Shoulder Fractures Flashcards
What is this a presentation of?
Young male, contact sport injury, arm forced into abduction, extension, and external rotation, loss of shoulder contour.
Anterior shoulder dislocation
How is an anterior shoulder dislocation investigated?
- Check pulses and nerves pre and post reduction
2. X-ray before and after reduction
What is the treatment for anterior shoulder dislocation?
Closed reduction, apply longitudinal traction to arm in abduction and replace humerus by gentle pressure, analgesia.
What is this a presentation of?
Limitation of external rotation, epileptic during seizure or an electric shock victim.
Posterior shoulder dislocation
How is a posterior shoulder dislocation investigated?
- AP x-ray shows light bulb sign
2. Lateral x-ray also needed
Which is more common, anterior or posterior shoulder dislocation?
Anterior
What is this a presentation of? Direct blow (contact sport commonly), young, tender swelling over superior shoulder, adduction of the arm increases pain.
Acromio-clavicular joint separation
How is an acromio-clavicular joint separation investigated and managed?
- X-ray
- If <200% displacement - sling for 1 week; if >200%/posterior displacement - surgical open reduction and ligament reconstruction.
What is this a presentation of?
Direct blow to shoulder/upper thorax, SCM muscle pulls bone to cause bulge.
Clavicle fracture
How is a clavicle fracture investigated?
Check neurovascular status and exclude pneumothorax, x-ray.
What is the management for a clavicle fracture?
Broad arm sling with follow-up x-ray at 6 weeks, if >100% displacement then surgical open reduction internal fixation.
What is this a presentation of?
Painful pop, weakness, and bruising in antecubital fossa (dominant side), taking anabolic steroids and is a smoker.
Biceps tendon rupture
How is biceps tendon rupture investigated?
X-ray, MRI to distinguish partial tear from complete.
What is the management for a biceps tendon rupture?
Analgesia, physio for the elderly, surgery for young patients.
