Shoulder & Upper-Arm Injuries
Assess dislocations and fractures while protecting nerves, vessels and shoulder function.
Quick revision ↓ Medical Dictionary
01Shoulder examination
Assess mechanism, deformity, skin and distal neurovascular function. Document axillary nerve function where possible, recognising pain-related limitations. A painful shoulder may reflect clavicular, proximal humeral or joint injury, and chest or cervical causes should be considered when the presentation is atypical.
02Dislocation
Anterior dislocation is common, but posterior dislocation may follow seizures or electrical injury and can be missed on an inadequate view. Obtain appropriate imaging and urgent skilled management. Reduction requires consent, suitable analgesia or sedation and post-procedure reassessment; it is not an unsupervised forceful manoeuvre.
03Clavicle and proximal humerus
Many injuries can be managed without surgery, but skin compromise, open injury, neurovascular damage or particular fracture patterns change urgency and treatment. Consider age, displacement and functional needs. Pain control and a clear rehabilitation plan matter even when operative treatment is not selected.
04Humeral shaft
Examine radial nerve function and document findings before and after treatment. Wrist or finger extension weakness can accompany the injury but does not alone define the full management plan. Decisions depend on fracture characteristics, open status, nerve findings and the broader clinical situation.
05Recovery
Immobilisation should follow the injury-specific plan, with appropriate progression of movement to limit stiffness. Explain recurrent instability risk after dislocation and signs requiring review. Persistent weakness after pain settles may indicate rotator-cuff or nerve injury and warrants reassessment rather than assuming ordinary soreness.
High-Yield Revision
- Document axillary or radial nerve function as relevant.
- Posterior dislocation can be missed on inadequate imaging.
- Persistent weakness requires reassessment.
Common Pitfalls
- Attempting forceful unsupervised reduction.
- Ignoring threatened skin over a displaced fracture.
References & Further Reading
Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.
Reference review: 28 September 2026. Consult current local protocols for prescribing, procedures and escalation.