glenohumeral instability Flashcards
What is glenohumeral instability?
Glenohumeral instability refers to excessive translation of the humeral head on the glenoid during active rotation.
What does instability involve?
Instability involves varying degrees of injuries to dynamic and static structures that function to contain the humeral head in the glenoid.
What is subluxation?
Subluxation refers to joint laxity, allowing for more than the humeral head to passively translate over 50% of the rim of the glenoid without dislocation.
What is dislocation?
Dislocation is the complete separation of the articular surfaces of the glenoid and the humeral head.
What percentage of dislocations detach the glenoid labrum?
Approximately 85% of dislocations detach the glenoid labrum (e.g., Bankart lesion).
What causes glenohumeral instability?
A combination of forces stress the anterior capsule, glenohumeral ligament, and rotator cuff, causing the humerus to move anteriorly out of the glenoid fossa.
What is the most common type of dislocation?
An anterior dislocation is the most common and is usually associated with shoulder abduction and lateral rotation.
What are the signs and symptoms of subluxation?
Signs and symptoms include feeling the shoulder ‘popping out and back into place’, pain, paresthesias, sensation of the arm feeling ‘dead’, positive apprehension test, capsular tenderness, and swelling.
What are the signs and symptoms of dislocation?
Signs and symptoms include severe pain, paresthesias, limited range of motion, weakness, visible shoulder fullness, and the arm supported by the contralateral limb.
What is the initial treatment for glenohumeral instability?
Initial immobilization with a sling for three to six weeks.
What treatments are often utilized in the early phase?
RICE and NSAIDs are often utilized in the early phase.
What should be initiated following immobilization?
Following immobilization, range of motion and isometric strengthening should be initiated.
What exercises should be emphasized in rehabilitation?
Progressive resistive exercises emphasizing the internal and external rotators, as well as the large scapular muscles.
