A shoulder fracture is a severe injury that can present in a variety of forms. Symptoms and manifestations of injury may vary depending on the type of injury and its location. For successful treatment, it is important to recognize the presence of a fracture of the shoulder joint in time and take appropriate measures. Therapy is carried out in a hospital, and in some situations, surgery may be required. The recovery period depends on the type of injury and the measures taken to treat the fracture.
Symptoms
The symptoms of a shoulder fracture can vary depending on the location of the injury. In any case, a pain syndrome of a high degree of intensity appears at the site of damage to the bone structures. Against the background of soft tissue rupture, swelling and bruising occur. When probing in the injured area, a crunch may be felt due to the presence of bone fragments. Motor function of the damagedlimb becomes limited.
Shorter Shoulder
If we are talking about a fracture of the neck of the shoulder joint, then we can observe the shortening of the shoulder. A displaced injury can lead to deformity changes in the hand. There are also cases where the fracture is open, which can lead to nerve damage and loss of sensation.
When the tubercle is damaged
If there is a fracture of the shoulder joint in the region of the tubercle, the pain syndrome appears above the shoulder. When the arm is moved to the side, the pain increases significantly or there is a sensation of an obstacle, indicating a violation of the tendon in the supraspinatus muscle. In the latter case, swelling is not expressed, moreover, deformation is not characteristic of such a fracture. When the tubercle is fractured, damage to blood vessels and nerve endings rarely occurs.
When the body of the shoulder bones is damaged, the patient experiences severe pain, swelling and bruising are pronounced and can reach the carpal areas of the limb. Motor function in the joints of the shoulder and elbow is limited. When bone fragments are displaced, shortening of the injured arm occurs. In this case, there is a violation of the nerve endings and blood vessels, which leads to loss of sensitivity and mobility of the fingers.
Transcondylar fracture
The transcondylar fracture of the humerus joint is characterized by intense pain radiating to the forearm and elbow joint. Puffiness occurs in the elbow joint, in addition, there aredeformation changes against the background of bone displacement. Mobility is impaired, while movements in the shoulder are slightly limited. Fracture of the supracondylar bones is dangerous for the brachial arteries, damage to which can cause gangrene of the limb. The absence of a pulse on the forearm is the main sign of damage to the vascular system.
Conservative treatment
After a patient with a fracture of the shoulder joint is taken to a medical facility, he is given drugs with an analgesic effect. When the pain syndrome loses intensity. X-rays are taken, and based on the results, an appropriate therapeutic regimen is selected, which may include:
- Conservative methods involving the application of a cast or tight bandage, as well as a splint.
- Surgical treatment, when special corrective plates, structures, etc. are installed on a broken joint
- Bone stretching.
If there is a fracture of the shoulder joint without displacement, or it is insignificant, the method of reduction of bone fragments is used. After a quick reposition, a plaster is applied to the damaged limb or fixed with a tight bandage or a special splint.
As a rule, a plaster cast is used in cases where there is damage to the tubercle of the humerus. Along with gypsum, a abduction splint can be used, which is able to ensure the immobility of the broken joint and contributes to the effective fusion of the muscle over the bone,which is often damaged when the tubercle is fractured.
When an impacted fracture of the greater tubercle and surgical neck without displacement is diagnosed, conservative treatment methods are used. The damaged limb is fixed with the help of a splint or scarf. The recovery period in this case is one month.
Surgical treatment
There are fractures of the joint of the humerus, in which it is impossible to avoid surgery. In particular, surgery may be required in the following cases:
- The impossibility of conducting an open type reposition, that is, the reduction of a bone.
- After reduction, the bones move away.
- Nerve root damage established.
- Muscle tissues are strangulated by bone fragments.
- The integrity of the vessels of the circulatory system is broken.
In order to restore the natural position of the damaged bone and fragments, an operation is performed to install a plate that fixes parts of the tissues before they are fused. When using devices for proper bone fusion, no plaster is applied.
If a displaced fracture is diagnosed, surgery is performed. Surgical intervention involves fixing the fragments with a screw or knitting needles, which are removed after a few months. In this case, immobilization with plaster is carried out for 4-6 weeks, and the total rehabilitation period can reach three months.
Bone traction
Skeletal traction is applied when a fracture occursshoulder joint with displacement. The essence of the procedure is to install a needle in the area behind the elbow process, due to which the shoulder is stretched. The splint is installed for four weeks and significantly limits the motor function of the limb. After removal of the spokes, rehabilitation is required for up to six weeks. The total treatment period is up to four months.
