Acute Injuries of the Shoulder

Separated Shoulder Def: A sprain of the acromioclavicular ligament MOI: A fall on the outstretched arm or a blow the the tip of the shoulder

Anterior View Posterior View

S/Sx: Point tenderness over AC joint - inability or pain with abduction - in some cases, gross deformity Tx: Immobilization with a sling - ice - NSAIDS - if grade II or above, refer to a doctor - if grade I protective padding

Clavicular Fracture Def: fracture of the clavicle - break is usually in the middle 1/3 - most commonly broken bone in the body MOI: fall on the outstretched arm - direct blow to the clavicle

Superior View Anterior View

S/Sx: -palpable deformity - positive percussion test - point tenderness over fracture site - decreased range of motion Tx: - ice - immobilization with sling or figure-8 brace - send to doctor

Dislocated Shoulder Def: dislocation of the glenohumeral joint - most commonly occurs in the anterior & inferior direction MOI: torque applied to arm while it is abducted and externally rotated

Anterior/Lateral View

Anterior View

S/Sx: gross deformity - athlete will complain that the shoulder “feels out” - decreased range of motion Tx: check for distal pulse & sensation - if absent or decreased call if strong, ice & send directly to a doctor

Complications Dislocated shoulders should be evaluated for fractures, glenoid labral tears and axillary nerve damage Hill-Sachs lesion is an indentation on the posterial humeral head that can be observed on x-ray If the patient is under 20 the chance of a recurrent dislocation is 80%-90%

Biceps Rupture Def: rupture of the long head of the biceps - commonly called “popeye arm” MOI: blow or force applied to the contracted biceps

S/Sx: gross deformity - decreased range of motion and strength of biceps - point tenderness - complained of hearing a “pop” Tx: ice and send directly to a doctor