Shoulder Injuries... And tight fingers

Question 1

Anterior shoulder dislocation Etiology and epidemiology

Answer 1

Any injury that
causes strain
on the
glenohumeral
ligaments.
Most common
type, more
than 95%

Question 2

Anterior shoulder dislocation cxfx

Answer 2

Arm held to the side
with externally rotated
forearm with severe pain

Question 3

Anterior shoulder dislocation best initial test

Answer 3

xray

Question 4

Anterior shoulder dislocation most

accurate test

Answer 4

MRI.
Must rule out
axillary artery
or nerve injury

Question 5

Anterior shoulder dislocation tx

Answer 5

Shoulder
relocation and
immobilization

Question 6

Posterior shoulder dislocation Etiology

Answer 6

Seizure or

electrical burn

Question 7

Posterior shoulder dislocation cxfx

Answer 7

Arm is
medially
rotated
and held to
the side

Question 8

Posterior shoulder dislocation dx

Answer 8

X-ray is the best
initial test and
MRI is the most
accurate test.

Question 9

Posterior shoulder dislocation tx

Answer 9

Traction and surgery if pulses or sensation are diminished during physical exam

Question 10

Clavicular

fracture Etiology. Epidemiology and mechanism

Answer 10

Trauma

usually affect children and adolescents and typically occur from a direct fall onto the shoulder

e.g., from bicycle accident
birth trauma

Question 11

Clavicular

fracture cxfx

Answer 11

Pain over

location

Question 12

Clavicular

fracture dx

Answer 12

X-ray is the best
test. Must rule
out subclavian
artery/brachial
plexus injury.

Question 13

Clavicular

fracture tx

Answer 13

Simple arm
sling
Exception: excessively shortened or displaced fractures (require surgery)

Question 14

Scaphoid

fracture Etiology

Answer 14

Falling on an
outstretched
hand

Question 15

Scaphoid

fracture cxfx

Answer 15

Persistent
pain in the
anatomical
“snuffbox”

Question 16

Scaphoid

fracture dx

Answer 16

X-ray won’t
show results for
3 weeks.

Question 17

Scaphoid

fracture tx

Answer 17

Thumb spica cast

Question 18

figure 8 slings

Answer 18

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

Question 19

Trigger finger tx

Answer 19

a trial of steroids should be attempted prior to surgery.

If steroids fail, surgery to cut the sheath that is
restricting the tendon

Question 20

Trigger finger patho

Answer 20

is caused by a stenosis of the tendon sheath leading to the finger in question.

Question 21

Do not confuse trigger finger with

Answer 21

Dupuytren contracture, a

condition more common in men age >40.

Question 22

Dupuytren contracture, patho and cxfx

Answer 22

palmar fascia becomes constricted and the hand can no longer be properly extended open

Question 23

Dupuytren contracture, tx

Answer 23

Surgery is the only effective

therapy

Question 24

Scaphoid fracture suspected. What to do If initial x-ray is negative,

Answer 24

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

Question 25

Scaphoid fracture suspected.

If repeat x-ray is normal but continued clinical suspicion of scaphoid fracture:

Answer 25

MRI of the wrist