A shoulder fracture is a broken bone that could affect your shoulder blade, collarbone, or the upper part of your arm bone and can be easily fractured after high-energy trauma or a direct hit, often requiring a surgical procedure performed by a fellowship-trained orthopedic surgeon. Lancaster shoulder fractures surgeon Michael J. Bercik, Jr., MD, provides expert orthopedic care for a shoulder injury that’s essential to restore your range of motion, relieve severe shoulder pain, and prevent shoulder instability, helping you return to normal activities. If you have a shoulder fracture, avoid chronic pain and disability by calling the office in Lancaster, Ephrata, or Mount Joy, Pennsylvania, or requesting an appointment online today to begin your treatment options with a trusted shoulder specialist.
What are shoulder fractures?
A shoulder fracture is an injury to one of the three bones in your shoulder that causes it to break, crack, or shatter, depending on the type of fracture, severe displacement, and associated shoulder conditions such as rotator cuff tears or arthritis.
There are three bones in your shoulder:
- The scapula (shoulder blade), which provides attachment for the rotator cuff muscles, is part of the upper extremity complex
- Clavicle (collarbone), sometimes referred to as the breast bone connection point
- Humerus (upper arm bone), which is often involved in fractures that may require rotator cuff repair or, in severe cases, reverse shoulder replacement surgery or total shoulder replacement.
These shoulder bones are held together by a network of ligaments, rotator cuff tendons, soft tissues, and surrounding muscles, and chest tissue that act as a protective cover, enabling you to move your shoulder joint and arm smoothly while supporting healing after injury or surgical intervention.
Any of these bones can suffer trauma, resulting in shoulder injuries, a broken clavicle, or a shoulder fracture. Clavicle fractures are a common injury, often caused by a fall, sports injury, or direct blow, and many shoulder fractures occur after impact injuries. Humerus fractures, including most proximal humerus fractures and distal humerus fractures, also occur due to similar trauma, such as landing on an outstretched arm, and may require surgical repair or rotator cuff tear surgery if accompanied by a torn rotator cuff or severe tears.
Scapula fractures, or shoulder blade fractures, are less common because your chest and upper back protect this flat bone. These usually result from high-impact trauma, such as a high-speed motor vehicle accident or car accident, and may require advanced imaging such as CT scans or an MRI to assess the extent of injury, including any partial tear or involvement of surrounding soft tissues.
Types of shoulder fractures
Understanding the specific bone involved in a shoulder fracture helps Dr. Bercik determine the most appropriate course of treatment. Each fracture type carries its own set of considerations for stability, healing potential, and surgical decision-making.
Clavicle fractures
Clavicle fractures are among the most common fractures seen in orthopedic practice, accounting for roughly 5% of all adult fractures. They most often occur at the midshaft of the collarbone following a fall onto the shoulder or a direct blow during contact sports. Midshaft clavicle fractures with minimal displacement frequently heal well with conservative management. However, fractures involving significant shortening, angulation, or displacement, as well as fractures near the acromioclavicular joint or sternoclavicular joint, may require surgical fixation to achieve proper alignment and restore shoulder function.
Proximal humerus fractures
Proximal humerus fractures involve the upper end of the arm bone near the shoulder joint and are one of the most common fractures in adults over age 65, frequently resulting from low-energy falls. These fractures are classified using the Neer classification system, which categorizes them based on the number of displaced fragments (two-part, three-part, or four-part fractures). Two-part fractures with minimal displacement are often managed conservatively, while three- and four-part fractures with significant displacement or involvement of the humeral head blood supply may require surgery to prevent avascular necrosis and restore joint function.
Scapula fractures
Scapula fractures are relatively rare and typically result from high-energy trauma such as motor vehicle accidents, falls from height, or direct impacts. Because the scapula is well protected by surrounding muscles and the chest wall, a significant force is required to fracture it. Scapula fractures are frequently associated with other injuries, including rib fractures, pneumothorax, and vascular injuries, making a comprehensive trauma evaluation essential. Most scapula fractures are managed non-surgically, though fractures involving the glenoid fossa (the socket portion of the shoulder joint) may require open reduction and internal fixation to restore joint congruence.
What are the symptoms of shoulder fractures?
All types of shoulder fractures typically cause intense pain, arm numbness, swelling, bruising, and reduced mobility. You might notice deformity, limited range of motion, or a grinding sensation in the socket joint or glenohumeral joint, often requiring rest and sometimes the use of a sling to immobilize the body area.
Symptoms can vary by fracture type and may be influenced by the patient’s age, medical history, and presence of arthritis or other joint conditions that affect shoulder care.
