Fractures & Trauma
A bone fracture is a medical condition in which a bone is cracked or broken. It is a break in the continuity of the bone. While many fractures are the result of high force impact or stress, bone fracture can also occur as a result of certain medical conditions that weaken the bones, such as osteoporosis.
Fractures: Types and Treatment
- Simple fractures in which the fractured pieces of bone are well aligned and stable.
- Unstable fractures are those in which fragments of the broken bone are misaligned and displaced.
- Open (compound) fractures are severe fractures in which the broken bones cut through the skin. This type of fracture is more prone to infection and requires immediate medical attention.
- Greenstick fractures: This is a unique fracture in children that involves bending of one side of the bone without any break in the bone.
Fracture HealingOur body reacts to a fracture by protecting the injured area with a blood clot and callus or fibrous tissue. Bone cells begin forming on the either side of the fracture line. These cells grow towards each other and thus close the fracture.
Medical TherapyThe objective of early fracture management is to control bleeding, prevent ischemic injury (bone death) and to remove sources of infection such as foreign bodies and dead tissues. The next step in fracture management is the reduction of the fracture and its maintenance. It is important to ensure that the involved part of the body returns to its function after fracture heals. To achieve this, maintenance of fracture reduction with immobilization technique is done by either non-operative or surgical method. Non-operative (closed) therapy comprises of casting and traction (skin and skeletal traction).
- Casting closed reduction is done for any fracture that is displaced, shortened, or angulated. Splints and casts made up of fiberglass or plaster of Paris material are used to immobilize the limb.
- Traction Traction method is used for the management of fractures and dislocations that cannot be treated by casting. There are two methods of traction namely, skin traction and skeletal traction.
- Open Reduction and Internal Fixation (ORIF) This is a surgical procedure in which the fracture site is adequately exposed and reduction of fracture is done. Internal fixation is done with devices such as Kirschner wires, plates and screws, and intramedullary nails.
- External fixation External fixation is a procedure in which the fracture stabilization is done at a distance from the site of fracture. It helps to maintain bone length and alignment without casting.
- Open fractures with soft-tissue involvement
- Burns and soft tissue injuries
- Pelvic fractures
- Comminuted and unstable fractures
- Fractures having bony deficits
- Limb-lengthening procedures
- Fractures with infection or non-union
RehabilitationFractures may take several weeks to months to heal completely. You should limit your activities even after the removal of cast or brace so that the bone become solid enough to bear the stress. Rehabilitation program involves exercises and gradual increase in activity levels until the process of healing is complete.
Growth Plate Fractures
Types of growth plate fracturesGrowth plate fractures can be classified into five categories based on the type of damage caused. Type I – Fracture through the growth plate The epiphysis is separated from the metaphysis with the growth plate remaining attached to the epiphysis. The epiphysis is the rounded end of the long bones below the growth plate and the metaphysis is the wider part at the end of the long bones above the growth plate. Type II – Fracture through the growth plate and metaphysis This type is the most common type of growth plate fracture. The growth plate and metaphysis are fractured without involving the epiphysis. Type III – Fracture through the growth plate and epiphysis In this type of injury, the fracture runs through the epiphysis and separates the epiphysis and growth plate from the metaphysis. It usually occurs in the tibia, one of the long bone of the lower leg. Type IV – Fracture through growth plate, metaphysis, and epiphysis: Type IV is when the fracture goes through the epiphysis and growth plate, and into the metaphysis. This type often occurs in the upper arm near the elbow joint. Type V – Compression fracture through growth plate: This type of fracture is a rare condition where the end of the bone gets crushed and the growth plate is compressed. It can occur at the knee or ankle joint.
CausesGrowth plate injuries are caused by accidental falls or blows to the limbs during sports activities such as gymnastics, baseball, or running. They may also result from overuse of tendons and certain bone disorders such as infection that can affect the normal growth and development of the bone. The other possible causes which can lead to growth plate injuries are:
- Child abuse or neglect – Growth plate fractures are one of the most common fractures that occur in abused or neglected children.
