Shoulder surgeries Flashcards
Clavicle fracture
common shoulder injury-especially pediatrics
MOI: fall on lat shoulder-contact sports
Presents with pain, swelling, and tenderness around clavicle. 80% middle 1/2 fractures/15% lateral
xray- AP ER view
Most managed conservatively
Clavicle ORIF: indications for surgery
open fracture
tenting of skin (bone press against skin)
significant displacement of fracture
overlap or shortening of fragment by 2 cm of more
AC jt dislocation
AC joint most common among males under 30
3-12% all shoulder injuries
MOI: fall w/ arm adducted
Rockwood system: AC jt dislocation scale
type I-II: tx conservatively
type III: conservative mgmt vs surgery
type IV-VI: injuries usually require surgery
Biceps tenotomy
LHB is released from superior glenoid tubercle.
can cause occasional weakness and discomfort
classical popeye sign
mainly for sedentary
tenodesis:
Biceps tenodesis
LHB is detached from the superior glenoid tub and attached to the humerus below shoulder
those with active lifestyle
Anterior reconstruction (Bankart, Capsulorrhapy)
banart lesion w/o avulsion of glenoid rim
-3 to 6:00
caused by ant dislocation and/or trauma
ant stability
multiple surgical procedures: caps shift, stable capsulorrhaphy, thermal capsulorrhaphy, putti-platt procedure
goal is to tighten/shorten ant capsule to reduce instability
Posterior repair (reverse bankart, capsuorrhaphy)
reverse bankart with or without avulsion fracture
6 to 9 o clock
caused by post dislocation/trauma
goal is to tighten/shorten post capsule to reduce instability
RTC repair
tears typically begin in the critical zone of the tendon, 1 cm from insertion
tears are common to the under surface (artic surface), which are hard to detect
many patients will have hx of chronic shoulder complaints
acute, traumatic tears account for only 8% of tears
