Shoulder injury w/nerve damage?

[peekawho]

My husband was riding his dirt bike, and crashed very hard on his shoulder.  Immediately after the fall for aout 10 minutes, he was completely unable to use his arm at all.  Function returned (along with great pain, of course!).
I took him to Urgent Care, and an xray of his shoulder was deemed "normal", and he was advised to follow up with his primary care MD.  Of course, this happened at the beginning of the holiday weekend.
Today, 3 days later, the shoulder pain has subsided somewhat, but he is unable to lift his arm, or to bend his elbow.  Not because of pain, but he is simply unable to move the arm.  

There is no numbness whatsoever.  He can move his fingers, and has a strong grip with both hands.  He still has very severe bruising of the arm and swelling around the elbow, which was not xray'd (he had so much shoulder pain, they concentrated on that and didn't even address the elbow at the time of his visit).

He can't get in to see his primary (who is just a family practitioner anyway) for several more days.  He can self refer to an orthopod, but the first available he can get is weeks away.  He'll surely need an MRI.  We are very concerned about nerve damage in this (his dominant) arm.

As a capper, he loses his insurance on the 31st, when he starts a new job.  Then I assume he'll have to wait for 3 months due to the pre-existing condition clauses.

What should we do in the meantime?  Any ideas?

[JainMD]

Hi,
If he is not able to raise his arm above shoulder then it might be due to biceps tendonitis or rotator cuff tendonitis, in which patients complain of pain exacerbated by overhead movements.
His swelling from mid upper to just below the elbow can cause Cubital tunnel syndrome to impingement of ulnar nerve.
You said he is not able to move his hand and also that he does not have numbness, does that his nerve is severely damaged.
You need get an X-ray done as early as possible to see for any fracture.
MRI is required urgently to look for any soft tissue pathology.
Keep me informed if you have any queries.
Bye.

[peekawho]

His pain is not in his elbow, he hurt his shoulder in a high velocity dirt bike crash--landed on his shoulder.
All motion hurts his shoulder, but the inability to raise the arm or bend the elbow is not from pain, he simply can't move the arm.
He has severe bruising and swelling from the mid upper arm to just below the elbow.
No numbness.

This is an acute injury, not anything involving weight loss or fever.  He has been on Naproxyn since the injury.

[JainMD]

Hi,
How is your husband feeling now?
Whenever a patient complains of elbow or proximal forearm pain, my differential diagnosis of the most common causes includes lateral epicondylitis, medial epicondylitis, ulnar collateral ligament injury, fracture, rheumatoid arthritis, and Cubital tunnel syndrome (in which the ulnar nerve is compressed at the Cubital tunnel in the elbow).
Where is his pain exactly?
What brought on the symptoms, and which movements most exacerbate them?
What is the quality of your pain—sharp, stabbing, numbness, tingling, etc.?
Is the pain and swelling symmetrical? Have you noticed any weight loss or systemic symptoms, such as flushing or fever?
Do you ever experience any locking or clicking in your elbow? Have you taken anything for the pain, and has it helped? Is there any grating when you move your elbow?
MRI study would be most helpful.
Initially he can be treated with RICE protocol.
Keep me informed if you have any queries.
Bye.