ABSTRACT
This chapter describes the acute anterior and posterior dislocations of the shoulder and upper arm. The great bugbear of upper-limb injuries is stiffness – particularly of the shoulder but sometimes of the elbow and hand as well. A fall on the shoulder or the outstretched hand may break the clavicle. In the common midshaft fracture, the lateral fragment is pulled down by the weight of the arm and the inner, medial half is held up by the sternomastoid muscle. Clavicle fractures are usually classified on the basis of their location: Group I – middle-third fractures; Group II – lateral-third fractures; and Group III – medial-third fractures. The arm is held immobile and there may be severe bruising over the scapula or the chest wall. Fractures of the scapula are divided anatomically into scapular body, glenoid neck, glenoid fossa, acromion and coracoid processes. Scapular neck fractures are the most common.
