Immobilisation for a shoulder fracture

The shoulder is difficult to enclose in a conventional cast without restricting the chest and elbow. Fractures near the top of the upper arm, collarbone or shoulder blade therefore need different support plans. Displacement, joint stability, skin condition and nerve function also influence treatment.

A sling supports the arm's weight and reduces painful shoulder movement while early healing begins. Some fracture patterns use a specialised brace that helps guide alignment. If fragments are in an unsuitable position, reduction or fixation may be considered rather than relying on external support alone.

Follow-up examinations and images help the clinician assess alignment. The support may be adjusted as swelling and discomfort change, and movement is introduced according to the fracture pattern rather than pain alone.

Wear the sling or brace in the position demonstrated, and check that straps do not press on the neck or skin. Support the arm during sleep as advised. Move the fingers, wrist and elbow only within the plan provided; removing support or starting shoulder exercises too early can disturb some fractures.

Keep any rigid material dry and inspect visible skin for rubbing. Avoid lifting and driving until cleared. At review, bring the support so its fit can be checked and explain any difficulty with dressing, washing or sleeping.

Get urgent help if the hand turns pale, blue or cold, sensation changes, grip becomes newly weak, or pain and swelling worsen despite the advised measures. Sudden breathlessness, chest pain, an open wound or visible bone also requires emergency assessment.

Contact the fracture service if the brace or sling no longer supports the arm, causes a sore, or breaks. New deformity or a further fall should be assessed even when the support still looks intact.

Confirm which bone and part of the bone is fractured, whether it reaches a joint, and whether current alignment is acceptable. Ask how long each day to use the support and which hand, wrist, elbow or shoulder movements are allowed.

Request clear milestones for sleeping without support, driving, lifting and returning to work. Discuss when physiotherapy should begin, because the balance between protecting healing and limiting shoulder stiffness differs by injury.