Shoulder surgery Flashcards
Stabilisers of glenohumeral joint
Dynamic:
- Ligaments: Glenohumeral,
Coracoclavicular etc
- Rotator cuffs
Stationary
- Labrum
- Capsule
Function of rotator cuff muscle
Dynamic stabiliser of shoulder at GHJ.
Acts as fulcrum for power muscles (deltoid, pec major, Lat. doors, trees major)
Muscles: infrapinatous, supraspinatus, pec minor, subscapularis
Power muscles of the shoulder
Deltoid
Pectoralis major
Latissimus Dorsi
Subacromial impingement
- Description
- Causes
- Treatment
Syndrome that describes pain on abduction and rotation of the shoulder.
- Due to rubbing of bursa on subacromial space
Causes:
- Bone spurs/ Osteophytes
- Tendinopathy/ Rotator cuff weakness= loss of fulcrum
Treatment:
- Physiotherapy
- Modification of activity
- Subacromial decompression
Subacromial decompression
Debridement of bony/ soft tissue impinging space
- Creates more space in subacriomial space= more free movement of tendons.
Rotator cuff tear
Most commonly supraspinatus
Degeneration of tendon is normal
Treatment: Arthroscopic rotator cuff repair if symptomatic
Calcific tendonitis
- Pathology
- Symptoms
- Epidemiology
Deposits of crystalline calcium phosphate in tendons.
Causes very severe pain and inflammation
- Can cause frozen shoulder
Mainly affects females 30-60.
- Mainly supraspinatus and infraspinatus affected
Arthritis of the shoulder
Most common= osteoarthritis
Rheumatoid
Post-traumatic (due to rotator cuff tear)
Symptoms
- Stiffness
- Creptius
- Pain
Anatomic shoulder replacement
Done when the rotator cuff muscles are intact.
- Can still act as fulcrum
Humeral head is replaced
Reversed shoulder replacement
Done when cuff muscles are damaged
- Loss of fulcrum
Head of humerus is swapped with glenoid socket.
- New fulcrum
Adhesive capsulitis
- Pathology
- Signs
- Risk factors
- Treatments
Frozen shoulder
Pathology
- Inflamed joint capsule, lints movement at shoulder
Signs
- Loss of passive external rotation
- Stiffness
Risk factors
- Age 40-60
- Female
- Diabetes
Treatment
- Leave it
- Injections
- Hydrodilation
- Capsular release/ manipulation
Main shoulder dislocation
Anterior
- Tears anterior glenoid labrum = Bankart lesion
Risk factors
- Collison sports
- Hyperlaxity
Treatment
- Athroscopic stabilisation (repairs tear)
- Open stabilisation (tightens capsule)
- Augmentaion of glenoid
Acromioclavicular fracture
Commonly occurs after falling on shoulder point.
