Session 7 - Common shoudler conditons Flashcards
Fractures of the Scapula
If these fractures occur, what are they an indication of?
An indication of severe chest trauma
Fractures of the Scapula
Where are this fractures frequently seen?
They are frequently seen in
- high-speed road collisions
- crushing injuries
- high impact sports injuries
Fractures of the Scapula
Why does this fracture not typically require fixation?
It does require fixation because the tone of the surrounding muscles hold the fragments in place whilst healing occurs
Fractures of the surgical neck of the humerus
How does this fracture normally arise?
- Blunt trauma to the shoulder
- From falling on an outstretched hand
Fractures of the surgical neck of the humerus
What are the 2 key neurovascular structures at risk here?
- The axillary nerve
- The posterior circumflex humeral artery
Fractures of the surgical neck of the humerus
What does damage to the axillary nerve result in?
- Result in paralysis of the deltoid and teres minor muscles
- Patients will have difficulty performing abduction of the affected limb
- Sensation in the skin over the insertion of the deltoid muscle will be impaired
Ruptures of the Biceps Tendon
What type of individuals do these ruptures take place and where?
Over the age of 50 - following quite minimal trauma - long head of biceps rupture near to its scapular origin
Weightlifters - distal tendon of biceps snaps near to its insertion
Ruptures of the Biceps Tendon
What does the patient report and why don’t they notice much weakness?
- heard something snap in the shoulder whilst lifting
- not notice much weakness in the upper limb because the action of the brachialis (flexion at the elbow and shoulder joint and supination at the radioulnar joint) are intact
Ruptures of the Biceps Tendon
What is the popeye sign?
A characteristic of a ruptured bicep tendon
- flexion of the arm at the elbow produces a frim lump in the lower part of the arm –> this is the unopposed contracted muscle belly of the biceps
Dislocated shoulder
Features of a dislocated shoulder
- visibly deformed
- visible swelling
- bruising around the shoulder
- movement will be severely restricted
(Loss of function)
Dislocated shoulder
In which direction does 90-95% of shoulder dislocation occur? Why?
Anteroinferiorly, anterior
- the glenohumeral joint is weak at its inferior aspect
Dislocated shoulder
Give examples of 2 types of anterior dislocation
In the Subcoracoid location 60% of cases - dislocation anteriorly due to the lull of the muscles and situation of the anterior capsule and ligaments
In the subglenoid location 30% of cases - head of humerus come to lie anterior-inferior to the glenoid
Dislocated shoulder
What is the mechanism of a anterior/ anterior-inferior dislocation?
- fall; direct or indirect
- direct blow to the posterior shoulder
Dislocated shoulder
Anterior dislocation
What is a Bankart lesion?
When the force of the humeral head popping out of the socket cause a part of the glenoid labrum to be torn off and there is a stretch of the glenohumeral ligaments
Shoulder dislocation
Anterior dislocation
What is a Bony bankart lesion?
When a bit of Bone as well as a bit of the glenoid labrum is torn off when the head of the humerus is popped out of the glenoid cavity/ fossa