Question:My father fell and landed right on his shoulder. Even though it was fractured, the doctor wanted him to see a physical therapist first before doing surgery. Well, it's been almost three months and he's still in rehab. Should it be taking this long for him to recover?
Answer:Fractures of the shoulder can be very slow to heal, especially in the older adult population. Sometimes it depends on the type of fracture. A single fracture line may heal faster than a comminuted fracture. Comminuted refers to the fact that the bone broke into many tiny pieces.
It's often the case that other injuries occurred along with the fracture. Cartilage and soft tissues can be damaged as a result of such an impaction injury. And studies show that older patients take longer to heal than younger adults.
Supervised range of motion and other exercises are important in the recovery process after a shoulder fracture. Such a program may be needed long after the fracture heals.
But if pain persists beyond the expected time given the patient's age and general health, then further testing may be needed. MRIs are useful to detect tears of the rotator cuff and labrum. The labrum is a thin but dense ring of fibrous cartilage. It's firmly attached to the acetabulum (shoulder socket). It provides depth and stability to the joint.
Surgery may be needed to repair this type of soft tissue damage before the patient can regain motion and function. You may want to go with your father to his next follow-up appointment with the physician. He or she can explain the management plan. There may be reasons why your father is not a candidate for surgery. Or he may be right on schedule with rehab and doing well for his age and condition.Michael S. George, MD. Fractures of the Greater Tuberosity of the Humerus. In Journal of American Academy of Orthopadedic Surgeons. October 2007. Vol. 15. No. 10. Pp. 607-613.
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