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Complex Fracture Repair of the Shoulder

What is Complex Fracture Repair of the Shoulder?

Complex fracture repair of the shoulder is a surgical procedure that involves the use of surgical plates and screws to repair a severe fracture of the bones that form the shoulder joint. Complex shoulder fractures are usually accompanied by ligament and tendon injuries that may also need to be repaired.  

Anatomy of the Shoulder Joint

The shoulder is a complex joint formed by the top of the arm bone (humerus) and the shoulder blade (scapula) as well as the end of the collar bone (clavicle) which connects to a bony projection on the scapula (acromion). The shoulder is surrounded by the rotator cuff,  a group of muscles and tendons that stabilize the joint while allowing a wide range of motion. A fracture of any of the bones in the shoulder joint can significantly compromise shoulder function. 

Indications for Complex Fracture Repair of the Shoulder

Complex fracture repair is indicated if the fractured ends of the bone are severely dis-placed, if multiple fragments of bone have broken off from the joint, or if the bone has come through the skin.  

Preparation for Complex Fracture Repair of the Shoulder

Your doctor will assess your symptoms and perform an examination. Imaging tests such as X-ray, MRI, or CT-scanning may be ordered. Inform your doctor about the medicines you are taking prior to the procedure, and if you are allergic to any medicines or anesthesia. Arrange for someone to drive you home after the surgery.

Procedure for Complex Fracture Repair of the Shoulder 

  • Either general or regional anesthesia can be used for the surgery.
  • An incision is made on the skin over the fracture site.
  • Loose bone fragments are removed from the area.
  • Bones are realigned to ensure properly shoulder mobility.
  • Bone cement is used to hold the bone's edges together.
  • Bone grafts may be used to fill in gaps between the broken bones.
  • Metal plates and screws are placed to hold bones in the correct position.
  • Soft tissue injuries to the ligaments and tendons will also be repaired during the surgery.
  • The incision is then closed with sutures.

Recovery after Complex Fracture Repair of the Shoulder

Prescription pain medicines or NSAIDs (non-steroidal anti-inflammatory drugs) are used to manage pain. Your shoulder will be placed in a sling for 4-6 weeks to immobilize it while it heals. Physical therapy will be recommended at the appropriate time to help you regain shoulder mobility. As the shoulder becomes stronger, you will be allowed to gradually return to routine activities. Most patients can expect a full return to normal activities after 6 months.

Risks of Complex Fracture Repair of the Shoulder

As with any surgery, there are associated risks and complications that may occur, such as the following:

  • Anesthetic complications
  • Infection
  • Nerve damage
  • Stiffness

Benefits of Complex Fracture Repair of the Shoulder

Most patients are able to regain sufficient mobility and function in the shoulder to maintain an active lifestyle and perform routine activities of daily living with minimal or no discomfort.

  • American Academy of Orthopaedic Surgeons
  • American Orthopaedic Society for Sports Medicine
  • American Association of Nurse Anesthetists
  • American Shoulder and Elbow Surgeons
  • OrthoInfo