3. Shoulder and Elbow Problems

Question 1

What are the most common Shoulder / Elbow Injury types, for patients in their teens/20’s?

Answer 1

Fractures and Instability

Question 2

What are the most common Shoulder / Elbow Injury types, for patients in their 30/40’s?

Answer 2

Rotator Cuff and Capsulitis

Question 3

What are the most common Shoulder / Elbow Injury types, for patients in their 50/60’s?

Answer 3

Impingement and AC Joint

Question 4

What are the most common Shoulder / Elbow Injury types, for patients in their 70’s +?

Answer 4

Degenerative Rotator Cuff and Joint

Question 5

What is the Epidemiology of Upper Limb Fractures?

Answer 5

1. Young - High Energy Injuries
2. Elderly - Osetoporotic Injuries
   Note - this is similar to the epidemiology of Hip Fracture

Question 6

What is the management of Upper Limb Fractures dependent on?

Answer 6

1. Fracture Configuration

2. Patient Biology

Question 7

What is the most mobile Joint in the body?

Answer 7

The Shoulder Joint

Question 8

What is sacrificed in making the Shoulder Joint the most stable in the body?

Answer 8

Its stability is sacrificed for mobility

Question 9

What is the shoulder predisposed to, due to its instability?

Answer 9

Traumatic Shoulder Dislocation

Question 10

What are the different proportions of type of Traumatic Shoulder Dislocation?

Answer 10

1. Anterior - 90%
2. Posterior - 9%
3. Inferior - 1%

Question 11

What is the treatment of Traumatic Shoulder Dislocation?

Answer 11

1. Manipulation
2. Immobilisation
3. Physiotherapy
4. Surgery

Question 12

What is the investigation for a Traumatic Shoulder Dislocation?

Answer 12

X-Ray - Light Bulb Sign

Question 13

What is the definition of Subacromial Impingement?

Answer 13

Pain and Dysfunction resulting from any pathology which:

1. Decreases the volume of the Subacromial Space
2. Increases the size of the Subacromial Contents

Question 14

What are the treatments of Subacromial Impingement?

Answer 14

1. Subacromial Steroid Injection
2. Physiotherapy
3. Arthroscopic Subacromial Decompression

Question 15

What is Adhesive Capsulitis known as?

Answer 15

A Frozen Shoulder

Question 16

What are the 2 types of Adhesive Capsulitis (Frozen Shoulder)?

Answer 16

1. Primary (Idiopathic) Adhesive Capsulitis

2. Secondary Adhesive Capsulitis

Question 17

How is Adhesive Capsulitis (Frozen Shoulder) diagnosed?

Answer 17

1. Clinically

2. Normal radiograph

Question 18

What is the treatment of Adhesive Capsulitis (Frozen Shoulder)?

Answer 18

Early Presentation - Steroid Injection

Later - Surgery

Question 19

How long can a case of Adhesive Capsulitis (Frozen Shoulder) go on for?

Answer 19

1. Pain - months 0-9 (peaking at 4.5 months)
2. Stiffness - months 4.5-14 (peaking at 14th month)
3. Thawing - months 14 - 24 (max)

Question 20

What are the 2 types of Rotator Cuff Tear?

Answer 20

1. Traumatic

2. Degenerative

Question 21

What is the treatment of an Acute Rotator Cuff Tear?

Answer 21

Early Surgery

Question 22

What is the treatment of Chronic Degenerative Rotator Cuff Tears?

Answer 22

Surgery if Symptomatic

Question 23

What is treatment for Rotator Cuff Tears dependent on?

Answer 23

1. Size of the Tear
2. Time (if chronic)
3. Age

Question 24

What are the 3 types of Shoulder Arthritis?

Answer 24

1. Osteoarthritis
2. Inflammatory Arthritis
3. Post-traumatic Arthritis

Question 25

What is paramount in Shoulder Arthritis?

Answer 25

Rotator Cuff Integrity

Question 26

What are the common Elbow Problems in the Young?

Answer 26

Fractures and Dislocations

Question 27

What are the common Elbow Problems in the Middle Aged?

Answer 27

Tendinopathies

Question 28

What are the common Elbow Problems in the Elderly?

Answer 28

Degenerative Disease

Question 29

At what age can Cubital Tunnel Syndrome occur?

Answer 29

At any age