Joe A Shaw PA-C - 11/10/2011

Question
Hello and thanks for taking my question. I am writing a novel and I need my hero to sustain a bad injury to his shoulder. I've written a bit where he's surrounded by a group of women (he's a famous actor) and one woman pulls out a pair of seamstress shears to cut his hair, but the woman behind her falls and she falls onto the guy. Would the scissors pierce his shoulder? I don't want him to be in critical condition, at least not for long, but for him to need PT and several months of recuperation.

Does that seem plausible? If large scissors penetrated his shoulder would it sever his rotator tendon? What would be the consequences of that injury? Immediate surgery? How long would he would be in hospital? How long would the surgery take?

Would the injury compromise the artery that runs down the arm? would it spurt blood or just ooze? How much pain would he be in or would his arm be numb? Would EMT take the scissors out and if they left them, how would they stabilize them?

Thanks so much. I know a bit about medicine but the shoulder region is not among what I've studied.

Cheers

Maria

Answer
Maria,
I think it could be plausible,but the back of the shoulder is pretty well protected,the scapula is a triangle plate bone,then clavicle on top,so you have a small area that the scissors would have to hit to miss bone,this would be right at the back of the shoulder joint,in b/w the joint itself but then the shoulder joint is only 1/2-1" in..so the knife would hit bone pretty quick..
Technically the rotator cuff is made up of 4 muscles not one.It would be painful injury and yes it could cut one of the rotator cuff tendons but would be hard to do,It would be painful but not life threatening..would be in hosp. 1-2 days,surgery could take 1-2 hrs if that long..would be hard to severe the "main artery",blood would probably just ooze.Would be hard for scissors to stick b/c of above..ie bony anatomy is so close to surface..kind of like trying to stick a knife in a knee..the blade would have to fit just right,to get in between joint otherwise it(tip of knife) would just poke skin hit bone and fall out.If it was impaled,they would leave it in and pack bulk dressing around knife and tape to stabilize..you would never ever pull out impaled object on the scene.