SSSC double disruption increases nonunion and dysfunction risk
Operative consideration triggers
Glenoid articular step-off greater than 2 to 5 mm
Glenoid surface involvement greater than 20 to 25 percent
Glenohumeral instability or subluxation
Scapular neck displacement greater than 10 mm
Scapular neck angulation greater than 40 degrees
Glenopolar angle less than 20 degrees
Floating shoulder with instability concern
Acromion displacement causing impingement
Coracoid displacement greater than 10 mm with SSSC disruption
Patient Discharge Instructions
Copy discharge instructions
Discharge instructions
Sling use for comfort
Hand and elbow motion several times daily
Shoulder motion plan per orthopedics timeline
Ice 15 minutes at a time
Elevation when resting
Pain control plan
Acetaminophen dosing per label or prescription
Ibuprofen dosing per label or prescription if safe
Opioid only if prescribed
Activity limits
No lifting with injured arm
No overhead activity
Return to ED triggers
Worsening shortness of breath
Chest pain
New numbness or weakness
Cold or pale hand
Increasing pain not controlled
Fever or drainage from wound
Splint or sling causing severe pressure
Follow-up plan
Orthopedics appointment timing
Repeat imaging if directed
References
Clinical guidelines and evidence sources
Reference set
ATLS principles for initial trauma care
Orthopaedic Trauma Association guidance for scapula fractures
AAOS general fracture management principles
Procedural sedation guidance for ED sedation
Surgical indication thresholds supported by orthopedic trauma consensus
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.