19 Del. Admin. Code § 1342-E-3.0

Current through Register Vol. 27, No. 12, June 1, 2024

Section 1342-E-3.0 - Introduction to Shoulder Injury

This section addresses the shoulder and the ten most common work-related injuries/syndromes/disorders to or involving the shoulder complex. The following format was developed to reduce repetitive text:

3.1 HISTORY TAKING AND PHYSICAL EXAMINATION provides information common to all injuries through a discussion of provider procedures which should be applied to each patient, regardless of the injury and diagnosis (this subsection is standard to all Division medical treatment guidelines).

3.2 SPECIFIC DIAGNOSIS, TESTING AND TREATMENT PROCEDURES provides information unique to each of the following work-related injuries/syndromes/disorders:

3.2.1 Acromioclavicular (AC) Joint Sprains/Dislocations

3.2.2 Adhesive Capsulitis/Frozen Shoulder Disorders

3.2.3 Bicipital Tendon Disorders

3.2.4 Brachial Plexus Injuries

3.2.4.1 Brachial Plexus

3.2.4.2 Axillary Nerve

3.2.4.3 Long Thoracic Nerve

3.2.4.4 Musculocutaneous Nerve

3.2.4.5 Spinal Accessory Nerve

3.2.4.6 Suprascapular Nerve

3.2.5 Bursitis of the Shoulder

3.2.6 Impingement Syndrome

3.2.7 Rotator Cuff Tears

3.2.8 Rotator Cuff Tendinitis

3.2.9 Shoulder Fractures

3.2.9.1 Clavicular Fracture

3.2.9.2 Proximal Humeral Fracture

3.2.9.3 Humeral Shaft Fracture

3.2.9.4 Scapular Fracture

3.2.9.5 Sternoclavicular Dislocation/Fracture

3.2.10 Shoulder Instability

Each diagnosis is presented in the following format:

3.2.10.1 A definition of the injury/disorder/syndrome;

3.2.10.2 Discussion of relevant physical findings;

3.2.10.3 Applicable testing and diagnostic procedures;

3.2.10.4 Diagnosis-based, non-operative therapeutic treatment procedures;

3.2.10.5 Options for operative/surgical treatment; and

3.2.10.6 Options for post-operative rehabilitation/treatment procedures.

3.3 MEDICATION provides information common to all injuries through detailed discussions of referenced medications with indications for expected time to produce effect, frequency, and optimum and maximum durations.

3.4 NON-OPERATIVE TREATMENT PROCEDURES provides information common to all injuries through detailed discussions of referenced therapeutic procedures with indications for expected time to produce effect, frequency, and optimum and maximum durations.

As shoulder injuries frequently involve a complex of problems, it is always necessary to consider the possible interaction of the various parts of the shoulder mechanism when proceeding with a diagnostic workup and a therapeutic treatment plan. Injuries to the shoulder may require the provider to reference and/or use the other Division medical treatment guidelines (i.e., Thoracic Outlet Syndrome Cumulative Trauma Disorder, and/or Complex Regional Pain Syndrome/Reflex Sympathetic Dystrophy.

19 Del. Admin. Code § 1342-E-3.0