FRACTURES AND RELATED INJURIES - Medicine for Mountaineering and Other Wilderness Activities - page 145

monly occurs with dislocation. A physician should be consulted as soon as possible, par-
ticularly if pain persists.
Shoulder
Shoulder dislocations result from strong jerks when the arm is rotated outward and held
away from the body. A typical situation is a kayaker thrusting back and downward with a
paddle ( Fig. 11-8 ). Many individuals have recurrent dislocations, can readily identify the
injury, and often are helpful with reduction.
Among shoulder dislocations ( Fig. 11-9 ) , 95 percent are anterior ( Fig. 11-10 ) . The indi-
vidualsareinpainandholdtheupperarmandforearmawayfromthebodyinvariousposi-
tions,butthearmcannotbebroughtintocontactwiththechest.(Withafracturedhumerus,
the arm is usually held snugly against the chest.) The absence of the end of the humerus
in the joint, which is located just lateral to the collarbone and below the shoulder, may be
most easily recognized by loss of the normal roundness or fullness of the deltoid muscle,
particularly when compared with the opposite shoulder.