Evaluation

How will my shoulder fracture be evaluated?

First aid for people who may have suffered a shoulder fracture will normally consist of treating for shock, splinting the shoulder with a sling, and rapid transfer to hospital.

In the Emergency Room the focus of the team would be on treating shock and making you comfortable, then establishing the extent of the injury (diagnosis) and consulting an orthopaedic surgeon if necessary. The whole region needs to be examined so clothes must be removed. Often this requires cutting them off to avoid hurting you or doing more damage.

The bony parts of the shoulder girdle will be gently felt to find the site of maximum tenderness and a note made of any wounds, swelling, or bruising. Wounds and abrasions will be dressed. Any areas of numbness or muscle paralysis will be noted. The circulation to the hand will be checked.

X-ray evaluation of the injury will be guided by the clinical evaluation of the fracture site. Different views are needed for fractures of the sternum, collarbone, shoulder blade and glenohumeral joint. Some fractures of the shoulder girdle can be treated without referral to an orthopaedic surgeon. This will differ from place to place and be the decision of the Emergency Room physician.

The orthopaedic evaluation will include a repeat of the history of the injury, a review of your general medical status, and a careful examination of the shoulder region. The x-rays will be reviewed to make sure they are complete and that no further injuries are suspected.

A computerized tomography (CT) scan of the region may be ordered in cases such as a fracture dislocation of the sternoclavicular joint or where the injury is complex (e.g., fracture dislocation of the shoulder). The treatment options will be discussed with you taking into account your general medical status, your expectations, and your normal level of activity in work and sports.