Shoulder Flashcards
Causes of humeral AVN
AS IT GgRrIiiPpS 3C
Alcohol Steroids Idiopathic Trauma Gaucher's Gout Rheumatoid radiation Infection increased lipids inflammatory arthritis Pancreatitis pregnancy Sickle cell smoking SLE Caisson's Chronic renal failure Chemotherapy
Shoulder Instability Severity Index Score
ASL HG
Age (<20) = 2 points Sports (Competitive) = 2 points Sports (Contact or overhead) = 1 point Laxity = 1 point Hill-Sachs (on AP XR with ER) = 2 points Glenoid loss of contour (on AP XR) = 2 points
<6 points = 10% recurrence risk with Arthroscopic
>6 points (so, 7?) = better with Open procedure
Shoulder Arthroplasty positions
Hemiarthroplasty:
30 degrees Retroversion
Top is 5-8mm above the GT
Standard TSR: 25-45 degrees Retroversion of the stem (usually 25) 130 degree neck cut Neutral glenoid Top of stem 5-8mm above GT
Reverse TSR component positioning
0 - 30 degrees stem Retroversion (usually 20)
155 degree neck cut
Neutral (0 degrees) Glenoid
Glenoid lateralized and inferior to avoid notching
At what range of abduction are the three GHL ligaments most useful
SGHL = 0 abduction prevents inferior translation MGHL = 45 abduction prevents AP translation IGHL = 90 abduction prevents AP translation
Spinoglenoid notch compression:
What is compressed?
What is the clinical picture?
What are the causes?
Suprascapular nerve compressed - only distal part
Infraspinatus only affected - Hornblower’s sign
Cyst - paralabral Ligament - spinoglenoid Ganglion - spinoglenoid notch Traction injury ORIF - screw penetration
Thoracic outlet.
What is compressed
What are the causes
Compressed: brachial plexus Trunks 95%, Subclavian artery 2%
Causes: Fibrous band from 1st rib to C-rib most common. Cervical rib (c-rib), large 1st rib, clavicle fracture callus, scalene muscles
Symptoms: ulnar-sided whole arm pain, worse with work, C8-T1 compression, decreased grip strength,
