Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute right shoulder pain following a high-energy trauma. Reports localized tenderness over the scapular region, exacerbated by shoulder movement and deep inspiration. No reported paresthesia or distal neurovascular deficits. Mechanism of injury: [Insert Mechanism].
Clinical Examination Findings
Inspection of the right scapular region reveals localized soft tissue swelling, ecchymosis, and tenderness to palpation. Crepitus noted upon gentle manipulation. Range of motion (ROM) of the right glenohumeral joint is severely restricted due to pain. Neurovascular status: Radial and ulnar pulses are 2+ and symmetric; capillary refill < 2 seconds; distal sensation intact to light touch in all nerve distributions.
Treatment Protocol
Right shoulder immobilized in a sling and swathe for comfort. Analgesia initiated with NSAIDs and acetaminophen. Patient advised to maintain strict immobilization of the right upper extremity. Follow-up imaging (CT scan) ordered to assess fracture displacement and rule out associated thoracic injuries. Orthopedic consultation requested for definitive management.