Shoulder fracture fixation surgery
Shoulder fracture fixation is a surgical procedure that uses a system of metal instrumentation such as screws, pins, plates and metal frames to internally or externally repair a broken bone in the shoulder. The shoulder consists of three bones: the clavicle (collar bone), scapula (shoulder blade) and the humerus (arm bone). These bones, together with tendons, muscles, ligaments and joints, form a platform for creating movement in the arm. Fractures of the shoulder usually are caused by a direct blow to the shoulder area. Falls, collisions, motor vehicle accidents and sports injuries are common causes of shoulder fractures.
Shoulder fracture fixation consists of two types of procedures. The type used for each case is chosen based on the extent and placement of the fracture. The types of shoulder fracture fixations include:
- External fixation – The surgeon will place pins or screws into the bone above and below the site of the fracture. The surgeon then realigns the bone fragments and connects the pins or screws to a bar that remains outside the skin. This bar acts as a stabilizing frame that keeps the bones in proper position during the healing process. Once the fractured bones have healed correctly, the fixations are removed
- Internal fixation – The surgeon will make an incision in the skin over the fracture, then remove any bone fragments from the area. The bones will then be realigned to ensure proper motion and function. Bone cement is sometimes used to hold the bones together. If bone fragments are missing, bone graft material may be used to fill in the gaps between the broken bones. Instrumentation is used in the next step when the surgeon inserts metal screws and plates in and over the bones to hold the bones together as they heal.
Prior to the development of internal fixation, physicians always relied on casts and splints to support the bone from outside the body. When members of the American Academy of Orthopaedic Surgeons (AAOS) were asked to list the most important advances in orthopaedic treatment in the 20th century, the development of internal fixation ranked high on their list. Also known as instrumentation, internal fixation surgery results in added benefits for patients:
- Shorter hospital stays
- Patients return to normal function sooner
- Reduces the incidence of nonunion (improper healing) and malunion (healing in improper position)