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Chapter 2 - Shoulder and elbow emergencies

Published online by Cambridge University Press:  05 November 2013

Michael C. Bond
Affiliation:
Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore
Andrew D. Perron
Affiliation:
Department of Emergency Medicine, Maine Medical Center, Portland
Michael K. Abraham
Affiliation:
Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore
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Summary

This chapter presents the key facts, clinical presentation, diagnostic testing, treatment of procedures, and prognosis of shoulder and elbow emergencies such as glenohumeral dislocations, scapular fractures, clavicle fractures, sternoclavicular (SC) injuries, acromioclavicular injuries, and proximal humerus fractures. Failure to obtain a lateral projection can result in missing a posterior dislocation in up to 50% of cases. Reductions performed with intra-articular anesthetic injections have been safely performed with equivalent success rates, similar patient comfort, shorter ED length of stays, and lower complication rates. Electromyogram (EMG) testing can be performed at a later date to evaluate suspected nerve injuries. Presence of a posterior SC dislocation should prompt evaluation for associated injuries to the trachea, esophagus, and great vessels, which are in close proximity to the SC joint. Plain radiographs are the preferred test for evaluation of suspected humeral shaft fractures.
Type
Chapter
Information
Orthopedic Emergencies
Expert Management for the Emergency Physician
, pp. 44 - 80
Publisher: Cambridge University Press
Print publication year: 2013

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