Shoulder instability Flashcards
1
Q
What features contribute to shoulder stability (anatomy)
A
- Labrum: deepens socket - Articular -Cartilage thinner thicker peripheral
capsule/ligaments - Musculature
- Synovial fluid - cohesion
- Negative intra articular pressure
- Slight tilt of glenoid fossa - lost with rounded shoulders
- Narrow glenoid fossa = more instability
2
Q
how can translation influence instability
A
- Translation: movement of humerus on glenoid
- instability: symptoms associated with unwanted translation
3
Q
circle of stability
A
- Since the capsule is round is stretches on both sides of the head
4
Q
Degree of instability
A
- had the jt dislocated or subluxed before
5
Q
-Nature of the shoulder instability
A
- Did we have an acquired laxity: dislocation or sublux
- Congenital: poor collagen, disease that affects
- Repetitive motions
6
Q
Classifications of shoulder instability
A
- TUBS: traumatic Unilateral/Unidirectional Bankart Lesion Surgery
- AMBRI: Atraumatic Multidirectional Bilateral Rehab Inferior capsular shift
Responds well to rehab
7
Q
GH translation grades
A
- humeral translation:
- Grade 0: none/no translation
- Grade 1: mild/humeral head moves slightly up face of glenoid
- Grade 2: moderate/humeral head rides up glenoid face to but not over the rim
- Grade 3: severe/humeral head rides up and over the glenoid rim
Usually reduces when stress removed
May remain dislocated when stress removed (rare)
8
Q
Translation for the GH joint norms
- posterior
- inferior
- anterior
A
- Posterior translation: normal = 3-20 mm; ½ width of head
- Inferior translation: 5-15 mm
- Anterior translation: 2-13 mm; normal ¼ width of head
9
Q
Mechanism of shoulder instability
A
- traumatic
- atraumatic
- overuse
10
Q
Traumatic mechanism of shoulder instability
A
- 90º of Abduction and ER with Habduction = most common dislocation
- Can dislocate posterior but must land on an outstretched hand in IR
11
Q
Atraumatic mechanism of shoulder instability
A
- 5% of dislocation
- AMBRI
12
Q
Associated conditions with shoulder instability
A
- Bankart lesion: anterior inferior tear in labrum
- Hills sachs lesion: impaction fracture from an anterior dislocation
- HAGL lesion: humeral avulsion glenoid ligament
- Axillary Nerve injury: damaged with dislocation at times
13
Q
Management trends with immobilization after dislocation
A
- Study that looked immobilization times: 1 week vs 4 weeks
- 10 years 50% in both groups recurrence
- 25 years: both groups had changes
14
Q
Age management trends with shoulder dislocations
A
- Should you do surgery for younger people to increase stability
- Under 30 they immobilize longer to protect from themselves (usually more than 3 weeks
- Over 30 they immobilize 1-2 weeks
15
Q
Position of immobilization in management trends for shoulder dislocation
A
- does not affect healing