- Exposure to intense cold (frostbite) – Extremely cold climatic conditions can cause damage to the growth plates resulting in short fingers and destruction of the joint cartilage.
- Chemotherapy and medications – Chemotherapy to treat cancer in children and continuous use of steroids for arthritis may affect bone growth.
- Nervous system disorders – Children with disorders of the nerves may have sensory deficits and muscular imbalances that can cause them to lose their balance and fall.
- Genetic disorders – Gene mutations may result in poorly formed or malfunctioning growth plates which are vulnerable to fracture.
- Metabolic diseases – Diseases such as kidney failure and hormonal disturbances affect the proper functioning of the growth plates and increase susceptibility to fractures.
Signs and symptomsSigns and symptoms of a growth plate injury include:
- Inability to move or put pressure on the injured extremity
- Severe pain or discomfort that prevents the use of an arm or leg
- Inability to continue playing after a sudden injury because of pain
- Persistent pain from a previous injury
- Malformation of the legs or arms as the joint area near the end of the fractured bone may swell
DiagnosisYour doctor will evaluate the condition by asking you about the injury and performing a physical examination of the child. X-rays may be taken to determine the type of fracture. Since the growth plates have not hardened and may not be visible, X-rays of the injured as well as the normal limb are often taken to look for differences in order to help determine the place of injury. Other diagnostic tests your doctor may recommend include computed tomography (CT) scan or magnetic resonance imaging (MRI). These tests are helpful in detecting the type and extent of injury as it allows the doctor to see the growth plate and soft tissues.
TreatmentThe treatment for growth plate injuries depends upon the type of fracture involved. In all cases, the treatment should begin as early as possible and include the following:
- Immobilization: The injured limb is covered with a cast or a splint may be given to wear. The child will be advised to limit activities and avoid putting pressure on the injured limb.
- Manipulation or surgery: If the fracture is displaced and the ends of the broken bones do not meet in proper position, then your doctor will unite the bone ends into correct position either manually (manipulation) or surgically. Sometimes, a screw or wire may be used to hold the growth plate in place. The bone is then immobilized with a cast to promote healing. The cast is removed once healing is complete
- Physical therapy: Exercises such as strengthening and range-of-motion exercises should be started only after the fracture has healed. These are done to strengthen the muscles of the injured area and improve the movement of the joint. A physical therapist will design an appropriate exercise schedule for your child.
- Long-term follow up: Periodic evaluations are needed to monitor the child’s growth. Evaluation includes X-rays of matching limbs at intervals of 3 to 6 months for at least 2 years.
- Establishing stability: Metal rods, plates or screws are implanted to hold the broken bones above and below the fracture site. Support may be provided internally or externally.
- Providing a healthy blood supply and soft tissue at the fracture site: Your doctor removes dead bone along with any poorly vascularized or scarred tissue from the site of fracture to encourage healing. Sometimes, healthy soft tissue along with its underlying blood vessels may be removed from another part of your body and transplanted at the fracture site to promote healing.
- Stimulating a new healing response: Bone grafts may be used to provide fresh bone-forming cells and supportive cells to stimulate bone healing.
TreatmentStress fractures can be treated by non-surgical approach which includes rest and limiting the physical activities that involves foot and ankle. If children return too quickly to the activity that has caused stress fracture, it may lead to chronic problems such as harder-to-heal stress fractures. Protective footwear may be recommended which helps to reduce stress on the foot. Your doctor may apply cast to the foot to immobilize the leg which also helps to remove the stress. Crutches may be used to prevent the weight of the foot until the stress fracture is healed completely. Surgery may be required if the fracture is not healed completely by non-surgical treatment. Your doctor makes an incision on the foot and uses internal fixators such as wires, pins, or plates to attach the broken bones of the foot together until healing happens after which these fixators can be removed or may be permanently left inside the body. Some of the following measures may help to prevent stress fractures:
- Ensure to start any new sport activity slowly and progress gradually
- Cross-training: You may use more than one exercise with the same intention to prevent injury. For example you may run on even days and ride a bike on odd days, instead of running every day to reduce the risk of injury from overuse. This limits the stress occurring on specific muscles as different activities use muscles in different ways
- Ensure to maintain a healthy diet and include calcium and vitamin D-rich foods in your diet
- Ensure that your child uses proper footwear or shoes for any sports activity and avoid using old or worn out shoes
- If your child complains of pain and swelling then immediately stop the activities and make sure that your child rests for few days
The thigh bone, femur, and the pelvis, acetabulum, join to form the hip joint. The hip joint is a “ball and socket” joint. The “ball” is the head of the femur, or thigh bone, and the “socket” is the cup shaped acetabulum.
