Fractures around the shoulder girdle and upper arm are common injuries in all age groups.
Collarbone (clavicle) fractures have undergone a change in treatment philosophy in the last decade due to the availability of better implants. While most fractures are still treated non surgically, displaced and shattered fractures are now frequently operated on in order to prevent delayed healing and deformity around the shoulder girdle, which may predispose patients to recurrent fractures in the future.
Fractures of the upper arm (humerus) may be subdivided into fractures around the shoulder joint, shaft fractures and elbow fractures. Fractures around the shoulder joint are common in elderly patients and are often a harbinger of osteoporosis. Uniquely among joint fractures, these may frequently be treated non-surgically despite significant displacement. Shaft fractures were traditionally treated non-surgically with few exceptions. This philosophy has also evolved over the last decade into an individualised approach which recognises that early stabilisation and accurate realignment may prevent joint stiffness as well as the risk for recurrent fractures in the future. Fractures around the elbow frequently require surgical treatment due to the fact that even minor alteration in the bony alignment around the joint may cause disabling stiffness.
Traumatic injuries around the shoulder may cause “soft tissue only” injuries. Structures which are often affected are the “rotator cuff” of muscles as well as the cartilaginous living of the shoulder joint cup. These injuries, as well as the many non-traumatic shoulder problems, which include rotator cuff impingement syndrome, shoulder joint and AC joint arthritis and biceps tendonitis are routinely referred to the Constantiaberg Arthroplasty Unit’s shoulder specialists.
