Shoulder Injuries... And tight fingers Flashcards
Anterior shoulder dislocation Etiology and epidemiology
Any injury that causes strain on the glenohumeral ligaments. Most common type, more than 95%
Anterior shoulder dislocation cxfx
Arm held to the side
with externally rotated
forearm with severe pain
Anterior shoulder dislocation best initial test
xray
Anterior shoulder dislocation most
accurate test
MRI.
Must rule out
axillary artery
or nerve injury
Anterior shoulder dislocation tx
Shoulder
relocation and
immobilization
Posterior shoulder dislocation Etiology
Seizure or
electrical burn
Posterior shoulder dislocation cxfx
Arm is medially rotated and held to the side
Posterior shoulder dislocation dx
X-ray is the best
initial test and
MRI is the most
accurate test.
Posterior shoulder dislocation tx
Traction and surgery if pulses or sensation are diminished during physical exam
Clavicular
fracture Etiology. Epidemiology and mechanism
Trauma
usually affect children and adolescents and typically occur from a direct fall onto the shoulder
e.g., from bicycle accident
birth trauma
Clavicular
fracture cxfx
Pain over
location
Clavicular
fracture dx
X-ray is the best test. Must rule out subclavian artery/brachial plexus injury.
Clavicular
fracture tx
Simple arm
sling
Exception: excessively shortened or displaced fractures (require surgery)
Scaphoid
fracture Etiology
Falling on an
outstretched
hand
Scaphoid
fracture cxfx
Persistent
pain in the
anatomical
“snuffbox”
Scaphoid
fracture dx
X-ray won’t
show results for
3 weeks.
Scaphoid
fracture tx
Thumb spica cast
figure 8 slings
For clavicular fractures, figure 8 slings are no longer used, as their outcomes have not been shown to be any better than a simple arm sling
Trigger finger tx
a trial of steroids should be attempted prior to surgery.
If steroids fail, surgery to cut the sheath that is
restricting the tendon
Trigger finger patho
is caused by a stenosis of the tendon sheath leading to the finger in question.
Do not confuse trigger finger with
Dupuytren contracture, a
condition more common in men age >40.
Dupuytren contracture, patho and cxfx
palmar fascia becomes constricted and the hand can no longer be properly extended open
Dupuytren contracture, tx
Surgery is the only effective
therapy
Scaphoid fracture suspected. What to do If initial x-ray is negative,
one of the following:
If the patient is not willing to immobilize the wrist: MRI of the wrist [6]
If the patient is willing to immobilize the wrist: cast the wrist and repeat an x-ray in 10–14 days