The joint surface is covered by a smooth articular surface that allows pain free movement in the joint.
The cartilage cushions the joint and allows the bones to move on each other with smooth movements. This cartilage does not show up on X-ray, therefore you can see a “joint space” between the femoral head and acetabular socket.
The hip joint is a “ball and socket” joint. The “ball” is the head of the femur or thigh bone and the “socket” is the cup shaped acetabulum. The joint surface is covered by a smooth articular surface that allows pain free movement in the joint.
Hip fracture is a break that occurs near the hip in the upper part of the femur or thigh bone. The thigh bone has two bony processes on the upper part – the greater and lesser trochanters. The lesser trochanter projects from the base of the femoral neck on the back of the thigh bone. Hip fractures can occur either due to a break in the femoral neck, in the area between the greater and lesser trochanter or below the lesser trochanter.
Hip fracture is most frequently caused after minor trauma in elderly patients with weak bones, and by a high-energy trauma or serious injuries in young people. Long term use of certain medicines, such as bisphosphonates to treat osteoporosis (a disease causing weak bones) and other bone diseases, increases the risk of hip fractures.
Signs and symptoms of hip fracture include
- Pain in the groin or outer upper thigh
- Swelling and tenderness
- Discomfort while rotating the hip
- Shortening of the injured leg
- Outward or inward turning of the foot and knee of the injured leg
Your doctor may order an X-ray to diagnose your hip fracture. Other imaging tests, such as the magnetic resonance imaging or (MRI), may also be performed to detect the fracture.
Depending on the area of the upper femur involved, hip fractures are classified as
- Intracapsular Fracture
- Intertrochanteric Fracture
- Subtrochanteric Fracture
Hip fractures can be corrected and aligned with non-operative and operative methods:
Traction may be an option to treat your condition if you are not fit for surgery. Skeletal traction may be applied under local anesthesia, where screws, pins and wires inserted into the femur and a pulley system is set up at the end of the bed to bear heavy weights. These heavy weights help in correcting the misaligned bones until the injury heals.
Hip fractures can be surgically treated with external fixation, intramedullary fixation, or by using plates and screws.
Pelvic fracture is a condition that arises due to breakage of the pelvis bones. It may damage internal organs, nerves, and blood vessels associated with the pelvis region.
The pelvis is a round structure of bones located at the base of the spine, connected to the sacrum of the spine with the help of strong ligaments. The pelvis is composed of three bones, namely ilium, ischium, and pubis that are fused together. The side of the pelvis is composed of a cup shape socket, known as acetabulum.
Various organs related to the digestive and reproductive systems lie within the pelvis ring. Also, several large nerves and blood vessels supplying the lower limbs pass through the pelvis. The pelvis ring also acts as point of attachment for muscles approaching from the upper and lower part of the body.
Based on the damage of the pelvis ring and associated structures, pelvic fractures can be categorized as:
- Stable pelvic fractures: Have single point breakage in the pelvis ring and broken bones remain in position; shows less bleeding
- Unstable pelvic fractures: Have breakage at two or more points, followed by severe bleeding. Unstable pelvic fractures may cause shock, extensive internal bleeding, and damage to the internal organs. It requires immediate medical care followed by long-term physical therapy and rehabilitation.
