Shoulder injuries Flashcards
Shoulder Injuries
Anatomy -Roatator cuff
Anatomy of the bones
Anatomy of the bones
Anatomy of Bones
Translateral view
Basic Examination and inspection
Basic Examination: Palpation
Basic Examination: Movement
Examination: Special tests
Practical assessment
Investigations
X rays
X-rays
The ‘Y’ view
Pathology
Supraspinatus tendonitis
Rotator cuff tear
Impingement syndrome
Frozen Shoulder
Clinical features are; reduction in movement, severe pain, more common in the non-dominant shoulder. There is classically 3 stages;
- Freezing Stage – Gradual onset of pain becoming severe associated with increasing stiffness.
- Frozen Stage – Pain subsides, leaving stiffness and severe decrease in function.
- Thawing Stage – Return to normal function gradually
Treatment is usually analgesics, physiotherapy and reassurance. Occasionally steroid injections, manipulations (only in the frozen stage) and rarely surgical release may be required.
Shoulder fractures
- Upper humerus
- Clavicle
- Shaft of humerus
- Dislocation
- AC joint subluxation
- Sternoclavicular joint subluxation
- Fracture scapula
- Rupture biceps
Fracture upper humerus
Fracture Clavicle
Fracture Shaft of Humerus
- Fall onto arm
- Painful swelling over biceps/bruising
- Check for neurovascular deficit-radial nerve
- Rx U- slab/collar and cuff
- Occasionally surgery
Shoulder dislocation
Anterior dislocation
- Most common type
- Forced external rotation or fall
- “squared off” appearance of shoulder
- Palpable gap below the acromion
- Humeral head palpable antero-inferiiorly to glenoid
- Must examine distal pulses and axillary nerve
Posterior dislocation
Inferior dislocation
- Uncommon also known as Luxatio erecta
- Arm held abducted, over head
- Around 1% of shoulder dislocations
- Usually associated injury to capsule
- Rx in-line traction with abduction then adduction often requires GA
AC joint subluxation
Sterno-clavicular subluxation
- Usually from fall onto anterior shoulder
- Clinical diagnosis poorly seen on x-ray
- Swelling tenderness over sterno-clavicular joint
- Usually bruising ++
- Rx sling/analgesia
Scapula fracture
Ruptured biceps
