1. Jeff Allen Director of Sports Medicine University of Alabama

2.  Football  13% of all reported time loss injuries  3 rd highest (knee, ankle)  Avg. time loss of 7 days  High School Survey  10% of all time loss injuries (2005-2010) Datalys Center, NCAA Injury Surveillance Program

3.  Rule out/manage life or limb threatening injuries  Determine the extent of the injury  Determine Transportation Options/Method  Make a Return to Play Decision

4.  Airway  Breathing  Circulation  Disability  LOC A LERT V ERBAL P AIN U NRESPONSIVE

5.  Vascular compromise  Open fracture  Overlying skin integrity  Neurological compromise

6.  Short-term -Deal with ABCD’s  Medium-term -Manage injury/plan to transport  Long-term -Management plan -Notification

7.  Fractures  Clavicle  Scapula  Humerus  Dislocations  GH  SC  C-Spine????

8.  Damage to the bone is the secondary concern  Primary concern is the damage the bone does to the surrounding structures  Evaluate Neurovascular Function Distally

9.  Mechanism  Fall on Outstretched Hand  Signs and Symptoms  Sudden pain  Tenderness  Loss of shoulder function  Deformity(rapid swelling/bony deviation)  Head tilt towards side of fracture  Crepitus

10.  Mechanism  Direct trauma  Indirect trauma from fall (on shoulder or arm)  Infrequent  Signs and Symptoms  Sudden pain Painful abduction  Loss of function  Tenderness (direct/indirect)  Possible crepitus

11.  Mechanism  Direct trauma  Fall on an outstretched arm  Signs and Symptoms  Sudden pain  Loss of function  Tenderness  Deformity  Rapid Swelling  Proximal or Shaft

14.  Mechanisms  Direct blow  Fall on Outstretched Arm  MDI  Signs and Symptoms  Deformity  Loss of motion  Neurovascular Status!!

15.  Mechanism  Anterior dislocations of the SCJ are much more common (by a 9:1 ratio)  Direct blow  Fall on Outstretched Arm  Signs and Symptoms  Pain and Deformity  Altered Neurovascular Status  Complications may include:  Pneumothorax  Laceration of the superior vena cava  Occlusion of the subclavian artery or vein  Disruption of the trachea.

16.  Pneumothorax  Hemothorax  Tracheobronchial injury  Neurovascular Injuries

17.  PMSC  PULSE  MOTOR  SENSORY  CAPILLARY REFILL

18.  YOU CAN RELAX NOW!  AC SPRAIN  SC SPRAIN  BPSI/NERVE INJURY  PEC RUPTURE

20.  ROM  STRENGTH  FUNCTIONAL ABILITY

21.  Don’t complicate the obvious  “Boy Scout” Philosophy  Understand potential life/limb threatening injuries  Always remember to check neurovascular status!