An emergency room physician examines a patient who has fallen from a motorcycle and injured his shoulder. The clinician notices a loss of the normal contour of the shoulder and a abnormal-appearing depression below the acromion. Which of the following injuries did the patient most likely sustain?
Avulsion of the coronoid process
Dislocated shoulder joint
Fracture of the midshaft of the humerus
Fracture of the surgical neck of the humerus
The abnormal depression described is a characteristic tip-off for a dislocated shoulder joint. This is impoant to remember, as it may help you make a rapid diagnosis.Avulsion of the coronoid process of the ulna (at the elbow) can occur following a severe contracture of brachialis.Fracture of the midshaft of the humerus may produce a "bend" in the upper arm.Fracture of the surgical neck of the humerus can lacerate the axillary branch of the posterior cord ( also called axillary), causing paralysis of the deltoid. Ref: McMahon P.J., Kaplan L.D. (2006). Chapter 4. Spos Medicine. In H.B. Skinner (Ed), CURRENT Diagnosis & Treatment in Ohopedics, 4e