Fractures Of The Scapula Flashcards
What is the fracture of the scapula?
Uncommon
Direct trauma to the chest wall
Healing is good due to good vascularization
What is the treatment for the fracture of the scapula?
Triangular sling
Analgesia and anti inflammatories
Start active movement as soon as possible and prevent shoulder stiffness and limit pain
What are the dislocations of the shoulder?
Anterior
Posterior
What is the anterior dislocation of the shoulder?
Very common
Violent abduction and external rotation forces
Ligaments and capsule tears and the head of the humerus dislocates anteriorly
Feeling of dead arm
What is the objective evaluation of a anterior shoulder dislocation?
Arm is supported by patient
Painful limitations of all shoulder movements
Test deltoid function
Hallow contour of shoulder
What are the common complications of the anterior shoulder dislocation?
Axillary nerve palsy -check sensation of the middle fibers of deltoid
Re dislocation
Stiffness
What is treatment of elders with anterior dislocation of shoulder?
Reduction under anesthesia
Rest is arm sling
Posture correction
Avoid abduction,external rot and external combination for 6 weeks
Heat and massage over trapezius area
Pendular exercises with sling with gravity assisted flexion and abduction of arm
Remove sling exercise within 1st week aim for full flexion
Advise patient to dress by putting unaffected arm first
What is treatment of young athletes with anterior dislocation of shoulder?
Reduction under analgesia
Sling and body bandage for 3 weeks
Follow by sling for 3 weeks
Same as for the elderly
What is a posterior dislocation?
Very rare
Unable to abduct and externally rotate
Refer to ortho surgeon
Caused by electric shock.forced int rot
What is the treatment of a posterior shoulder dislocation?
Reduction and triangular sling if stable
Unstable splintage in abduction and ext rot for 3 to 4 weeks
Avoid combination of adduction and int rot
What is the fracture of the humerus?
Caused by fall on an abducted arm
Indirect aversion of supraspinatus or other rotator cuff muscles
Treatment for fracture of the humerus?
Gentle pendulum exercises as soon as pain permits to avoid stiffness
Slowly begin active shoulder,elbow and finger movements
What is the fracture of the surgical neck?
Caused by falling on an outstretched hand and distal shaft displaces medially and proximal fragment to flex and abduct
What is the treatment and assessment of the surgical neck fracture?
Local swelling and bruising
Inability to move arm
Treatment massive hematoma may be treated with ice then ultrasound and interferential therapy
Heat and massage in prep for exercise and posture correction
Pendulum exercise
Patient should sleep 5I half sitting position to allow gravity to maintain traction
