Shoulder Lecture 4-4-17

Question 1

What is the second most common UE fracture? Does incidence increase with age?

Answer 1

Shoulder fracture

Incidence increases with age

Question 2

What percent of shoulder fractures can be treated non-operatively?

Answer 2

85%

Question 3

Which fracture has a better prognosis: anatomical or surgical neck? Why?

Answer 3

Anatomic- poor (less blood flow)
Surgical- better (more blood flow)

Supplied by the ascending branch of the anterior circumflex artery

Question 4

Non-operative treatment

Answer 4

Sling and initial immobilization

Question 5

Operative treatment

Answer 5

Pins
tension bands
hemiarthroplasty
TSR (Humoral  head and glenoid) 
reverse TSR (makes the humoral head concave and the glenoid complex)

Question 6

PT management for non-operative

Answer 6

Early motion is relative to the patient
Patient specific, determined by MD

7-10 days is a reasonable range to expect to initiate movement

Question 7

PT management of surgical intervention

Answer 7

Consider: age, bone quality, fracture pattern

Wide range of when motion is initiated- determined by the MD

Question 8

Are isometrics typically allowed during immobilization for non-operative shoulder patients?

Answer 8

Typically- yes

Question 9

Where should the hand be in the sling?

Answer 9

Should be somewhat elevated- don’t let the patient’s hand just hang out of it