The common causes responsible for pelvic fractures include:
- Sports injuries or trauma
- Abrupt muscle contraction
- Conditions such as osteoporosis, especially in elderly people
- Accidental injury or fall from a great height
The common symptoms associated with pelvic fractures are:
- Pain and swelling in the groin or hip region that may worsen with ambulation
- Abdominal pain
- Bleeding through the urethra or vagina and the rectum
- Problems in urination
- Unable to stand or walk
The diagnosis of pelvic fracture starts with physical examination including checking the functional activity of the various body organs present in the pelvic region. Imaging techniques such as X-rays, CT (Contrast Tomography) and MRI (Magnetic Resonance Imaging) scan may also be used to confirm the exact condition or breakage of the pelvic bones. In some cases, additional contrasting studies using radioactive dye may be recommended to evaluate the structural and functional activity of organs such as the urethra, bladder, and the pelvic blood vessels.
Treatment of the pelvic fracture depends upon the severity of the injury and condition of the patient. Minor or stable fractures can be treated with conservative methods such as rest, medications, use of crutches, physical therapy, and if required minor surgery. These methods may take 8–12 months for complete healing.
The treatment of unstable fractures includes management of the bleeding and injuries of the internal organs, blood vessels, and nerves. Surgical intervention may be employed for fixation of the fractured pelvic bones using screws and plates. Pelvic bone fixation provides stability to the pelvic bone and promotes natural healing of the fracture.
Knee & Leg
Fractures of the Proximal Tibia
The tibia or shin bone is a major bone of the leg which connects the knee to the ankle. A tibial fracture is a break in the continuity of the shin bone (tibia).
Fractures of proximal tibia: A proximal tibial fracture is a break in the upper part of the shin bone or tibia. Proximal tibial fractures may or may not involve the knee joint. Fractures that enter the knee joint may cause joint imperfections, irregular joint surfaces, and improper alignment in the legs. This can lead to as joint instability, arthritis, and loss of motion. These fractures are caused by stress or trauma or in a bone already compromised by disease, such as cancer or infection. Proximal tibia fractures can result in injury to the surrounding soft tissues including skin, muscle, nerves, blood vessels, and ligaments.
The symptoms of tibia fracture include painful weight bearing movements, tenseness around the knee, limitation of movement and deformity around the knee. In some individuals, impairment of blood supply secondary to the fracture may result in a pale or cool foot. Patients may also experience numbness or feelings of ‘pins and needles’ in the foot as a result of associated nerve injury.
The diagnosis of tibial fracture is based on the medical history including history of any previous injuries, complete physical examination and imaging studies. The physician will evaluate a soft tissue around the joint to identify any signs of nerve or blood vessel injury. Multiple X-rays and other imaging studies such as CT and MRI scans may be used to identify the location and severity of the fracture.
Surgical treatment is considered to maintain alignment of the fractured bone. External or internal fixators may be used to align the fractured bone segments. If the fracture does not involve the knee joint, rods and plates can be used to stabilize the fracture. For a fracture involving the knee joint, a bone graft may be required to prevent the knee joint from collapsing. An external fixator is used when the surrounding soft tissue is severely damaged, as the use of plate and screw may be harmful.
As the tibial fracture usually involves the weight bearing joint it may cause long term problems such as loss of knee motion or instability and long term arthritis. Hence a rehabilitation program is initiated along with the treatment comprising of instructions on weight bearing, knee movements, and the use of external devices such as braces.
Pediatric Thighbone (Femur) Fracture
The femur or thighbone is the largest and strongest bone in the human body. Pediatric thighbone fractures can occur when your child falls hard on the ground and gets hit during sports, automobile accidents, and child abuse. In a thighbone fracture, the broken bones may be aligned or displaced. The fracture can either be closed (with skin intact) or open (with the bone piercing out through the skin). Your child may experience severe pain, swelling, inability to stand and walk, and limited range of motion of hip or knee.
Your child’s doctor will conduct a physical examination. An X-ray or CT-scan may be recommended to locate the position and number of fractures, and determine if the growth plate is damaged. Femur fractures may be treated with non-surgical or surgical methods.
