A 20-Year-Old College Football Quarterback Is Evaluated in the Emergency

A 20-year-old college football quarterback is evaluated in the emergency department for acute right shoulder pain.  One hour ago, the patient sustained a blow to the arm when tackled mid-throw during a championship game.  On physical examination, there is flattening of the right deltoid muscle and insensitivity of the overlying skin to pinprick.  Peripheral pulses in the upper extremities are intact.  Which of the following injuries is most likely responsible for this patient's findings?

A) Acromioclavicular joint subluxation
B) Anterior dislocation of the humerus
C) Clavicular fracture
D) Fracture of the coracoid process
E) Rotator cuff tear
F) Spiral fracture of the midshaft humerus

Correct Answer:

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