Accident Shoulder Trauma

October 2, 2014

Accident shoulder trauma from auƒto crashes or falls can result in numerous types of personal injury ranging from fractures to dislocations to tears of tendons or ligaments. As a tort claims lawyer in California, I have seen many such instances of the traumatic event of a motor vehicle collision causing these types of injuries to the upper extremities of accident victims. Sometimes this results in permanent immobility which can have devastating consequences on a person’s day to day living. I thought I would explore the different types of shoulder injuries from auto collisions and the possible treatments and outcomes from such bodily harm.

The human shoulder is made up of three main bones: (1) the Humerus (upper arm), (2) the Clavicle (collar bone); and (3) the Scapula (shoulder blade). It is a “ball and socket” joint with the “ball” being the Humeral head and the socket being the Glenoid Cavity (shallow joint of the scapula), which works in conjunction with the acromioclavicular (AC) joint in the clavicle. All of these bones are connected by tendons (tissue that connects muscle to bone) and ligaments (fibers that connect bone to bone).

The shoulder is actually the single most flexible joint in the human body (i.e. it has the greatest range of motion of any human joint). It allows us to reach in many different directions (up, down and side to side) to grasp objects, move things, and manipulate our environment. It is said that the upper limbs are meant as the “organs of manipulation” compared to the lower limbs as the “organs of locomotion”. (See Medical Gross Anatomy – Movements of the Upper Limbs).

Because the shoulder is so flexible, it is more prone to injury than just about any other portion of the human anatomy. Furthermore, because we use our shoulders for so many things, upper extremity traumatic blows can cause a huge disruption to our ability to function. We literally, “shoulder the burden” of many of life’s tasks with this one portion of the body charged with upper mobility.

Shoulder injuries come in two major varieties: Fractures of bones and tears of either ligaments or tendons. Oftentimes, you have both a fracture and a tear or multiple tears of different fibers. The most common of these are as follows:

• Separated Shoulder: This occurs when the outer end of the clavicle separates from the end of the shoulder blade. This type of injury is common in falls such as a slip or trip and fall or a spill on a motorcycle or bicycle.
• Torn Rotator Cuff or Labral Tears: The Rotator Cuff is a group of tendons and muscles that connect the top of the upper arm with the scapula. The labrum is a ring of soft tissue that also helps keep your arm bone in your shoulder socket. While it takes a considerable amount of pressure to tear these tissues, such injuries are common in both falls where the accident victim tries to “break the fall” and in instances where an auto accident victim tries to “brace themselves” by holding on to the steering wheel and tensing up to keep from striking the dashboard or windshield. These injuries vary in degree from the so-called “SLAP tear” (a rip in the top part of the labrum from front to back) to full tears of the cuff. With sufficient force, there can be multiple tears in these fibrous tissues.
• Broken Collar Bone: The clavicle is one of the thinner bones in the body. Therefore, it is prone to fracture more easily than many other bony structures. A blow from a car crash, fall or strike from a blunt object can cause this type of fracture.
• Nerve Injuries: Running throughout all of the tissues of the shoulder are many nerve cells. When these are damaged (so-called “nueropathy”), it can cause major pain, numbness and other symptoms. Again, falling down or suffering a major blow sufficient to cause tearing can also cause this type of nerve damage.

Any time a person is involved in a car crash, falls and strikes their shoulder or is hit in their upper extremity and experiences pain, inability to lift their arms, bruising, pain, stiffness, numbing, or other symptoms, they should seek out a thorough diagnosis of the medical issues than can cause such symptomatology. Fractures can be diagnosed with X-rays, tears of tendons or ligaments are most often found through diagnostic tools like Magnetic Resonance Imaging (MRI). Treatments for shoulder trauma can range from immobilizing slings to physical therapy to surgical intervention. Nerve damage can be diagnosed with tools such as nerve conduction testing. Most often tears can be repaired with arthroscopic surgery where a small incision is made and instruments are inserted to reconnect the tissue. Post-surgical treatments can include pain management and physical therapy.

As discussed above, the human shoulder plays a vital role in allowing us to function. Such common things as picking up a child or grabbing groceries off the shelf can be impeded when we are not able to fully utilize this most important of joints. Such impairment can either be temporary or, sometimes, even permanent. Without full diagnosis, treatment, surgery if necessary, and the right types of therapy, it is impossible to fully heal or to know the extent of any future partial or full physical limitations caused by the traumatic event. A quality personal injury attorney will provide medical referrals if necessary and closely coordinate with the various medical specialists including Orthopedic doctors and Neurologists to full ascertain these issues. This is vitally important because, as I have pointed out elsewhere (see prior post), once a personal injury claim settlement has been reached and a written release has been signed, the injured party has waived all present and future legal rights to compensation. This makes it critical for any injury victim in California to get the proper advice!

Shoulder Problems and Injuries – WebMD