Shoulder and elbow problems Flashcards
What kind of fracture is more common in the elderly?
Osteoporotic
What is the most mobile joint in the body?
Shoulder
Not very stable tho
What is involved in the treatment of shoulder dislocation?
Manipulation
Immobilisation
Physiotherapy
Surgery
In which direction does the shoulder usually dislocate?
Anteriorly (90%)
Posterior (Electric shock, fits) (9%)
Inferiorly (Falls onto outstretched arm over head) (1%)
What are the main methods for manipulating a dislocated shoulder?
Hippocratic
Cocker
What is the labrum?
Cup-shaped rim of cartilage that lines and reinforces the ball-and-socket joint of the shoulder
In which position is the shoulder usually immobilised?
Internal rotation
Allows any necessary healing of evulsion of the labrum
What is subacromial impingement?
When arm is abducted there is a painful arc as abduction increases and fades as abduction continues
What causes subacromial impingement?
Friction in acromion-clavicular joint produces osteophytes
Rotator cuff is impinged between these osteophytes and the greater tuberosity
How is subacromial impingement managed?
Subacromial steroid injection to reduce inflammation
Physiotherapy
Arthroscopic subacromial decompression if first 2 fail (acromial ligament resected)
What is another name for frozen shoulder?
Adhesive capsulitis
What is the normal progression of frozen shoulder?
Pain increases then eases
Stiffness increases as pain decreases
Gradual thawing of stiffness, not always full recovery
How does frozen shoulder appear on radiographs?
Normal
Diagnosis clinical
What is the difference between subacromial impingement and frozen shoulder?
Frozen shoulder all movement restricted
SI only abduction affected
How are acute rotator cuff tears managed?
Early surgery usually yields good results if present early
