Lecture 5- Surgery of the Shoulder Flashcards
what are the common shoulder symptoms?
Pain
Stiffness
Weakness
Instability
Why is the shoulder prone to injuries?
-Inherently unstable joint
What makes the glenohumeral joint to be stable?
- Rotator cuff muscle
- Capsule and Labrum
Name the 4 rotator cuff muscles?
- Supraspinatous muscle
- Infraspinatous muscle
- Subscapularis muscle
- Teres minor
what force does the following muscle produce on the GHJ?
Deltoid: upward
Supraspinatous: medial force
Subscapularis and infraspinatus: Lateral force
what are the function of the rotator cuff muscles?
stabilises GHJ
-Provides a FULCRUM for power muscles to move the arm
What are the power muscles that enable the arm to move?
Deltoid Pec major Trapezius Lat dorsi Teres Major
which are the superficial power muscles of GHJ?
- Deltoid
- Pec Major
- Serratour anterior
What are the risk factors for shoulder pian?
- Sports related injuries
- Traumatic injuries
- Degenerative conditions
- Work related conditions
What are the causes of shoulder pain?
Subacromian problem:
1) Acromoin joint arthritis
2) Rotator cuff tear
3) Calcific tendonitis
What is subacromial impingement?
common injury
pain on abduction & rotation of arm
Felt over deltoid
What are the causes subacromial impingement?
-Extrinsic: bony spurs
Intrinsic: Tendinopathy/cuff weakness
Name the three rotator cuff disorders?
- subacromial impingement
- Rotator cuff tears
- Calcific tendinitis
what are the treatments for rotator cuff disorders?
Non-surgical
1) activity modification
2) Physiotherapy
Surgical:
1) Subacromial decompression
2) Debridement of bony and soft tissue impinging area
what are the causes of rotator cuff tears?
- tears: supraspinatus and infraspinatus
causing: weakness and pain - tendon degeneration is normal
- Repair if symptomatic
what are GHJ problems?
- Osteoarthritis
- Frozen shoulder
- Instability
Name the glenohumeral arthritis?
- Osteoarthritis
- RA
- Post traumatic arthritis
what are the symptoms of arthritis?
- stiffness
- crepitus and grinding
- pain at rest and at night
- pain with activity
What are the symptoms of frozen shoulder?
- Stiffness and pain
- Loss of passive motion (external rotation)
- X-ray normal
who is most likely to affected by frozen shoulder?
40-60 years old
female
diabetic
What are the treatment options for frozen shoulder?
Non- surgical: natural history to resolve over 2 years -Injections -Hydrodilatation Surgical: -Capsular release and manipulation
What are the risk factors for shoulder instability?
- Collision sport
- Hyperlaxity
what are the surgical treatment options for the frozen shoulder?
- Arthroscopic stabilisation - labral repair
- Open stabilisation: capsule tightening
- Bony procedures: augmenting glenoid
what are the traumatic shoulder conditions?
- Bony trauma
1) fractures
2) dislocations
Soft tissue trauma
1) bicep problems
2) pec major rupture
Name some of the shoulder fractures?
- Proximal humeral fractures
- Acromioclavicular Joint Dislocations
