Anatomy Of The Shoulder
Anatomy of the Ligaments
Anatomy of the Muscles
Common Types of Shoulder Fractures: Clavicle, Scapula, and Proximal Humerus Fractures.
Clavicle: most common type of fracture, and a result of a fall
Scapula: rarely occur, and usually a result of high trauma accident
Proximal Humerus Fracture: fracture in the upper part of the arm, more common in the elderly
Signs and Symptoms:
Pain, Swelling, Bruising, Severely restricted movement, Numbness and tingling of the arm and hand, and deformity of the upper arm
Treatment: Simple sling or “figure 8” strap worn for three to eight weeks, depending on the patient’s pain, Or : Surgery, which may include placing plates and screws or wires and sutures (Figure 3). This is more often needed when there is injury to the glenoid (shoulder socket) or when broken bone pieces are severely out of place
Surgery is a possibility, if fracture fragments are displaced.
Rehab: "Physical therapy will be crucial to restore proper function of your shoulder and arm. If surgery is required, physical therapy will typically begin 1 to 4 weeks following the surgery, depending on the specific surgical intervention required"
SOAP Case Study:
S (Subjective) : Megan, 28- sustained shoulder injury when falling after snowboarding. Complains of severe pain, and bruising. Pain is constant and especially when being moved. Has been in a sling, but came in for second opinion. Been on regular tylenol medication for pain control.
O (Objective) : Slouching of body, swollen shoulder, bruising all around. Sensitive and painful to the touch. X Ray shows clear proximal humerus fracture at head of humerus. Age: 28, Weight: 135 Height: 5'4
A (Assessment) : After analyzing results of X-Ray, the shoulder is displaced, and use of sling is needed, but surgery is the course of treatment. Surgery will be tomorrow at 3:30 pm to get patient started with flexibility and motion
P (Plan) : Surgery is scheduled, and as a source from Mayo Clinic, the following pain medications will be provided for after surgery.
"Often called multimodal pain relief, this involves receiving a combination of opioid and one or more other drugs, such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others), celecoxib (Celebrex), ketamine (Ketalar) or gabapentin (Gralise, Neurontin). All of these medications share the ability to relieve pain, and each can be given in low enough doses to avoid side effects"