Case 3

A 45-year-old teacher attempts to replace a fuse in the generator in her school basement. She touches a wire on the under surface of the fuse box and immediately feels pain and a jolt-like sensation in her shoulder. She is thrown across the room. Upon arrival in the ED she is alert and orientated, but complaining bitterly of severe pain in her right hand and shoulder.

Her obvious hand injury is depicted below.

A shoulder x-ray was also obtained.