Exam 3: Shoulder Fractures Flashcards

1
Q

What are the most common areas for shoulder fractures

A
clavicular fractures
surgical neck of the humerus
displaced fracture of the proximal humerus
fracture of greater tuberosity
scapular fractures - rare
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2
Q

Clavicular fractures are seen more in (kids/adults)

A

kids

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3
Q

What are three typical MOI of a clavicular fracture

A

FOOSH, falling on tip of shoulder or direct impact

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4
Q

If a clavicular fracture is present, where is the fracture typically located

A

middle 1/3 or distal 1/3 of clavicle

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5
Q

A ____ fracture occurs often in children in which the middle or distal 1/3 of the clavicle is broke

A

greenstick

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6
Q

If a patient presents with supporting of the arm with the head and chin titled away, what would be your hypothesis

A

clavicular fracture

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7
Q

A clavicular fracture may appear (higher/lower) laterally

A

lower

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8
Q

What does closed management of a clavicular fracture look like

A

A sling to support the arm to decrease pain for 2 weeks or less
If significant, immobilize with figure 8 brace for 6-8 weeks

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9
Q

When can ROM and strengthening begin after a clavicular fracture? Does strengthening begin with isotonics or isometrics

A

ROM can begin after sharp pain subsides. Strengthen with isometrics at first

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10
Q

What are 4 absolute indications that operative management is needed to heal a clavicular fracture

A

open fractures
fractures with neurovascular compromise
floating shoulder
symptomatic non-union

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11
Q

What is the MOI for a scapula fracture

A

direct impact or force transmitted up through the humerus

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12
Q

Because of the surrounding musculature, most scapular fractures are (stable/unstable)

A

stable

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13
Q

Glenoid rim fractures are usually due to ____

A

dislocations

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14
Q

Fractures of the body of the scapular (always/rarely) need treatment because they are usually (displaced/non-displaced) and (supported/unsupported) by soft tissue

A

rarely
non displaced
supported

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15
Q

What does general management of a fracture to the body of the scapular look like

A

A sling for 3 weeks with overhead strengthening

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16
Q

What is the MOI of an acromion fracture

A

direct trauma

17
Q

When is surgical intervention recommended for an AC fracture

A

If its comminuted and depressed

18
Q

What does the Neer 3 phase program treat

A

humeral fractures

19
Q

What are the three phases of the Neer program

A
  1. Passive exercises, including pendulum 2-6 weeks
  2. Active exercises, including stretching 6-12 weeks
  3. Resistive exercises 3+ months
20
Q

What patient population and MOI are impacted humeral head fractures typically associated with

A

elderly patients who are osteoporotic following FOOSH

21
Q

Do impacted humeral head fractures heal well? Why or why not

A

Yes because it occurs through cancellous bone with is soft and spongy

22
Q

A fracture of the anatomical neck of humerus can be serious if ____. The typical MOI is _____

A

displaced; FOOSH

23
Q

What patient population commonly is seen with a fracture of the anatomical neck of the humerus

A

elderly and adolescents

24
Q

A fracture of the surgical neck of the humerus has a MOI of _____ with a typical patter of a ____ fracture. Symptoms of this include enormous ____ and _____

A

FOOSH
spiral
bleeding and bruising

25
Q

How is a fracture of the surgical neck of the humerus treated if its unstable/displaced

A

ORIF with pins, plates, and screws or IM rod

26
Q

PT treatment of a surgical neck of humerus fracture can begin AAROM within 2-3 weeks. What motions are emphasized during this time

A

abduction, ER, and IR

27
Q

Beware of _____ with and ___ nerve injury with a surgical neck of the humerus fracture

A

OP; axillary

28
Q

True or False:

While recovering from a surgical neck of the humerus fracture, mild to moderate joint mobs are done to gain ROM

A

False, super gentle and light joint mobs are done bc of OP

29
Q

What muscle group should be worked on first with a fracture of the greater tuberosity

A

RC muscles first then deltoids, lats, and biceps

work form the inside out

30
Q

The proximal humeral shaft is a common site for ______ in _____

A

metastases in cancer

31
Q

During the immobilization phase of PT management for a shoulder fracture, when can pendulum exercise be done for both a stable and non stable injury

A

stable - week 1

unstable - week 3 or when hard callous appears