Rules of Shoulder Splinting • Shoulder is the most commonly dislocated large joint in the body • These dislocations are always very painful • Might have numbness of hand or skin CMS A shoulder dislocation occurs when there is an injury to the joint between the humerus and scapula Is Shoulder Dislocated? • To verify dislocation 1. Do full palpation of the entire limb starting at the proximal clavicle; look especially for Fx of humerus 2. If negative, ask patient to gently touch opposite shoulder with their injury-side fingertip 3. if YES, not dislocation; probably AC separation, contusion, clavicle injury • Patient will guard shoulder; Arm will be held in some fixed position Splinting a Dislocation • If shoulder is dislocated, see if patient can move arm to any part of body – if YES, secure the arm to that body part, eg. head, chest; takes some weight from shoulder – If No, support the arm as best you can, without moving it • Whatever you do, arm must be – supported – secured If Dislocated and Arm in front • Most common is arm locked forward of the body, away from chest wall; result of fall with outstretched arm to side An anterior dislocation – the top of the humerus is sitting in front of the shoulder blade. If Dislocated and Arm in front • Effective Splint is “pigs in blanket” • Sequence is on website If Dislocated and Arm to rear • 1: 20 dislocations is arm locked aft of body posterior dislocation - the top of the humerus is behind the shoulder blade Blanket Roll Splint 1. Put Blanket Roll snugly under arm 2. Use Cravat to support blanket roll and tie over good shoulder 3. Tie Swath with cravat to secure blanket roll. If Dislocated and Arm is up • This is extremely rare in skiing If Dislocated and Arm is up • Add bandaging of hand to head to the “blanket roll” splint Airplane Splint (on the website) Shoulder Separation • NOT truly an injury to the shoulder joint; actually involves the stretch or tear of ligaments holding clavicle to shoulder blade; there is pain & swelling; telltale is bump on top of shoulder caused by lifting of shoulder blade Treatment is Sling and Swath