Shoulder fractures occur often due to mechanical falls; they are among the most common fractures in the elderly.
Treating these fractures depends mainly on two factors:
Type of fracture.
When it is a simple fracture where movement is less important, a simple conservative treatment can be considered, with immobilization in a removable splint for about 4 to 6 weeks.
Surgical treatment is providedin case of a fracture strongly displaced and of more fragments.
Most of the fractures may benefit from fixing, either with a screwed plate or with a nail specially adapted.
I mostly use adapted synthesis plates (anatomic plate specially designed for humeral head), which are fixed with special screws with end screwed into the plate. This type enables a speedy recovery of shoulder movement, which can already be mobilized in the next week after surgery. This plate mounted outside the joint has little impact on the mobility of the shoulder and the recovery is complete in about four months of falling or injury.
Some fractures cannot be fixed with synthetic material, because the arteries that feed the humeral head are damaged. A necrosis (bone death) of the humeral head results, which in this case must be replaced with prosthesis.
Depending on various parameters, which are considered by the surgeon (age, right or left arm, shoulder condition before the fall….), we propose several types of prostheses. It may be a prosthesis that replaces only the damaged head (humeral prosthesis) or total prosthesis that replaces the entire joint completely.
For the elderly, a total prosthesis called “inverted” is preferred.
After this intervention, patients will have to undergo several sessions of kinesiotherapy to satisfactorily recover the joint operated on.
Length of hospital stay will depend on the type of fracture and especially on the type of surgical treatment applied.