Shoulder Fractures and Dislocations Flashcards

1
Q

Proximal humeral fractures most commonly occur in which scenarios?

A
  1. Fall onto outstretched hand
  2. Fall directly onto shoulder
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2
Q

What is the most common pattern of humeral neck fracture?

A

Surgical neck

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3
Q

What is the main reason the humeral shaft is displaced in proximal humeral fractures?

A

Pull of the pectoralis major

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4
Q

Persistantly displaced humeral neck fractures are usually treated in which way?

A

Internal fixation

(plate, screws, wires or intra-medullary nail)

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5
Q

What are some potentially negative outcomes of internal fixation of proximal humeral shaft fractures in the older patient?

A
  1. Stiffness
  2. Chronic pain
  3. Failure of fixation
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6
Q

When would a shoulder replacement be considered in a proximal humeral fracture?

A

If there is a 3 or 4 part comminuted humal fracture

(the humeral head may undergo AVN otherwise)

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7
Q

Head splitting fractures of the humerus usually require what type of treatment?

A

Shoulder replacement

(unless the patient is young with very good bone quality)

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8
Q

Anterior shoulder dislocation is much _____ __________ than posterior shoulder dislocation

A

Anterior shoulder dislocation is much more common than posterior shoulder dislocation

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9
Q

Why may anterior shoulder dislocations occur?

A
  1. Excessive external rotational force
  2. Fall onto back of shoulder
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10
Q

Anterior shoulder dislocations usually result in detachment of the anterior glenoid labrum and capsule.

What is this called?

A

Bankart lesion

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11
Q

What happens when the posterior humeral head impacts the naterior glenoid?

A

Hill-Sachs lesion

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12
Q

What is a Hill-Sachs lesion?

A

Impactation fracture of posterior humeral head

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13
Q

Which nerve is particularly at risk during an anterior shoulder dislocation?

A

Axillary nerve

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14
Q

What is the principle sign of axillary nerve damage?

A

Loss of sensation in the regimental badge area

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15
Q

Shoulder dislocation occurs commonly alongside which two types of fracture?

A
  1. Fracture of surgical neck of humerus
  2. Fracture of greater tuberosity of humerus
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16
Q

What is the mainstay of treatment for shoulder dislocations?

A
  1. Closed reductuion under anaesthetic
  2. Sling for 2-3 weeks
17
Q

What causes a posterior shoulder dislocation?

A

Posterior force on adducted and internally rotated arm

18
Q

What is the main X-ray finding for a posterior shoulder dislocation?

A

Light bulb sign

19
Q

What happens in an AC joint subluxation?

A

The AC ligaments are ruptured

20
Q

What happens in AC joint dislocation?

A
  1. Coracoclavicular ligaments (conoid and trapezoid) are ruptured
  2. AC ligaments are ruptured
21
Q

How can AC joint injuries be treated?

A
  1. Sling for a few weeks
  2. Physio
  3. Surgery for chronic pain (coracoclavicular ligaments are reconstructed)

(surgery may be attempted sooner for young athletes)