Elbow and Shoulder problems Flashcards
What issues commonly affect each age group?
Teens/20’s Fractures and instability
30’ and 40’s Rotator cuff and capsules
50’s and 60’s impingement and AC joint
70’s Degenerative rotator cuff and joint
What causes a shoulder fracture?
How do you manage it?
Young high energy, old osteoperotic damage
Depends on fracture configuration and patient biology
In which direction does the shoulder typically dislocate?
Anterior-90%
Posterior- 9%
Inferior- 1%
How does a traumatic shoulder injury affect someone in later life
100% chance of further injuries in later life due to torn labrum
How do you treat a dislocated shoulder
Manipulation- put it back in
Immobilisation- 3 weeks in sling
Physiotherapy- post sling
Surgery- individual decision
What is a subacromial impingement
Pain and dysfunction which results from any pathology which decreases the volume of the subacromial space or increases the size of the contents
How do you treat a subacromial impingement
Subacromial steroid injection
Physio (always ask patient if they’ve had physio before as it can be shite)
Athroscopic subacromial decompression
What is frozen shoulder
Adhesive capsulitis can be primary or secondary and it is a clinical diagnosis. Typically has a normal radiograph
How do you clinically diagnose a frozen shoulder?
Global restriction of range of movement
Typically presents with pain, then stiffness, then thawing
Good test is to test external shoulder rotation. Frozen shoulder is indicated if rotation is 50% less than the good shoulder.
How do you treat a frozen shoulder
Early presentation- hydrodilatation
Later-surgery
How do you treat a rotator cuff tear
Acute- early surgery
Chronic degenerative- surgery if symptomatic
What is superior capsular reconstruction
An option for massive, iireparable rotator cuff tears
Cadaveric skin graft can be used to reconstruct capsule
What are the different types of shoulder athritis?
Osteoathritis
Inflammatory arthritis
Post traumatic arthritis
What common pathologies occur at what age within the elbow
Young- fractures and dislocation
Tendinopathies in middle age
Elderly- degenerative disease in elderly
Cubital tunnel syndrome at any age
What is golfers elbow?
What is tennis elbow?
Pain arising from the medial epicondyle of humerus
Pain arising from lateral epicondyle of humerus
