For pediatric injuries, plain radiographs may reveal fractures at the base of the coracoid. Field management of these injuries involves immobilization of the shoulder with a sling and swath. Assess and immobilize the spine, if indicated. With significant instability, strap immobilization for 2-4 weeks and no heavy lifting for 6 weeks are appropriate. A Kenny-Howard shoulder harness may be used for strap immobilization, though this device frequently is uncomfortable for the patient and may not change the outcome.
Treatment is controversial.
I-III, closed reduction can be effective, though surgical intervention for selected cases may be indicated to achieve better functional results. The goals of therapy are to reduce pain and inflammation. In the absence of contraindications, usually the DOC for treatment of mild to moderate pain. Nonopioid analgesics - These agents are used for mild to moderate analgesic effects. Interactions May increase serum concentrations of MAOIs, TCAs, carbamazepine, phenobarbital, and warfarin Pregnancy C - Safety for use during pregnancy has not been established.