Clavicle fracture
This involves swelling and a visible bump where the bone ends protrude. A displaced fracture of the broken collarbone may push against the skin, sometimes requiring open reduction and internal fixation through an open incision by an orthopedic surgeon. These injuries can affect the acromioclavicular joint or the sternoclavicular joint, and surgical intervention may be required.
Humerus fracture
This can involve either a proximal humerus or distal humerus fracture, leading to severe shoulder pain, swelling, and reduced motion. Humeral head involvement may also affect the shoulder socket, including the glenoid cavity, and, in advanced cases, may require shoulder hemiarthroplasty, a surgical procedure often performed by a Lancaster shoulder fractures doctor as part of full-spectrum shoulder care within an orthopedic practice.
Scapular fracture
These shoulder blade fractures often include extensive bruising and difficulty moving the shoulder, commonly seen after motor vehicle collisions.
How are shoulder fractures diagnosed?
Accurate diagnosis is the foundation of effective shoulder fracture treatment. Dr. Bercik begins with a thorough physical examination, assessing the location and nature of pain, visible deformity, neurovascular status, and the patient’s ability to move the arm. Understanding the mechanism of injury, whether a fall, collision, or direct blow, provides important context for predicting which structures may be involved.
X-ray
X-rays are the first-line imaging study for any suspected shoulder fracture. They can identify fracture lines, displacement, angulation, and involvement of the joint surfaces. Multiple views, including AP, lateral, and axillary images, are typically obtained to fully characterize the fracture pattern.
CT scan
A CT scan provides significantly more detail than X-rays alone and is often essential for complex fractures, particularly those involving the glenoid, humeral head, or scapula. CT imaging allows Dr. Bercik to evaluate the number of fracture fragments, the degree of displacement, and the involvement of the joint surface, all of which directly influence the surgical plan.
MRI
MRI is used when soft tissue injury is suspected alongside a fracture, such as a concurrent rotator cuff tear, labral injury, or ligament damage. It is also helpful in evaluating for avascular necrosis of the humeral head in cases where the blood supply to the bone may have been compromised.
How are shoulder fractures treated by a Lancaster shoulder fractures surgeon, Michael J. Bercik Jr., MD?
Some non-displaced fractures or minimally displaced fractures may not require surgery, which is determined after a thorough physical examination by a shoulder fracture specialist. In these cases, non-surgical treatment includes initial treatment with immobilization, followed by physical therapy to restore function and encourage bone growth until the fracture heals naturally. A physical therapist may guide you through rehab to strengthen the arm and shoulder safely, using proper exercises and motion exercises as early physical therapy to support a pain-free range of motion.
However, shoulder fracture surgery may be necessary for displaced fractures, comminuted fractures (with multiple bone fragments), or open fractures where the bone breaks through the skin. Lancaster shoulder fractures specialist Doctor Michael Bercik and his specialized team may need to realign the shoulder bones and secure them with metal plates, rods, or screws to return the bone to its correct position, often utilizing minimally invasive techniques to reduce trauma and speed recovery.
In complex cases, such as a severely shattered proximal humerus fracture or damage near a growth plate, the specialist may recommend shoulder replacement surgery to restore full shoulder function and improve overall functional outcome. Surgery for shoulder fractures may also be necessary when they are accompanied by a dislocated shoulder or require advanced stabilization procedures such as an arthroscopic Latarjet, with tailored recovery programs designed for both adults and children to optimize healing and life quality.
Conservative shoulder fracture treatment: sling and physical therapy
For fractures that are stable and well-aligned, non-surgical treatment is often the most appropriate path. The shoulder is immobilized in a sling, typically for 4 to 6 weeks depending on the fracture type and location, to protect the healing bone and allow the surrounding soft tissues to recover.
Pain management during the early weeks includes oral anti-inflammatory medications, ice application, and in some cases a brief course of prescription pain relief. Patients are encouraged to keep the hand, wrist, and elbow moving during immobilization to prevent stiffness in the surrounding joints.
Physical therapy begins as soon as the fracture is stable enough to allow gentle movement, often within the first 2 to 4 weeks. Early exercises focus on pendulum movements and passive range of motion to reduce stiffness without placing stress on the healing bone. As healing progresses, active range of motion and strengthening exercises are introduced under the guidance of a physical therapist.
Most patients treated conservatively for a non-displaced clavicle or proximal humerus fracture achieve good functional outcomes, though full recovery including return to overhead activities and sports can take 3 to 6 months. Regular follow-up X-rays are used to confirm that the fracture is healing in proper alignment throughout the recovery period.
Surgical options for shoulder fractures
When a fracture is displaced, unstable, or involves the joint surface, surgery is often necessary to restore proper alignment and allow the shoulder to heal in a position that supports long-term function.