Non-surgical treatment involves stabilizing the bones so they can heal and fuse together. Braces, spica casting (cast applied from the chest, down the fractured leg) or traction (placing the leg in a weight system) may be used to ensure that the bones are properly set in their normal position.
Surgery is recommended for complicated injuries. Your child’s surgeon aligns the broken bones and uses metal plates and screws to hold the fractured bones together in proper alignment. Your child may have to wear a cast for a few weeks until complete healing. An external fixator may be used in case of open injury to the skin and muscles.
- Tibial shaft fractures: A tibial shaft fracture is a break that occurs along the length of the tibia or shin bone (larger bone of the lower leg) between the knee and ankle joints. These fractures can occur while playing sports such as soccer and skiing.
Thighbone (Femur) Fracture
The femur or thigh bone is the longest and strongest bone in the body, connecting the hip to the knee. A femur fracture is a break in the femur. The distal femur is the lower part of the thigh bone which flares out like an upside-down funnel and its lower end is covered by a smooth, slippery articular cartilage that protects and cushions the bone during movement. Fracture of the distal femur may involve the cartilaginous surface of the knee as well and result in arthritis.
- Distal femurfracture: The distal femur ispart of the femur bone that flares out like the mouth of the funnel.A distal femur (top part of knee joint) fracture is a break inthighbone that occurs just above your knee joint.
- Femoralshaft fracture: A femoral shaftfracture is a break that occurs anywhere along the femoral shaft,long, straight part of the femur.
- Proximalfemur fracture: A hip fracture orproximal femur fracture is a break in the proximal end of the thighbone near the hip.
Femur fractures may be caused by high energy injuries such as a fall from height or a motor vehicle accident. Patients with osteoporosis, bone tumor or infections, or a history of knee replacement are more prone to femur fractures. In the elderly, even a simple fall from a standing position may result in a fracture as the bones tend to become weak and fragile with advancing age.
Sudden, severe pain along with swelling and bruising are the predominant symptoms of femur fracture. The site is tender to touch with a visible physical deformity and shortening of the leg.
The diagnosis of femur fracture is based on the patient’s medical history including history of any previous injuries, complete physical examination and imaging studies. The physician will evaluate the soft tissue around the joint to identify any signs of nerve or blood vessel injury. Multiple X-rays and other imaging studies such as CT and MRI scans may be used to identify the location and severity of the fracture.
Surgical treatment is considered to realign the fractured bone. The use of advanced technology and special materials has improved the surgical outcome even in older patients. External or internal fixation or a knee replacement may be required depending on the extent of the fracture. Timing of the surgery is an important factor in improving the surgical outcome.
Timing of surgery
In most cases, the surgery is delayed for a few days to develop an effective treatment plan and for preparation of the patient. With most distal femur fractures the surgery can be delayed unless the fracture is open to the environment.
An external fixator is used when the surrounding soft tissue is severely damaged, as the use of plates and screws may be harmful. The external fixator maintains the alignment of the bone till surgery.
Once the patient is prepared for surgery, the surgeon removes the external fixator and places internal fixation devices into the bone during surgery.
The internal fixation may be performed using intramedullary nailing or plates and screws. In intramedullary nailing a metal rod is inserted into the marrow canal of the femur to keep the fractured fragment in position. In the plate and screw method the bone fragments are realigned and held together with screws and plates, attached to the outer surface of the bone. If the fracture is of the comminuted type or the bone has broken into many pieces, plates or rods may be used at the ends of the fracture without disturbing the smaller pieces. The plate or rod will maintain the shape or strength of the bone till it heals. In elderly patients and those with poor bone quality, bone grafting may be used to improve the healing. Knee replacement may also be considered in complicated fractures or those with poor bone quality.
Artificial implants may be used to replace the fractured segments of the bone and joint.
Rehabilitation of the femur fracture depends upon several factors such as age, general health of the patient and the type of fracture. As the femur fracture usually involves the weight bearing joint it may cause long term problems such as loss of knee motion or instability and long term arthritis. Hence a rehabilitation program is initiated along with the treatment comprising of instructions on weight bearing, knee movements, and the use of external devices such as braces.
