Shoulder & Upper Arm Injuries Mechanism, Signs & Symptom and Treatment of Fractures & Dislocations

Shoulder & Upper Arm Injuries Fractures & Dislocations Introduction Think back to the lessons on bone injuries. What is a fracture? What is a dislocation?

Shoulder & Upper Arm Injuries Fractures & Dislocations Objectives Students will be able to: Identify the mechanism, signs & symptoms and appropriate treatment of injuries to the shoulder & upper arm.

Shoulder & Upper Arm Injuries Fractures & Dislocations - Terminology An injury to a bone in which the tissue is broken or disrupted. A break in a bone. May be open or closed.

Shoulder & Upper Arm Injuries Fractures & Dislocations - Terminology A complete disruption of the bones that form a joint. The head of the humerus comes out of the glenoid fossa & does not go back in spontaneously.

Shoulder & Upper Arm Injuries Fractures & Dislocations - Terminology Subluxation A partial disruption of the bones that form a joint. The head of the humerus came out of the glenoid fossa & spontaneously went back in.

Shoulder & Upper Arm Injuries Fractures & Dislocations Glenohumeral Dislocation Shoulder Dislocation Mechanism: Forced abduction & external rotation of the humerus Usually occurs in an anterior direction May also occur in an inferior direction

Shoulder & Upper Arm Injuries Fractures & Dislocations Shoulder Dislocation S & S: “My shoulder came out” Pain Inability to use shoulder Deformity of deltoid muscle – flat Athlete will carry humerus away from the body

Shoulder & Upper Arm Injuries Fractures & Dislocations Shoulder Dislocation S & S: Under 25 yrs of age, 80-85% chance of reoccurrence Following acute dislocation subsequent dislocations & subluxations common Consider surgery May have associated capsule tear, RC tear, cartilage tear or FX

Shoulder & Upper Arm Injuries Fractures & Dislocations Shoulder Dislocation Treatment (TX): Ice (RICE) Anti-inflammatory meds Sling Orthopedic referral Strengthening exercises Restrictive harness (FB)

Shoulder & Upper Arm Injuries Fractures & Dislocations Clavicle Fracture Mechanism: Direct blow Fall on top of shoulder Fall on outstretched arm Occurs most commonly at distal 1/3 –weakest point

Shoulder & Upper Arm Injuries Fractures & Dislocations Clavicle FX S & S: Pain Swelling Pain on active movement Deformity Athlete will hold arm close to body

Shoulder & Upper Arm Injuries Fractures & Dislocations Clavicle FX Treatment (TX): Ice (RICE) Anti-inflammatory meds Figure 8 brace (clavicle harness) Orthopedic referral

Shoulder & Upper Arm Injuries Fractures & Dislocations Humeral Fracture Mechanism: Direct blow Excessive force applied to the humerus Mid-shaft FX easier to detect Humeral head FX more difficult to detect (musculature)

Shoulder & Upper Arm Injuries Fractures & Dislocations Humerus FX S & S: Pain Inability to move arm Hear or feel “pop” Hold arm against body Pain on all sides of humerus

Shoulder & Upper Arm Injuries Fractures & Dislocations Humerus FX Treatment (TX): Splint Ice (RICE) Anti-inflammatory meds Sling/long arm cast Orthopedic referral at least 6 weeks to heal

Shoulder & Upper Arm Injuries Fractures & Dislocations Epiphyseal Fracture Mechanism: Direct blow to head of humerus Indirect blow Falling on elbow May be difficult to detect because of shoulder musculature

Shoulder & Upper Arm Injuries Fractures & Dislocations Epiphyseal FX S & S: Pain Inability to move arm Hear or feel “pop” Hold arm against body

Shoulder & Upper Arm Injuries Fractures & Dislocations Epiphyseal FX Treatment (TX): Splint Ice (RICE) Anti-inflammatory meds Sling Orthopedic referral May require surgery

Shoulder & Upper Arm Injuries Fractures & Dislocations What’s My Injury? With a partner, choose an injury from today’s lesson & write a creative scenario including mechanism, signs & symptoms & treatment. Be prepared to share with the class.