Description
In this presentation by Amar Rangan, two illustrative cases of shoulder trauma are discussed, emphasizing learning points crucial for treatment. The first case is about a 68-year-old woman who sustained a fragile shoulder fracture from a fall at home. Despite her age and COPD condition, surgical treatment was chosen to restore her independence efficiently. Initial surgery provided a good compression, but later X-rays six weeks post-injury revealed complications including humeral head collapse and screw cutout, emphasizing the need for stable reduction in such injuries.
In the second case, a male patient with a history of T4 paraplegia suffered a complex shoulder injury that required surgical fixation. Although he initially recovered well, he experienced a decline in shoulder function three months post-surgery. This led to concerns about potential vascular necrosis, which revealed he had dissociated sensory loss due to previous spinal injury. The case taught the importance of performing a thorough neurological assessment, particularly in patients with prior spinal issues before proceeding with fracture fixation. Rangan concludes with the vital takeaway that detailed neurological evaluations are critical in similar orthopedic practices.