Browse categories and answer follow-up questions to refine your symptom profile.
Immediate priorities
Stabilization triggers
If airway compromise, standard airway pathway
If agitation limits neurovascular exam, analgesia first
If hypotension, trauma resuscitation and search for alternate bleeding source
Proximal humerus fracture rarely primary cause of shock
If open fracture, antibiotics and urgent ortho consult
If gross contamination, tetanus prophylaxis and irrigation planning
If expanding hematoma, bruit, absent distal pulses, urgent vascular imaging and consult
High suspicion with high energy injury or elderly atherosclerosis
If progressive neurologic deficit, urgent ortho evaluation
Consider brachial plexus traction injury
Limb threat screening
Neurovascular status
Radial pulse presence and symmetry
If pulse abnormal, Doppler signals and compare contralateral limb
Capillary refill and hand warmth
If delayed refill, consider arterial injury or compartment syndrome
Motor function
Deltoid activation for axillary nerve
Wrist and finger extension for radial nerve
Finger abduction for ulnar nerve
Thumb opposition for median nerve
Sensation
Lateral shoulder sensation for axillary nerve
Dorsal first web space for radial nerve
Small finger for ulnar nerve
Index finger pad for median nerve
Pain and immobilization
Analgesia strategy
Multimodal nonopioid first line when feasible
Paracetamol
NSAID if no contraindications
Opioid for severe pain or inadequate response
Titrate to comfort and respiratory safety
Regional anesthesia option
Interscalene block for severe pain and imaging tolerance
If respiratory compromise risk, avoid high volume interscalene
Immobilization
Sling and swathe or shoulder immobilizer
Neutral rotation position as tolerated
If significant deformity or skin tenting, gentle traction and repositioning with analgesia
If inability to restore alignment, urgent ortho input
Key concepts and escalation
High risk patterns
3 part and 4 part fractures
Higher risk of humeral head ischemia and stiffness
Fracture dislocation
Higher risk of neurovascular injury
Head split fracture
Often requires operative management
Medial calcar disruption
Higher risk of avascular necrosis
Consultation triggers
Open fracture
Emergent ortho consultation
Neurovascular compromise
Ortho and vascular consultation
Fracture dislocation or irreducible malalignment
Ortho consultation in ED
Polytrauma with suspected shoulder girdle injury
Trauma team activation per local protocol
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.