Glenohumeral joint fracture

Anatomy

The shoulder provides more motion than any other joint in the human body and is a marvel of mobility and stability. The glenohumeral joint is where the ball (humeral head) and the socket (the glenoid) meet. When you move your shoulder, the ball of the shoulder head remains centered in the glenoid. The glenoid’s purpose is to offer stability to the shoulder. The ligaments within the shoulder also help with stability and keep the shoulder from moving beyond its range of motion. The rotator cuff holds everything together using concavity compression, working like a golf ball held in place by the concavity of a golf tee.

About

Shoulder fractures are relatively uncommon. But they can occur when there is significant trauma to the shoulder, such as during a hard fall or a car accident, or as a result of high-energy sports injuries. The two most common types of glenoid fractures are:

• Glenoid lip fracture – This type of fracture occurs when the shoulder dislocates. As the ball of the shoulder socket dislocates, it pushes against the rim of the socket, causing it to break.
• Glenoid fossa fracture – The glenoid fossa is the center part of the socket. This type of fracture is far less common and occurs when the shoulder sustains severe trauma, causing the glenoid fossa to break.

Symptoms

There are a wide variety of symptoms associated with shoulder socket fractures.

Symptoms include:

• Pain
• Swelling
• Bruising
• Inability to move the shoulder
• Limited shoulder mobility
• A grinding sensation when the shoulder moves

Diagnosis

Your Florida Orthopaedic Institute physician will take a look at your symptoms and overall medical health and history, followed by a physical examination. Your physician will probably also order an X-ray, which shows the dense structures such as bone. If your shoulder socket is fractured, the X-ray will show the fractured bone.

Treatment

There are both surgical and nonsurgical treatment options available to heal your shoulder fracture. Surgical treatment is the primary way to treat this injury. The type of surgical treatment you receive will be completely dependent on the severity of your shoulder fracture. There is no one way to surgically treat a shoulder fracture, but many different ways. But if your shoulder fracture is not severe, non-surgical treatments can work.

Nonsurgical treatment

If the shoulder socket fracture is not severe, non-surgical treatments will usually do a great job of healing your fracture and allowing you to return to your daily activities. Nonsurgical treatments involve keeping the shoulder in place so that the bone can heal. This can be done by wearing either a sling, splint, or cast for a few weeks or longer, depending on the severity of the fracture.

Another option to help speed up the healing process is bone stimulation. This treatment option uses low electric current or low-intensity pulsed ultrasound, which tricks the body into thinking an injury has occurred. In response, your body produces proteins that begin to repair cells in your injured shoulder.

Surgical treatment

Treatment of a glenoid rim fracture focuses on restoring the normal contour of the shoulder socket to prevent repeat dislocations (recurrent instability) of the shoulder joint. Surgical treatment is often considered for these injuries, especially when the fracture is out of position or if there is a large fragment of the glenoid bone.

There is little data on the ideal treatment of these injuries because they are so uncommon. But most surgeons agree that fracture management decisions must consider both the fracture type and the patient’s need. More active patients with fractures that are not in the proper position will most likely benefit from surgery to realign these injuries.

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