Exam 3: Shoulder Fractures Flashcards
What are the most common areas for shoulder fractures
clavicular fractures surgical neck of the humerus displaced fracture of the proximal humerus fracture of greater tuberosity scapular fractures - rare
Clavicular fractures are seen more in (kids/adults)
kids
What are three typical MOI of a clavicular fracture
FOOSH, falling on tip of shoulder or direct impact
If a clavicular fracture is present, where is the fracture typically located
middle 1/3 or distal 1/3 of clavicle
A ____ fracture occurs often in children in which the middle or distal 1/3 of the clavicle is broke
greenstick
If a patient presents with supporting of the arm with the head and chin titled away, what would be your hypothesis
clavicular fracture
A clavicular fracture may appear (higher/lower) laterally
lower
What does closed management of a clavicular fracture look like
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
When can ROM and strengthening begin after a clavicular fracture? Does strengthening begin with isotonics or isometrics
ROM can begin after sharp pain subsides. Strengthen with isometrics at first
What are 4 absolute indications that operative management is needed to heal a clavicular fracture
open fractures
fractures with neurovascular compromise
floating shoulder
symptomatic non-union
What is the MOI for a scapula fracture
direct impact or force transmitted up through the humerus
Because of the surrounding musculature, most scapular fractures are (stable/unstable)
stable
Glenoid rim fractures are usually due to ____
dislocations
Fractures of the body of the scapular (always/rarely) need treatment because they are usually (displaced/non-displaced) and (supported/unsupported) by soft tissue
rarely
non displaced
supported
What does general management of a fracture to the body of the scapular look like
A sling for 3 weeks with overhead strengthening
What is the MOI of an acromion fracture
direct trauma
When is surgical intervention recommended for an AC fracture
If its comminuted and depressed
What does the Neer 3 phase program treat
humeral fractures
What are the three phases of the Neer program
- Passive exercises, including pendulum 2-6 weeks
- Active exercises, including stretching 6-12 weeks
- Resistive exercises 3+ months
What patient population and MOI are impacted humeral head fractures typically associated with
elderly patients who are osteoporotic following FOOSH
Do impacted humeral head fractures heal well? Why or why not
Yes because it occurs through cancellous bone with is soft and spongy
A fracture of the anatomical neck of humerus can be serious if ____. The typical MOI is _____
displaced; FOOSH
What patient population commonly is seen with a fracture of the anatomical neck of the humerus
elderly and adolescents
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 _____
FOOSH
spiral
bleeding and bruising
How is a fracture of the surgical neck of the humerus treated if its unstable/displaced
ORIF with pins, plates, and screws or IM rod
PT treatment of a surgical neck of humerus fracture can begin AAROM within 2-3 weeks. What motions are emphasized during this time
abduction, ER, and IR
Beware of _____ with and ___ nerve injury with a surgical neck of the humerus fracture
OP; axillary
True or False:
While recovering from a surgical neck of the humerus fracture, mild to moderate joint mobs are done to gain ROM
False, super gentle and light joint mobs are done bc of OP
What muscle group should be worked on first with a fracture of the greater tuberosity
RC muscles first then deltoids, lats, and biceps
work form the inside out
The proximal humeral shaft is a common site for ______ in _____
metastases in cancer
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
stable - week 1
unstable - week 3 or when hard callous appears
