INJURIES OF THE SHOULDER – SERIOUS INJURIES & SERIOUS COMPENSATION

The shoulder joint is considered to be one which has the widest range of movement in the human body. This being the case, injuries to any part of the structures making up the shoulder can be, and are, debilitating. Here, we consider the anatomy of the shoulder, common scenarios in which a person can suffer injury to this body part which result in compensation payments, the types of damage suffered and the types of compensation available.

Anatomy:

The shoulder is considered a ‘ball and socket’ joint which comprises of bony structures as follows:

• The acromioclavicular joint (where the shoulder blade and collar bone meet);
• The glenohumeral joint (where the humeral head, or ‘ball’, and glenoid, or ‘socket’, meet).

Holding this bony structure together is the rotator cuff, which operates to keep the ball nice and secure in the socket. This structure connects the humerus and scapula with tendons of four muscles:

• The supraspinatus;
• The infraspinatus;
• Teres Minor;
• Subscapularis.

The socket has a soft tissue called a labrum, and the joint capsule has a fluid sack to lubricate the joint.

How is the Shoulder Injured?

As with all body parts, there are many and varied ways that people suffer injuries to their shoulders, but some of the common mechanisms we see as expert personal injury lawyers include:

• Direct blows (impact injuries) from moving objects or falling;
• Falling onto an outstretched hand/arm resulting in a violent twisting;
• Wrenching;
• Lifting;
• Overhead activities;
• Overuse;
• Overextension.

It is common for people to hear terrible noises such as “cracks”, “pops” and “snaps” or “tears” in frank (traumatic incidents), but sometimes the pain comes on with time and can be a burning or ‘stabbing’ pain in nature that keeps you awake at night. People find they are unable to roll onto or lie on that shoulder in bed. Injured shoulders sometimes also “grind” with movement.

In the context of incidents which may sound in compensation for personal injury, such mechanisms are often sustained in the following:

• TAC claims:
  • Occupants of vehicles (drivers or passengers), cars, trucks, trains, trams in motor vehicle accidents: arms may be outstretched and braced against impact by holding the steering wheel, there may be side-on blows, or the arms may be raised to protect the face;
  • Pedestrians struck by motor vehicles: pedestrians can go under vehicles, be thrown up onto and over vehicles, and can be knocked to the roadway or into other objects;
  • Cyclists struck by, or taking evasive action to avoid, motor vehicles: cyclists have been known to land heavily onto their shoulders or strike their shoulders up on the bonnet of vehicles;
  • Motorcyclists struck by, or taking evasive action to avoid, motor vehicles: motorists failing to give-way or large vehicles, including trucks, where a driver has failed to perform a head-check.

• Public Liability claims:
  • Slipping and falling onto an outstretched arm (from wet floors or spillages);
  • Tripping and falling onto an outstretched arm (from raised sections of pavement or other trip hazards);
  • Falling down stairs or from otherwise elevated sections (usually resulting from poor step demarcation and poor lighting);
  • Physical altercations (assaults);

• WorkCover claims:
  • Heavy lifting of objects;
  • Awkward and unsupported lifting (for example, carrying an item or patient with co-workers who suddenly let go leaving you holding on);
  • Repetitive and overuse actions (pushing, pulling and lifting);
  • Working above the head;
  • Working with arms outstretched from the body;
  • Slips, trips and falls.

Common Injuries:

• Fractures: fractures involving the ‘ball’ and/or ‘socket’ in what is referred to as the articular surface can be devastating injuries requiring surgery, often leading to risks of arthritis in that joint into the future;
• Tendon tears: most tears occur in the supraspinatus tendon, but all other parts of the rotator cuff can be involved. Tears can be full thickness (as the name suggests, complete tearing and detachment from the bone) or partial thickness (the tendon remains attached to the bone, but can be thinned due to partial tearing);
• Dislocations and Instability: the tendons of the rotator cuff can become loose from being overstretched and may mean the shoulder is prone to further dislocations;
• Bursitis: the bursa (fluid filled sacs) that cushion the joint become inflamed and filled with excess fluid, irritated by movement (which in turn can impact arm mobility);
• Adhesive Capsulitis/Frozen Shoulder: this is a difficult condition which can result in pain and stiffness of the shoulder joint, often resulting from the development of inflammation and scar tissue following trauma or overuse;
• Nerve damage: the brachial plexus is a network of nerves sending signals from the spinal cord to the shoulder and arm; severe brachial plexus injuries (compressed or torn) can result in arm paralysis.

Radiology (Scans):

• Shoulder X-Rays: will be used to identify fractures, subluxation, arthritis;
• Shoulder Ultrasounds: will be used to identify large rotator cuff tears and other pathology such as bursitis;
• Shoulder MRIs: will be used to identify rotator cuff tears and most other pathology;
• Shoulder CT Scans: will be used to identify damage in the joint surfaces.

Common Invasive Treatments:

A person will be referred to an Orthopaedic Surgeon with a special interest in the shoulder and some of the procedures they may undergo can (depending on the nature of the injury and the person’s circumstances) include:

• Total shoulder replacements to replace aspects of the damaged joint;
• Partial shoulder replacements to replace aspects of the damaged joint;
• Insertion of plates and screws to reduce and secure fractures (open reduction and internal fixation)
• Rotator cuff repairs to repair tears to one or more of the tendons (some procedures are performed as traditional ‘open’ surgeries, and some are performed as ‘arthroscopic’ surgeries through small portals made by the surgeon to insert cameras and instruments). Bone spurs can be removed from the underside of the acromion (acromioplasty) and screws (suture anchors) and suture thread are used to repair the tear(s);
• Shoulder reconstructions to reduce instability;
• Hydrodilatation (an injection using cortisone and saline);
• Cortisone injections;
• Manipulation under anaesthetic.

Personal Injury Compensation:

As we have noted, given the importance and wide range of movement of the shoulder joint, we often find that shoulder injuries will satisfy the “serious injury” thresholds in TAC claims under the Transport Accident Act 1986 (Vic) and WorkCover claims under the Workplace Injury Rehabilitation and Compensation Act 2013 (Vic), resulting in Serious Injury Certificates being granted, as well as satisfying the “significant injury” threshold for public liability claims under the Wrongs Act 1958 (Vic).

Therefore, if there was negligence as a cause of the person’s injury, loss and damage, it is possible to recover damages for pain and suffering (general damages), loss of earnings and loss of earning capacity and medical expenses and care. Damages can be significant for shoulder injuries.

We also find that shoulder injuries can rate well for impairment benefit lump sum claims under the TAC and WorkCover no-fault schemes.

If you have suffered a shoulder injury the subject of a TAC claim, WorkCover claim or Public Liability claim in Victoria, and particularly if you have been referred by your General Practitioner or Physiotherapist to an Orthopaedic Shoulder Surgeon (there are a range of Geelong Shoulder Surgeons, Ballarat Shoulder Surgeons, Western Suburbs Shoulder Surgeons, Melbourne Shoulder Surgeons who will treat people with compensation claims), it is in your interests to seek legal advice.

Contact us on 1300020618 for a free, no obligation chat.

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