Shoulder trauma

Acute / recurrent shoulder injury or dislocation following trauma.

Eligibility

At least one must be met for the patient to be eligible for referral.

Shoulder trauma or dislocation with appropriate imaging and primary-care work-up completed

Red flags

Indicate urgent (Category 1) referral or emergency assessment.

Irreducible shoulder dislocation — refer to ED

Brachial plexus injury after reduction — refer to ED

Suspected fracture — refer to ED

Traumatic and deformed acromioclavicular (AC) joint injury — refer to ED

Routine referral criteria

Determine Category 2 or 3 urgency.

First episode of trauma/dislocation in a patient whose occupation requires working above shoulder height

First episode in a patient at risk of further dislocations due to ongoing high-impact activities

First episode with structural pathology placing the patient at risk of instability

Acute full-thickness rotator cuff tear with functional impairment (including post-dislocation)

Recurrent dislocation or instability despite ≥3 months of active rehab/physio, medications and trigger avoidance

Instability associated with structural pathology (e.g. SLAP lesion, large Bankart lesion)

Usually managed in primary care

First episode of trauma/dislocation without occupational, activity or structural risk factors
Acute full-thickness cuff tear without functional impairment after dislocation
Recurrent dislocation where ≥3 months of rehab, medications and trigger avoidance has not been trialled