Introduction to surgery of the shoulder Flashcards
Why is shoulder pain important?
3rd most common MSK consultation in GP practice
1% adults each year visit GP with shoulder pain
25% of adults self reported prevalence of shoulder pain
Risk factors for shoulder pain
Sports related injuries
Traumatic injuries
Degenerative conditions
Work related conditions
Common shoulder symptoms
Pain
Stiffness
Weakness
Instability
Causes of shoulder pathology
Glenohumeral joint: arthritis, instability, frozen shoulder
Rotator cuff: tears, bursitis/ impingement/ calcific tendonitis
Bone trauma
Biceps, pec major
What stabilises the glenohumeral joint?
Rotator cuff (dynamic)
Capsule and labrum (static)
Rotator cuff muscles
Anterior shoulder
- supracapularis muscle
- supraspinatous muscle
Posterior shoulder
- teres minor muscle
- infraspinatous muscle
Rotator cuff role
Stabilise the GHJ
Provide a fulcrum for power muscles to move arm
- deltoid pec major
- trapezius
- lat dorsi
- teres major
Rotator cuff disorders
Subacromial impingement
Rotator cuff tears
Calcific tendonitis
Subacromial impingement
Common
Pain on abduction and rotation of arm
Felt over deltoid
Causes of subacromial impingement
Extrinsic
- bony spurs
Intrinsic
- tendinopathy/ cuff weakness
Treatment for subacromial impingement
Non surgical
- activity modification
- physiotherapy
Surgical
- subacromial decompression
- debridement of bony and soft tissue impinging areas
Rotator cuff tears
Most common- supraspinatus/ infraspinatus
Weakness and pain
Tendon degeneration is normal
15% in 60s have a full thickness tear
Repair if symptomatic
Glenohumeral disorders
Arthritis
Frozen shoulder
Instability
Glenohumeral arthritis
Osteoarthritis
Rheumatoid arthritis
Post traumatic arthritis
Symptoms of arthritis
Stiffness
Crepitus and grinding
Pain at rest and at night
Pain with activity
