A man falls forward and to one side, but manages to break the fall to some degree by putting out his hand on the side toward which he is falling. Although he lands on his hand and knees, causing some abrasion, and he feels shaken and somewhat sore overall, no other injuries are noted at the time. However, a few hours later, he complains of severe pain in the area of the shoulder and upper chest

Question

region. What has most likely happened, and how could a knowledge of surface anatomy help?

What will be an ideal response?

Answer 1

The injuries resulting from the fall include possible damage to the shoulder joint, caused by forcing the head of the humerus into the glenoid cavity in an asymmetrical fashion from below. This might have caused the humeral head to push superiorly, damaging the supraspinatus muscle and potentially separating the acromioclavicular joint. These problems would explain pain in the shoulder region. In addition, pain in the superior chest region would be explained by rupture of the ligamentous connection at the sternoclavicular joint, one of the most common injury sites in this type of an accident. All of these problems could be diagnosed using surface anatomy.