Polysling skin pressure necrosis--a complication of shoulder immobilisation.

DESCRIPTION A 65-year-old man sustained a closed minimally displaced fracture of the right proximal humerus following a lowvelocity road traffic accident. The alignment of the humeral head was satisfactory and the patient was treated conservatively with a polysling shoulder immobiliser (TalarMade, Universal Multi Arm Sling). He was reviewed in fracture clinic 2 weeks postinjury where the position and alignment of the fracture fragments remained satisfactory on check radiographs. Subsequent review at 4 weeks revealed a 10×2 cm grade 3 pressure sore and surrounding erythema caused by the polysling strap (figure 1). The finding was incidental and he was completely asymptomatic to the effect of the strap on his neck. Following this, the strap was adjusted and additional padding was used to relieve pressure. The wound was managed by a district