Open reduction and internal fixation (ORIF)
ORIF is the most common surgical approach for displaced shoulder fractures. During this procedure, Dr. Bercik makes an incision to access the fracture site, manually repositions the bone fragments into proper alignment (open reduction), and secures them in place using metal plates, screws, or intramedullary nails (internal fixation). The hardware remains in place permanently in most cases and allows early rehabilitation while the bone heals.
ORIF is commonly used for displaced clavicle fractures, two- and three-part proximal humerus fractures with adequate bone quality, and glenoid fractures involving the joint surface. The goal is to restore the normal anatomy of the shoulder so that the joint can move and function properly after healing.
Shoulder replacement for complex fractures
In cases involving severely comminuted proximal humerus fractures, particularly four-part fractures in older patients with osteoporotic bone, the humeral head may not be reconstructable with plates and screws. In these situations, shoulder replacement surgery, either a hemiarthroplasty (replacing only the ball) or a reverse total shoulder replacement, provides a more reliable path to pain relief and functional recovery. Reverse total shoulder replacement is increasingly preferred for complex fractures in older patients due to its superior functional outcomes, particularly when the rotator cuff is compromised.
Recovery timeline and return to function
Recovery from a shoulder fracture varies considerably depending on the bone involved, the severity of the fracture, the treatment approach, and the patient’s age and overall health. Most patients follow a progressive recovery that can be divided into three general phases.
The early protection phase, typically the first 4 to 6 weeks, focuses on pain control and protecting the healing bone. The shoulder is kept in a sling and physical therapy is limited to gentle pendulum exercises and distal joint movement.
The motion recovery phase, from roughly 6 weeks to 3 months, introduces progressive range of motion exercises as bone healing is confirmed on X-ray. The focus shifts to restoring flexibility and reducing the stiffness that commonly develops after shoulder immobilization.
The strengthening and return-to-function phase, from 3 to 6 months and beyond, involves progressive resistance exercises targeting the rotator cuff, deltoid, and periscapular muscles. Return to overhead activities, sports, and physically demanding work is guided by functional benchmarks rather than a fixed calendar.
Patients who have undergone shoulder replacement for a complex fracture typically follow a modified timeline with restrictions on lifting and overhead use during the first 3 months. Most achieve meaningful functional gains within 6 months, with continued improvement for up to a year or more after surgery.
In addition to fractures, Dr. Bercik is regarded by patients as one of the best shoulder surgeons in PA, treating tendon-related injuries, including those requiring rotator cuff surgery, joint degeneration, shoulder stiffness, and AC joint instability, with a comprehensive approach that integrates diagnostics, surgical expertise, and rehabilitation.
Frequently asked questions about shoulder fracture treatment
How long does a shoulder fracture take to heal?
Most shoulder fractures show evidence of bone healing on X-ray within 6 to 8 weeks. However, full functional recovery, including restored strength and range of motion, typically takes 3 to 6 months for non-surgical cases and up to a year or longer for patients who undergo shoulder replacement for a complex fracture.
Do all shoulder fractures require surgery?
No. Many shoulder fractures, particularly non-displaced or minimally displaced clavicle and proximal humerus fractures, heal well with a sling and physical therapy. Surgery is generally reserved for displaced or unstable fractures, fractures involving the joint surface, and cases where conservative treatment is unlikely to produce an acceptable functional result.
What is the difference between ORIF and shoulder replacement for a fracture?
ORIF preserves the patient’s own bone by realigning and securing the fracture fragments with hardware. Shoulder replacement removes the damaged humeral head and replaces it with an implant. Replacement is typically considered when the fracture is too complex to repair reliably with hardware, particularly in older patients with four-part fractures or poor bone quality.
Can a shoulder fracture cause long-term problems?
Yes, if not treated appropriately. Malunion (healing in a poor position), avascular necrosis of the humeral head, post-traumatic arthritis, and chronic stiffness are all possible complications. Early evaluation and proper treatment planning significantly reduce the risk of long-term complications and improve functional outcomes.
Where can I find a shoulder fracture surgeon near Lancaster, PA?
Michael J. Bercik Jr., MD sees patients at orthopedic practice locations in Lancaster, Ephrata, and Mount Joy, Pennsylvania. He provides comprehensive evaluation and treatment for all types of shoulder fractures, from conservative management with a sling and physical therapy to complex surgical reconstruction and shoulder replacement.
For more information or to schedule a consultation about a shoulder injury or shoulder fracture, don’t wait and call the nearest office or request one online today to begin your personalized treatment plan with a trusted Lancaster shoulder fractures surgeon.