The clavicle or the collarbone is the bone that connects your sternum or breastbone to your shoulder. Clavicle fracture, also called broken collarbone is a very common sports injury seen in people who are involved in contact sports such as football and martial arts as well as impact sports such as motor racing.
A broken collarbone normally occurs after a fall onto the shoulder or a motor vehicle accident. The most common sports associated with clavicle fractures include football, hockey, and skiing.
A broken collarbone most often causes pain, swelling and bruising over the collarbone. Pain increases with shoulder movement. Your shoulder may be slumped downward and forward. You may also have a bump around the area of the break. You may hear a grinding sound when you try to raise your arm.
To diagnose a broken collarbone, your doctor will take a brief history, about the injury, and perform a physical examination of your shoulder. An X-ray of the clavicle is taken to identify the location of the fracture. Your doctor may also recommend a computerized tomography (CT) scan in some cases.
Conservative Treatment Options
Most broken collarbones heal without a surgery. An arm sling may support the arm and hold the bones in their normal position. You may also be given pain medications to relieve the pain. After your pain reduces your doctor may recommend gentle shoulder and elbow exercises to minimize stiffness and weakness in your shoulder. Follow up with your doctor until your fracture heals.
Surgery may be required in case of displaced fractures. Surgery is performed to re-align the fractured ends and stabilize them during healing. Surgery often involves use of pins or plates and screws to maintain proper position of the bone during healing.
Plates and Screws fixation
During this surgical procedure, your surgeon will reposition the broken bone ends into normal position and then uses special screws or metal plates to hold the bone fragments in place. These plates and screws are usually left in the bone. If they cause any irritation, they can be removed after fracture healing is complete.
Placement of pins may also be considered to hold the fracture in position and the incision required is also smaller. They often cause irritation in the skin at the site of insertion and have to be removed once the fracture heals.
Fracture of the Shoulder Blade (Scapula)
The scapula (shoulder blade) is a flat, triangular bone providing attachment to the muscles of the back, neck, chest and arm. The scapula has a body, neck and spine portion.
Scapular fractures are uncommon but do occur and require a large amount of force to fracture. They are usually the result of intense trauma, such as a high speed motor vehicle accident or a fall from height onto one’s back. They can also occur from a fall on an outstretched arm if the humeral head impacts on the glenoid cavity.
Symptoms of a scapular fracture include the following:
- Pain: Usually severe and immediate following injury to the scapula.
- Swelling: The scapular area quickly swells following the injury.
- Bruising: Bruising occurs soon after injury.
- Impaired Mobility: Decreased range of motion of the joint occurs, often with inability to straighten the arm.
- Numbness: Numbness, tingling, or coldness of the hand and forearm can occur if blood supply is impaired or nerves are injured.
- Popping Sound: A cracking or popping sound, also referred to as crepitus, can often be heard or felt at the time of the fracture.
Scapular fractures should be evaluated by an orthopaedic surgeon for proper diagnosis and treatment.
Your surgeon will perform the following:
- Medical History
- Physical Examination
Diagnostic Studies may include:
- X-rays: A form of electromagnetic radiation that is used to take pictures of bones.
- CT scan: This test creates images from multiple X-rays and shows your physician structures not seen on regular X-ray.
- MRI: Magnetic and radio waves are used to create a computer image of soft tissue such as nerves and ligaments.
Most scapular fractures are not significantly displaced due to the strong supporting soft tissue structures surrounding it. Therefore, a majority of scapular fractures are treated conservatively and with early motion to reduce the risk of stiffness and will usually heal without affecting shoulder movement.
Conservative treatment options include:
- Immobilization: A sling is used for comfort and to support the shoulder to allow healing to take place. This is usually worn about 3-6 weeks depending on the type of fracture and how well you heal.
- Prescription Medications: Pain medications will be prescribed for your comfort during the healing process.
