Shoulder MDT Flashcards
Type I AC Injury
AC ligaments partially disrupted and coracoclavicular ligaments are intact.
No separation of clavicle from acromion
Type II AC Injury
AC ligaments are torn and CC ligaments are intact resulting in partial separation of clavicle from acromion
Type III AC Injury
AC and CC ligaments completely disrupted resulting in complete separation of the clavicle from acromion
Type IV AC Injury
AC and CC ligaments are completely disrupted with superior and prominently posterior displacement
Type V AC Injury
AC and CC ligaments are completely disrupted with CC interspace more tan twice as large as opposite shoulder
Type VI AC Injury
Uncommon.
Clavicular periosteum and/or deltoid and trapezius muscle are torn resulting in wide displacement. Clavicle lies in either then subacromial space or subcoracoid space
Which types of AC separation present with obvious deformity
Type III-VI
Patient presents with:
Pain over AC joint
Pain on lifting affecting arm
AC separation
Rads for AC Injury
AP and axillary rads
Which type of AC injury can be seen on radiographs?
Type III
AC joint widening can be seen
Treatment of Type I AC and II AC injury
Sling x 24-48 hours
Ice, Analgesics, HEP
RTD within 4 weeks
Treatment of type III AC injury
Ortho consult
Ice, Analgesics, HEP
Light duty until evaluated by ortho
Treatment of Type IV-VI Injury
Ortho consult, WILL REQUIRE SURGERY
Ice, Analgesics, HEP
Light duty until evaluated by ortho
Causes of clavicle frature
- Falling on shoulder
- most common bony injury
How are clavicle fractures classified
Proximal
Middle
Distal
What is the most common anatomic location for clavicle fracture
Most common location is middle third
Pt presents with:
- Pain over clavicle
- Pain with arm motion
- Snapping or cracking with reported event
- Swelling
Clavicle Fracture
Special test for clavicle fracture
Cross body
Rads for clavicle fracture
AP and 10 degree cephalic tilt radiographs
Treatment of clavicle fracture
Ice, Analgesics, sling or figure 8 strap
Ortho consult
Red flags of fracture clavicle
- MEDEVAC
- Painful nonunion after 4 months of treatment
- Widely displaced lateral or mid-shaft fractures or segmental fractures
What are the common structures impinged in the subacromial space?
Subacromial bursa
Tendon of supraspinatus
Tendon of infraspinatus
Long head of biceps tendon
Types of acromion morphology?
Which has greater association with Shoulder impingement?
- Flat
- Curved
- Hooked, greatest association with shoulder impingement
Pt presents with:
- Gradual onset of anterior and lateral shoulder pain exacerbated by overhead activity
- Night pain and difficulty sleeping on affected side
- Pain worse between 90 and 120 degrees of abduction when lowering arm
Shoulder impingement syndrome
Special tests for shoulder impingement
Neers and Hawkins