulder again.

The doctor or physical therapist from the hospital often already provides some exercises. Nevertheless, guidance from a physical therapist during further recovery is recommended. The physical therapist focuses the treatment on improving mobility with mobilizations and strengthening the muscles around the shoulder.