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 911- 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 thebiceps - 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