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

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

3. 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.

4. 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.

5. 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.

6. 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.

7. 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

8. 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

9. 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

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

11. 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

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

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

14. 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)

15. 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

16. 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

17. 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

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

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

20. 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.