Shoulder Fracture Fixation Surgery

Shoulder fracture fixation is a surgical procedure that uses a system of metal instrumentation such as screws, pins, plates and metal frames to internally or externally repair a broken bone in the shoulder. The shoulder consists of three bones; the clavicle (collar bone), scapula (shoulder blade) and the humerus (arm bone). These bones, together with tendons, muscles, ligaments and joints, form a platform to create movement in the arm.

Fractures of the shoulder are usually caused by a direct blow to the shoulder area. Falls, collisions, motor vehicle accidents and sports injuries are common causes of shoulder fractures.

Types of Shoulder Fracture Fixation Surgery
Shoulder fracture fixation consists of two types of fixations. Both types of fixations are surgical procedures and are decided upon based on the extent and placement of the fracture. The types of shoulder fracture fixations include:

  • Internal fixation – The surgeon will make an incision in the skin over the fracture then remove any bone fragments from the area. The bones will then be realigned to ensure proper motion and function. Bone cement is sometimes used to hold the bones together. Bone graft material may be used to fill in the gaps between the broken bones in case bone fragments are missing. Instrumentation is used in the next step; the surgeon inserts metal screws and plates in and over the bones to hold the bones together as they heal.
  • External fixation – The surgeon will place pins or screws into the bone above and below the site of the fracture. The surgeon then realigns the bone fragments and connects the pins or screws to a bar that remains outside of the skin. This bar acts as a stabilizing frame that keeps the bones in proper position during the healing process. Once the fractured bones have healed correctly the fixations are removed

Type of Fractures
There are many different types of fractures. The specific type of shoulder fracture fixation is based upon the severity and type of fracture affecting the bone. Different fracture types include:

  • Stable fracture – In this type of fracture the broken bones remain aligned, which usually means the bones will stay together during the healing process.
  • Displaced fracture – The broken ends of the bones are not aligned as a result of this type of fracture. Surgery is usually requires to line the bones back together.
  • Open fracture – Also known as a compound fracture, this break causes the bones to shift and break out through the skin. The surrounding muscle, ligaments and tendons are often damaged during this injury.
  • Closed fracture – The bones do not break through the skin but can still damage the surrounding soft tissue and nerves
  • Comminuted fracture – The broken bone shatters into three or more pieces
  • Transverse fracture – The fracture is at a right angle to the long axis of the bone
  • Greenstick fracture – A fracture on one side of the bone that causes the other side to bend

Importance of Fixation Surgery
Prior to the development of internal fixation, physicians always relied on casts and splints to support the bone from outside the body. When members of the American Academy of Orthopaedic Surgeons (AAOS) were asked to list the most important advances in orthopaedic treatment in the 20th century, the development of internal fixation ranked high on their list. Also known as instrumentation, internal fixation surgery results in added benefits for patients:

  • Shorter hospital stays
  • Patients return to normal function sooner
  • Reduces the incidence of nonunion (improper healing) and malunion (healing in improper position).

The multidisciplinary team of orthopaedic experts at North Shore-LIJ Orthopaedic Institute's Shoulder & Elbow Services in New York performs shoulder fracture fixation as well as a broad range of nonsurgical and surgical treatments for conditions that affect the foot and ankle.

Rehabilitation Services
The Rehabilitation Network of the North Shore-LIJ Health System is dedicated to providing you and your family with result-oriented, comprehensive rehabilitation services. Our goal is to help you and your loved ones find relief from pain and get moving again after an accident, illness, injury or surgery. We’re your partner in a safe, healthy, more rapid recovery.

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