Shoulder And Elbow Problems Flashcards
Epidemiology of shoulder injuries
- Teens/20’s: Fractures and instability
- 30’s & 40’s: Rotator cuff and capsulitis
- 50’s & 60’s: Impingement and AC joint
- 70’s + : Degenerative rotator cuff and joint
Upper limb fracture epidemiology
- Young high energy injuries
- Elderly Osteoporotic injuries
Traumatic Shoulder Dislocation
- Shoulder joint is the most mobile joint in the body
- Stability sacrificed for mobility
- Anterior 90%, posterior 9%, inferior 1%
- posterior - epilepsy, electric shock
Shoulder dislocation treatment
- Manipulation
- Immobilisation
- Physiotherapy
- Surgery
Subacromial impingement
Pain and dysfunction resulting from any pathology which decreases the volume of the subacromial space or increases the size of the contents
Subacromial Impingement Treatment
- Subacromial Steroid injection
- Physiotherapy
- Arthroscopic subacromial decompression
Adhesive capsulitis (frozen shoulder)
- a chronic fibrosing condition characterised by insidious and progressive severe restriction of both active and passive shoulder range of motion in the absence of a known intrinsic disorder of the shoulder
- generally regarded as a self-limiting condition that usually resolves after 18-24 months
Adhesive capsulitis diagnosis
- shoulder stiffness
- decreased shoulder active range of movement
- decreased shoulder passive range of movement
- positive coracoid pain test
- positive shoulder shrug test
Adhesive capsulitis investigations
X-Ray (excludes arthritis, dislocated shoulder)
Adhesive capsulitis treatment
- activity modification and physiotherapy
- NSAID or oral corticosteroid
- intra-articular corticosteroid injection
- manipulation under anaesthesia
- hydrodilation
Rotator cuff tear cause
- trauma
- shoulder dislocation
- attritional
- repetitive overhead injury
- chronic degeneration
Rotator cuff tear treatment for patient with lower functional demands
- rehabilitation therapy including range of movement and strengthening exercises
- a subacromial injection can relieve pain
Rotator cuff tear treatment for patient with higher desired activity level or acute tear
surgical intervention
Epidemiology of elbow injuries
- Fractures & dislocations in young
- Tendinopathies in middle age
- Degenerative disease in elderly
- Cubital Tunnel syndrome at any age
Epicondylitis of the elbow
- associated with repetitive forearm and elbow activities
- lateral epicondylitis (tennis elbow) and medial epicondylitis (golfers elbow)
- characterised by elbow pain following elbow flexion or extension
