Trauma Shoulder & Pectoral Girdle

Clavicle

  • Diaphysis
    • generally no treatment required
  • Medial
      • pseudodislocation of the sternoclavicular joint through the growth plate
      • Growth plate does not close until 20-25 years of age
      • May be anterior or posterior
    • Posterior
      • reduce with the towel clip
    • Anterior
      • unstable however, will remodel
  • Lateral – sleeve remains attached to the corocoid & leave to remodel

AC separation

  • Generally occuring in adolescents
  • No special treatment, treat as adults

Scapula

  • Generally look for fracture & possible associated neurovascular injury
  • Treat
  • Body fracture treated conservatively
  • Neck, Glenoid may require ORIF

Shoulder Dislocation

  • Immobilize 2-3 weeks
  • 60-85% recurrence

Proximal Humerus

  • Patterns
  • < 5 years – SH 1, leave to remodel
  • 10-12 years – metaphyseal, manipulate if > 50° angulation
  • Adolescent SH 2
  • If < 50 % displaced & 20-30° angulated = shoulder immobilizer
  • If > 50% displaced or > 35° angulated = reduce & pin then sling, smooth pins if crossing the growth plate

Humeral Shaft

  • Coaptation splint & then functional brace for most
Return to top