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Musculoskeletal System > Fx of the Shoulder > Flashcards

Fx of the Shoulder Flashcards

1
Q

Clavicle Fx

A

80% occur at middle third
15% lateral
5% medial

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2
Q

What is the common site of clavicle fx and what does it result in?

A

middle third

results in bayonet apposition

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3
Q

Etiology of Clavicle Fx

A

trauma - fall
pathologic - bone
cyst

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4
Q

What type of clavicle fx require surgery?

A
  1. distal clavicle fx near the AC joint
    because of the impingement on the rotator
    cuff
  2. communition fx

surgery can use plates

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5
Q

Tx of most clavicle fx

A

SLING

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6
Q

Fx of clavicle can occur from underlying diseases

A

infection or bone tumor

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7
Q

Distal Clavicle fx

A

post traumatic can lead to arthritis - joint problem

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8
Q

What is the tx goal for clavicle fx?

A

restore length

use clavicle strap - unpopular (patient compliance is low)

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9
Q

PROXIMAL clavicle fx

A

require surgery

hard to replace it back into original place

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10
Q

Complications of clavicle fx

A
  1. nonunion when done surgery (won’t heal)
  2. pneumothorax - the more communiuted the more likely chance of pneumothorax
  3. subclavian a injury
    more sublux of the clavicle the more chance of injury for subclav a.
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11
Q

Fx of the scapula

A

body
neck
glenoid
acromion

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12
Q

If glenoid of the scapula fx, how to tx?

A

if displaced or intra-articular

need surgical management

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13
Q

Mechanism of injury of scapula fx

A

direct trauma

FOOSH

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14
Q

Fx of humerus

A

Head
Surgical neck
anatomic neck
proximal shaft

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15
Q

How to tx fx of humerus

A

No surgery
wait 3 wks after putting a sling
multiple portions of the scapula in involved

STABILIZE

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16
Q

CODMAN described the proximal humeral fx

A

Proximal humeral fractures

adults occur along the lines of the old physeal scars

17
Q

The 4 anatomic parts of the proximal humerus fx

A

greater tuberosity
lesser tuberosity
humeral head
humeral diaphysis (shift)

18
Q

How common is the proximal humerus fx?

A

more common than hip
4-5% of all fx
affects women more than men = a typical patient is a elderly woman who falls (osteoporosis)

19
Q

What are the majority of the proximal humerus fx?

A

nondisplaced fx (still has anatomic alignment)

20
Q

Neer classification of proximal humerus fx

A

One part - impacted compression
Two part - greater tuberosity fx
Three part - head separates from the greater tuberosity and shaft
Four part- head , tuberosities, and shaft separate

21
Q

one part fx

A

compression - impacted

22
Q

two part

A

greater tub. fx

23
Q

three part

A

greater tub and head fx

24
Q

four part

A

greater tub less tub and head fx

25
Q

if greater tub. fx what is at risk

A

rotator cuff
pulled off
displaced

26
Q

AVN = avascular necrosis of the head of the humerus

A

result from four part fx

won’t heal

27
Q

Etiology of proximal humerus fx

A

FOOSH

decreased abduction

28
Q

What vessels are destroyed in 4-part fx

A

anterior and posterior humeral circumflex a.

29
Q

Tx of one part

A 
non surgical 
1-3 immobilization 
sling 
pendulum exercises 
elbow ROM
30
Q

Tx of two part

A

surgical neck is fx
REDUCED CLOED AND IMPACTED
open reduction internal fixation can be okay if unstable

31
Q

Tx of three part

A

Use ORIF if greater than 5 mm displacement
for greater tuberosity
and suture fixation for lesser tuberosity but this is rare

32
Q

ORIF

A 
open the skin, put it back in place by plates and screws 
cement it for elderly
used for three part fx (usually) 
both the tuberosities will heal 
use wire and suture
33
Q

Tx 4 part

A

generally ORIF doesn’t work because the head will collapse down and AVN won’t let it heal properly
AVN
prosthesis is the best tx

34
Q

Prosthesis of the humerus

A

replace the humerus

need tuberosities for motions

Musculoskeletal System (27 decks)

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