Shoulder and elbow problems Flashcards
What is the epidemiology of shoulder and elbow problems in different age groups?
Teens/20s - Fractures and instability
30s and 40s - rotator cuff and capsulitis
50s and 60s - impingement and acromioclavicular joint
70s + - degenerative rotator cuff and joint
What are the most common causes of uppper limb fractures in the young and the elderly?
Young - High energy injuries
Elderly - Osteoperotic injuries
What is the most common direction of shoulder dislocation?
Anterior
Why is the shoulder joint not as stable as the hip joint?
It has sacrificed stability for mobility
How can shoulder problems be treated?
Manipulation
Immoilisation
Physiotherapy
Surgery if required
Why are anterior shoulder dislocations more common than others?
There is a lack of stability anteriorly during abduction and rotation
What is subacromial impingement?
The subacromial space is closed and the supraspinatus muscle is constricted causing a painful abductor arc
How can subacromial impingement be treated?
Subacromial steroid injection
Physiotherapy
Arthroscopic subacromial decompression
What is frozen shoulder?
Pain and stiffness in the shoulder that lasts for months, also known as adhesive capsulitis
What are features of frozen shoulder?
Can be idiopathic or secondary
Begins with pain and progresses into stiffness
Shows a normal radiograph
Tissue around joint becomes inflamed and tightens
How is frozen shoulder treated?
Early presentation - hydrodilatation
Late presentation - surgery
What are the 2 main types of rotator cuff tear??
Traumatic - injury
Degenerative - age
How is rotator cuff tear treated?
Acute tear - early surgery
Chronic degenerative tears - surgery if symptomatic
What is superior capsular reconstruction?
A cadaveric skin graft to reconstruct the capsule, an option for massive irreparable rotator cuff tears
What are the three types of shoulder arthritis?
Osteoarthritis
Inflammatory arthritis
Post-traumatic arthritis
