GH Joint Injuries

Question 1

Most common direction of shoulder instability

Answer 1

Anterior inferior

Question 2

Mechanism of injury that causes anterior shoulder instability

Answer 2

Abduction and externally rotated arm

Question 3

If patient presents with arm in an adducted and internally rotated arm, what do you expect?

Answer 3

Posterior shoulder instability

Question 4

Mechanism of injury that causes posterior shoulder instability

Answer 4

Landing on an arm that is flexed and adducted

Question 5

If patient has GH instability due to a traumatic cause, what other findings do you expect?

Answer 5

TUBS
Traumatic shoulder instability 
Unidirectional 
Bankart lesion
Surgical mgmt usually required

Question 6

If patient has GH instability due to an atraumatic cause, what other findings do you expect?

Answer 6

AMBRI
Atraumatic shoulder instability 
Multidirectional 
Bilateral lesions 
Rehab mgmt
Inferior capsule shift if surgery is done

Question 7

Bankart vs Hill Sachs

Answer 7

Bankart is a labral tear of anterior glenoid.

Hill Sachs is bony lesion of posterolateral humeral head

Question 8

Bennett lesion of shoulder

Answer 8

Mineralization of posterior band of the IGHL as a result of extra-articular posterior capsular avulsion injury.

Question 9

Shoulder instability is typically seen in what kind of patients

Answer 9

Athletes who require repetitive overhead arm motion

Question 10

What is the laxity exam?

Answer 10

Ask patient to touch their thumb to the volar surface of forearm, which tests for ligament laxity. Patients who have lax tissue are more likely to have capsular laxity and can easily dislocate shoulder.

Question 11

4 provocative tests for anterior shoulder instability

Answer 11

1. Apprehension
2. Relocation
3. Anterior drawer
4. Anterior load and shift test

Question 12

What is the jerk test?

Answer 12

Tests for posterior shoulder instability. Flex arm, internally rotate, flex elbow and adduct shoulder with posterior force on humerus. Patient will jerk away when arm passes midline.

Question 13

3 provocative tests for posterior shoulder instability

Answer 13

1. Jerk test
2. Posterior drawer
3. Posterior load and shift

Question 14

What does sulcus sign indicate?

Answer 14

Multidirectional GH instability

Question 15

What X-ray view do you want for bankart vs Hill Sachs lesion

Answer 15

Bankart - West Point lateral axillary view

Hill Sachs - Stryker notch view

Question 16

If patient presents with shoulder dislocation, what are some contraindications to reducing it?

Answer 16

If patient has Hx of osteoporosis or if there is suspected fracture

Question 17

If patient presents with shoulder dislocation, how long do you keep sling on?

Answer 17

6 weeks if patient is younger, 2 weeks if older

Question 18

If patient has anterior shoulder dislocation, what type of rehab exercises do you prescribe?

Answer 18

PROM
Codman’s pendulum
Isometric exercises at first then progress to resistive exercises

Question 19

After a shoulder dislocation, when is surgery indicated?

Answer 19

If rehab fails to prevent recurrence. After 3rd dislocation, surgery is considered.

Question 20

If patient presents with posterior shoulder dislocation, how long do you put sling on?

Answer 20

3 weeks