- Physical Therapy: Early progressive range of motion exercises is essential in restoring full shoulder function. Your physician will most likely refer you to a Physical Therapist for instruction on proper exercises and early motion of the shoulder to prevent complications.
Fractures of the scapula involving the neck or glenoid or with severe displacement have been associated with poor outcomes when treated non-operatively. will usually require surgical intervention to realign the bones properly and restore a functional, pain free range of motion to the shoulder joint.
Scapular fracture repair surgery has historically been performed through a large, open incision. Newer, minimally invasive techniques have evolved and surgery to repair scapular fractures can now be performed through arthroscopy.[/tab] [tab title="Olecranon"]
Olecranon (Elbow) Fractures
Three bones, humerus, radius and ulna make up the elbow joint. The bones are held together by ligaments thus providing stability to the joint. Muscles and tendons around the bones coordinate the movements and help in performing various activities. Elbow fractures may occur from trauma resulting from a variety of reasons, some of them being a fall on an outstretched arm, a direct blow to the elbow, or an abnormal twist to the joint beyond its functional limit.
Olecranon fractures: These are fractures occurring at bony prominence of the ulna. The fractures, if stable, are treated using an immobilizing splint followed by a regimen of motion exercises. However severe fractures require surgical repair.
Symptoms of an olecranon fracture include pain, swelling, bruising, stiffness in and around the elbow, a popping or cracking sound, and deformity of the elbow bones.
To diagnose olecranon fractures X-rays of the joint are taken. In some cases, a CT scan may be needed to get to know the details of the joint surface.
The aim of the treatment is to maximize early motion to reduce the risk of stiffness. Nonsurgical treatment options include use of a splint or a sling to immobilize the elbow during the healing process. Surgery is indicated in displaced and open fractures to realign the bones and stabilize the joint as well as to avoid deep infections.
Strengthening exercises, scar massage, therapy with ultrasound, heat, and ice are recommended to improve the range of motion. Splints are also used to facilitate stretching of the joint.
Shoulder injuries most commonly occur in athletes participating in sports such as swimming, tennis, pitching, and weightlifting. The injuries are caused due to the over usage or repetitive motion of the arms.
Shoulder injuries cause pain, stiffness, restricted movements, difficulty in performing routine activities, and popping sensation.
Some of the common shoulder injuries include sprains and strains, dislocations, tendinitis, bursitis, rotator cuff injury, fractures, and arthritis.
- Sprains and strains: A sprain is stretching or tearing of ligaments (tissues that connect adjacent bones in a joint). It is a common injury and usually occurs when you fall or suddenly twist. A strain is stretching or tearing of muscle or tendon (tissues that connect muscle to bone). It is common in people participating in sports. Strains are usually caused by twisting or pulling of the tendons.
- Dislocations: A shoulder dislocation is an injury that occurs when the ends of the bone is forced out of its position. It is often caused by a fall or direct blow to the joint while playing contact sport.
- Tendinitis: It is an inflammation of a tendon, a tissue that connects muscles to bone. It occurs as a result of injury or overuse.
- Bursitis: It is an inflammation of fluid filled sac called bursa that protects and cushions your joints. Bursitis can be caused by chronic overuse, injury, arthritis, gout, or infection.
- Rotator cuff injury: The rotator cuff consists of tendons and muscles that hold the bones of the shoulder joint together. Rotator cuff muscles allow you to move your arm up and down. Rotator cuff injuries often cause a decreased range of motion.
- Fractures: A fracture is a break in the bone that commonly occurs as a result of injury, such as a fall or a direct blow to the shoulder.
- Arthritis: Osteoarthritis is the most common type of shoulder arthritis, characterized by progressive wearing away of the cartilage of the joint.
Early treatment is necessary to prevent serious shoulder injuries. The immediate mode of treatment recommended for shoulder injuries is rest, ice, compression and elevation (RICE). Your doctor may also prescribe anti-inflammatory medications to help reduce the swelling and pain.
Your doctor may recommend a series of exercises to strengthen shoulder muscles and to regain shoulder movement.