When the fracture of the shoulder is of an open type, the Ilizarov apparatus is installed on the limb, which is a complex structure of rings and spokes. Such treatment can last up to six months, but at the same time, movements in the joints are available from the first days of therapy.
When nerve endings and blood vessels are damaged, additional surgical treatment is performed. Special seams are superimposed on them. The recovery period in this case may be prolonged.
Summarizing the methods of treatment depending on the location of the fracture, we can draw the following conclusions:
- Fracture of the body of the shoulder without displacement - application of a plaster cast for a period of 6-8 weeks.
- Fracture of the body of the shoulder with displacement - installation of plates, screws and rods. Plaster cast for 4-6 weeks.
- Non-displaced surgical neck - bandage with plaster for four weeks, then development of mobility.
- Surgical neck with displacement - with successful reduction, recovery for a month and a half.
- Fracture of the lower end of the shoulder bone with displacement - plaster cast for 6-8 weeks. If the bone cannot be reset, surgical treatment is used.
Rehab
In case of fractures of the shoulder joint after immobilization of the arm for the required period, further treatment is carried out on an outpatient basis. After the bandage is removed, treatment with physiotherapeutic methods is prescribed, and a course of restorative gymnastics is also prescribed, aimed at developing the joint. Thus, it is possible to restore mobility to the injured hand. Rehabilitation for a shoulder fracture can take up to three months.
Regardless of the type and location of the fracture, the patient is prescribed painkillers and anti-inflammatory drugs for the rehabilitation period. In addition, in order for the bones to grow together quickly and correctly, calcium preparations are prescribed. The patient is also instructed to follow a special diet and include foods enriched with this microelement in the diet.
After the cast is removed, the patient is given an x-ray. Based on the image obtained, a conclusion is made about the degree of bone fusion and subsequent treatment. If plates were installed, a decision may be made to leave them. This is especially true for older patients, for whom a second operation can be dangerous.
What else is used in the treatment of a shoulder joint fracture?
Massage
Massage improves blood circulation in the injured hand. You can start the massage immediately after removing the plaster cast. When performing a massage, it is recommended to follow the following rules:
- Massage should start with light strokes.
- Gradual warm-up of muscles, warm-up.
- Massage movements should start with the fingers, gradually rising to the shoulder. You can not strongly massage the broken area and put pressure on the damaged joint.
The patient can massage himself. To get the best effect, you need to spend at least ten sessions. Physiotherapy should be used to relieve inflammation and improve blood flow.
Proper development of the shoulder joint after a fracture is important.
Physical Education
Therapeutic exercise is necessary to normalize muscle tone and accelerate the process of bone fusion. The following exercises are considered the most effective:
- Limb movements like a pendulum. In this case, the exercise is performed with both limbs.
- Circular movements of the shoulder joints to increase their flexibility. If pain occurs, stop the exercise.
- Abduction of limbs to the sides. If it is not possible to perform the exercise with an injured hand, you can help a he althy one. In this way, it will be possible to relieve the load from the shoulder joint.
- Mahi with straight arms in front of the chest.
- Closing the arms in front of the chest. Gradually try to straighten the brushes.
- Putting the injured hand behind the head.
The listed exercises after a fracture of the shoulder joint are performed in order to prevent possible complications thatcan lead to loss of mobility of the affected limb.
The consequences of a fracture
Injury to the neck, body, joint, nerve or muscle tissue can lead to the following unpleasant consequences:
- Deltoid paralysis condition.
- Arthrogenic contractures.
- Habitual dislocations.
- The occurrence of false joints.
- Volkmann's contractures.
- Impaired mobility of the muscles in the forearm.
Nerve damage
In addition, complex damage to the shoulder joint can lead to damage to the nerve endings, which will later cause paresis or complete paralysis of the arm. Changes in the structure of the joint can cause cartilage destruction, proliferation of scar tissue, and hardening of the ligaments, neck, and capsules. Prolonged wearing of a plaster cast leads to squeezing of blood vessels, as well as damage to bones by fragments. In addition, the supply of oxygen to damaged tissues is disrupted, motor function is impaired, and loss of sensitivity is observed. Also, atrophy of muscle tissue while wearing a cast is not excluded.
