The shoulders are made up of bones that make them good supporters of some weight. However, there are certain movements that can cause fracture injury to these bones in the shoulders. A shoulder bone fracture refers to a crack or break in the upper part of the humerus bone. This bone forms a part of the shoulder joint. The usual victims of this type of fracture are the middle aged people, especially those who suffer from osteoporosis.
There are several types of shoulder fractures, one of which is the scapula or shoulder blade fracture. This one involves the glenoid fossa, a part of the wing-like bone structure in the shoulder which is the scapula. This is particularly found at the upper back looking like a triangular, flat bone. The humerus serves as the anchor to which the scapula is connected to as much as it is also connected to the clavicle bone or collar bone. The scapula anchors the arm to the body trunk. Thus, this makes the arm more flexible in moving.
The main function of the glenoid is to act like a cover for the upper end of the humerus bone, which is found between the shoulder and the elbow. The shoulder is made up of certain parts, such as: the bones, glenoid cavity, tendons, soft tissue, and joint capsules.
When there is shoulder blade or scapula fracture, there will also likely be glenoid fracture. This is because there are some body parts involved, such as the shoulder joint, gelenoid fossa, and the soft tissues in the injured site. These soft tissues refer to tendons, nerves, ligaments, blood vessels, and joint membranes and capsules.
Having scapula fracture will also cause glenoid fractures. Thus, the patient should also be aware of what scapula bone breakage is. This should also apply for patients who have Galeazzi fracture that affects the arms and its surrounding areas. It pays to be informed about the things that will affect one’s self. This way, protection can be obtained. For instance, parents should also be informed about growth plate fracture because this can occur in children and adolescents. The x-ray result though might not immediately show the fracture because the growth plates will not appear on the film. Hangman fracture, which occurs on the neck that is a neighboring part of the shoulder, should also be watched out for especially during high impact accidents. This usually happens when the head and the neck is forcefully pushed by the impact of the vehicular collision or the fall. When a patient knows the essential information about the fractured shoulder, arm, hip, wrist, or whatever part it is that got injured, recovery time would be faster. This is because the patient would know more about the do’s and don’ts of the fractures for a speedy recovery. Among the types of shoulder fracture, the scapula and the glenoid fossa fracture are quite linked together. Thus, it would make sense to learn more about this fracture on the shoulder, more so when glenoid fracture in children happens. The parents should immediately find an effective way on how to heal this shoulder fracture.
Glenoid Fracture Types
There are several types of scapula fractures occurring on different parts of the body. A dislocation of the shoulder might result to any of the following fractures:
- Scapular neck fractures. The break or the cracked bone is the one adjacent to the glenoid. This scapular fracture can be treated using nonsurgical methods except for difficult cases, such as when angulation or misaligned bones are involved. If these bones are not realigned, the shoulder joint would be affected and the shoulder will continue to grow deformed.
- Scapular body fracture. This is usually simply treated with the use of arm sling. A fracture cast might be necessary for a worse case of this fracture. Among the three types of scapular fractures, this is the most common. This is because it is usually associated with other injuries in the chest and lungs.
- Glenoid fracture. This fracture occurs on the cartilage part of the joint. Inferior glenoid fracture that is unstable would need fracture surgery. This is to avoid the risk of shoulder arthritis for patients with glenoid bone fracture.
Glenoid Fracture Causes
Scapula and glenoid rim fracture are not really common fracture injuries. They are usually caused though by trauma from accidents. Moreover, this also affects the humerus, clavicle, chest, and lungs. During a fall, an outstretched hand does not only possibly fracture the wrist but also the shoulder blade. Other causes of broken glenoid bones are contact sports and brawling. Indirect injury, like falling on the elbow, is another cause of fracture on the glenoid fossa.
Signs and Symptoms
There are signs and fracture symptoms of scapula fracture that should prompt the patient to see a doctor after the injury. These are:
- Swelling of the soft tissues surrounding the fractured glenoid area
- Extreme and bothersome pain at the injured area
- Tenderness in the area surrounding the broken scapula
- Deformed bone
- Distorted body contours dues to separated fragments
- Warmer feeling on the injured area in relation to the temperature of the other parts of the body
There are several tests that the patient should undergo for fracture diagnosis. These are important tests because their results can help the doctor tell what should be the right scapula fracture treatment to use. This also goes the same for glenoid fracture treatment. These tests include CT scan, x-rays, and MRI scan. These tests can give images that will be analyzed by the doctor. Most glenoid fractures are not visible from the outside. Thus, the diagnostic machines will do far better work at helping to doctor do an evaluation of the glenoid injury. Careful diagnosis will help the doctor determine the right kind of treatment for the patient with a fractured glenoid.
Glenoid Fracture Treatment
A. First Aid
- Keep the injured person warm to avoid the risk of going into shock after the injury.
- Use the R.I.C.E. instruction, which means rest, ice, compression, and elevation.
- Avoid moving the injured shoulder so as not to affect more fragments in the fracture.
- The doctor should be seen immediately after the injury. Tests will be performed and the decision for a surgery or nonsurgical method will be chosen based on test results. Going to the doctor six hours or more after the injury is already too risky, the patient might have been in shock already.
B. Continuing Care
- Immobilization with the help of braces is necessary. The brace or sling should be worn for three to four weeks.
- Ice massage should be done for 15 minutes, three to four times a day. When exercises are recommended, the ice pack should be placed on the fracture before starting with the routine.
- After 48 hours, heat treatment should be done. This is to promote better blood circulation that will not cut off the injured shoulder. It would be dangerous if blood flow will not reach the fractured area. Heat treatment includes the use of compresses, hot showers, heat lamps, heat ointments, and heating pads.
- In severe shoulder fractures, bone manipulation might be necessary. Thus, general or local anesthesia might be administered by the doctor.
- Stool softening medicines should be taken for smooth bowel movement despite the bed rest.
- Pain relieving emedicine is taken to avoid discomfort.
There are certain fracture complications that should be watched out for when it comes to fractures in the shoulder. These are:
- Non-union, wherein the broken bones do not connect with each other
- Mal-union, wherein the connection of the bones is wrongly done
- Death of the head fragment
- Nerve injury
- Shoulder arthritis
- Frozen or stiff shoulder
During rehabilitation, the patient should be careful with the diet. Aside from exercise routines for rehab, a proper diet will make fracture healing time shorter. A good diet for a recovering person would include lots of protein from fish, meat, cheese, poultry and eggs. There should also be more intakes of fiber and fluid so as to avoid constipation while the patient is less mobile. Follow all these things and you will cut your glenoid fracture healing time short.