NB - With ALL shoulder injuries, test nerves and circulation to upper limb.
Fracture clavicle
Broad arm sling. Refer Virtual Fracture Clinic (VFC)
Fracture scapula (beware of other injuries as it take a lot of force to fracture the scapula)
Broad arm sling and refer VFC.
Fracture greater tuberosity
Sling, Refer VFC.
Anterior dislocation SC joint
Ask advice
Dislocation/subluxation AC joint
Broad arm sling. Review clinic. If marked skin tenting, refer fracture clinic
Posterior dislocation SC joint
Ask advice
Fracture surgical neck humerus
Test axillary nerve, Collar & Cuff/Sling. Refer VFC.
Fracture shaft of humerus
Test radial nerve. If radial nerve deficit refer Ortho On-call. Otherwise Humeral brace/ POP 'U' slab & Collar and Cuff. Refer VFC. Ask advice if significantly displaced.
Anterior Dislocation of shoulder
Test axillary nerve and other nerves pre-reduction AND DOCUMENT. Reduce. Recheck nerves. Post reduction x-ray. Shoulder immobiliser. Refer VFC.
Dislocation shoulder associated with fracture greater tuberosity
Treat as for dislocation.
Dislocation shoulder, associated with fracture surgical neck
Refer orthopaedics, seek senior advice.
Soft tissue shoulder injuries
Broad arm sling for short time (2-3 days) only if necessary for symptomatic relief. Review clinic 2 weeks if necessary.
Rupture long head biceps
Refer to Physiotherapy
NOTE
Shoulder injuries with the exception of displaced fracture neck of humerus are treated in a broad arm sling NOT a collar and cuff