Shoulder

Question 1

A) Which GH ligament is the primary ligament to stabilize all directions? B)Which limits anterior and inferior translation?

Answer 1

Inferior GH ligament
Superior GH Ligament

Question 2

What is the MOI for an anterior traumatic shoulder dislocation and which structures are injured

Answer 2

Abduction and ER at 90°. Injury to inferior glenohumeral ligament and anterior inferior glenoid rim causing bankart injury

Question 3

What is a hillsachs lesion? what image view is best?

Answer 3

Posterior lateral humeral head injury with injury to glenoid edge during this location
See with Stryker notch view

Question 4

What is the difference between a Bankart repair and an open Bankhart repair

Answer 4

Bankhart repair: repair of separated labrum from glenoid with glenohumeral ligaments
Open: includes the subscap??

Question 5

When can rotator cuff strengthening begin postoperatively

Answer 5

4 weeks, start at 45* of elevation and isometrics

Question 6

What is the action of the long head of biceps; what directional stability does it provide?

Answer 6

Provide stability in abducted and externally rotated positions. Without proper activation anterior and superior humeral head migration can be seen

Question 7

What is a slap tear?

Answer 7

superior labral tear from anterior to posterior
damage to the superior most aspect of the labrum
Often involves long head of biceps tendon.

Question 8

What are the main differences between a traumatic slap tear and slap tear in patients >/= four years old ?

Answer 8

Traumatic terrors occur with awkward lifting with a single or forceful event.
Non-traumatic injuries are repeated micro traumas and overhead/abducted/externally rotated positions. This constant repetition frays the tendon
Young patients experience tendon trauma, “anchor pulled out” older patients, anchor stays in place and tendon tear is main c/c.

Question 9

What are the four grades of bicep tendon tears? Which require surgery

Answer 9

1 long head bicep tendon is intact

2 disruption of long head biceps tendon and superior labrum . Most common

3 labrum is intact, bucket handle tear. No BT injury

4 labrum and tendon involvement. Labrum has a bucket handle tear

Beyond G2 require surgery. Grade one is managed conservatively with potential for debridement

Question 10

What treatment guidelines are available for conservative, or post surgical strengthening following slap tears

Answer 10

posterior cuff loading: Side-lying external rotation, face pull, straight arm pull down.
Biceps loading.
Proprioceptive exercise

Question 11

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