What immediate complication should be suspected in a patient with a significant shoulder injury and sensory loss in the hand?

In the context of a significant shoulder injury accompanied by sensory loss in the hand, the suspicion for nerve avulsion is warranted due to the mechanism of injury and the neurological implications. A nerve avulsion occurs when a nerve is pulled away from the spinal cord or its root, which can happen during trauma to the shoulder, particularly in cases of extreme force or displacement.

Sensory loss in the hand indicates that there may be a disruption in the nerve pathways that innervate the arm and hand, commonly involving the brachial plexus. Nerve avulsion injuries can lead to deficits in sensation and motor function, manifesting as weakness or loss of movement in the affected limb.

While other conditions like fracture dislocation or arterial injury are complications that can occur with shoulder trauma, the specific presentation of sensory loss in the hand points more directly to a nerve injury, particularly when considering the trauma's impact on nerve integrity in the brachial plexus region. This makes nerve avulsion the most immediate concern in this scenario, as it requires prompt evaluation and potential surgical intervention for optimal recovery.