Occasionally associated with intrathoracic pathology, i.e., tuberculosis, or carcinoma. Symptoms often last 1-2 years. Physical therapy should emphasize stretching. If no improvement after 12 months, consider manipulation under anesthesia in nonosteoporotic patients. The vast majority of patients recover by 2 years with mild permanent loss of motion.
Diabetics however have a poor prognosis.
Evaluate neurovascular status. Axillary nerve or artery injuries are potential complications. A minimum of 3 x-ray views for proper evaluation. Non displaced fracture treated in sling. Significant displacement requires surgical fixation or prosthetic replacement.