Shoulder Problems Flashcards
Mr D Robinson
Age of presentation:
20-30s - 30-40s - 40-50s - 50-60s - >60 -
20-30s - instability 30-40s - impingement 40-50s - frozen shoulder 50-60s - rotator cuff tear >60 - arthritis
name the intrinsic muscle of the shoulder
rotator cuff supraspinatous infraspinatous teres minor subscapularis
name the extrinsic muscles of the shoulder
deltoid
trapezium
shoulder instability is seen in who?
teenage to 30s
young
sporty
what is shoulder instability normally due to?
trauma
what is anterior shoulder dislocation due to?
trauma/sport
what is posterior shoulder dislocation due to?
electrocution and epileptic fits
‘light bulb sign’ on XR
name the methods used to put a anterior dislocated shoulder back in place
kocher method
hippocratic method
Stimson method
name 2 syndrome that result in hyper-flexibility
EDS
marfans
name the associated injuries with shoulder instability
labral lesion - Bankart
fracture humeral head - Hill Sachs
fracture of glenoid - Bony Bankart
rotator cuff tear
what is the treatment in shoulder instability?
physiotherapy
the younger the patient the ______ the risk of recurrent dislocation
higher the risk
shoulder instability buzzwords
young and sporty
traumatic
Bankart lesions
surgical or physiotherapy
name the intrinsic and extrinsic causes of impingement in the shoulder
intrinsic -
tendon vascularity
watershed area
tendon degeneration
cuff dysfunction
extrinsic -
external ‘pressure’
name the types of impingenent in the different age groups:
<30s - 30-40s - 40-50s - 50-60s - >60s -
<30s - RC tendonitis/subacromial burisitis 30-40s - calcific tendonitis 40-50s - tendinitis/ partial RC tears 50-60s - cuff tear >60s - cuff arthropathy
what is the duration you must wait before you commence surgery on shoulder impingement?
6 months
what is the surgery performed in shoulder impingement?
arthroscopic/ open subacromial
shoulder impingement buzzwords
common resolves in most cases 30-40s painful arc physio and steroid injection surgery as last resort
what is the presentation in cuff tears?
50-60s gray hair = cuff tear wasting of muscle active < passive weak
frozen should is more common in females
true or false?
true
what conditions is frozen shoulder associated with?
diabetes
lipid and endocrine disease
Dupuytrens disease
is there adhesion in frozen shoulder?
no
what are the 3 phases of frozen shoulder?
freezing
frozen
thawing
what is the main symptoms in frozen shoulder?
pain and stiffness
are radiographs normal in frozen shoulder?
yes
what are the management options in frozen shoulder?
manipulation under IV
arthroscopic capsular release
what is the surgical intervention in shoulder arthritis?
total shoulder replacement
name the acronym for medical nerve innervation
LOAF
