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Shoulder Injury : FractureShoulder fractures can occur from a direct blow, or indirectly, from a fall onto the shoulder. The shoulder is composed of two main structures: the HUMERUS (upper arm bone) and the SCAPULA (shoulder blade), which provides the articulating surface (socket) for the humeral head (ball). Often it is the upper humerus, close to the shoulder, that is most likely to be fractured. Other, more uncommon areas, include fracture of the scapula. Shoulder fractures are more common in the elderly who fall on an extended arm or shoulder. Common signs of a fracture include swelling at the shoulder, with tenderness to the touch, and pain while at rest. The patient will be reluctant to move the arm, due to intensification of the pain. Evaluation involves a careful examination for tenderness to palpation, deformity, and swelling. Nerve and vascular integrity must be scrutinized (pulses, sensation, movement of fingers, hand, and wrist), since associated injuries to these structures can occur. Bone x-rays will show a fracture or dislocation, and will guide the physician in the appropriate course of treatment. Treatment of most fractures of the upper humerus (close to the shoulder) can be initially managed with a sling and swathe (arm held close into the body), or, a special splint. Ice packs should be used on the fracture site. Each case management must be considered individually, on the basis of the patient's age, displacement of fracture fragments, or comminution (multiple pieces). Bone healing takes 6 weeks, with special regard given to early range of motion exercises. Reluctance to perform any range of motion exercises during the healing phase can lead to adhesive capsulitis (frozen shoulder). The Physical Therapist plays an important role in aiding the return of normal joint function. Acetaminophen, aspirin, or anti-inflammatories (ibuprofen) can help reduce pain and swelling. Stronger pain medications may be necessary. The Orthopaedic Surgeon will guide the patient on the most appropriate form of treatment for this injury. Any development of numbness, tingling, increased pain in the involved extremity, or bluish discoloration to the fingers, requires IMMEDIATE re-evaluation. Hope this article will provide you information about shoulder injury.
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