shoulder and elbow problems Flashcards
directions of shoulder dislocations
anterior 90%
posterior 9%
inferior 1%
treatment of shoulder dislocation
manipulation - under sedation, reduction
immobilisation - usually on rotation
physiotherapy
surgery - younger people may benefit from primary surgery
subacromial impingement presentation
painful arc when abducting arm
how does subacromial impingement occur
shoulder joint produces osteophytes and when arm is abducted the greater tuberosity impinges on the osteophytes between the acromioclavicular joint and rotator cuffs
bursae and tissues become inflamed so there is less room in subacromial space and the acromioclavicular ligament becomes inflamed too
management of subacromial impingement
subacromial steroid injection
physiotherapy
arthroscopic subacromial decompression - when first 2 dont work
frozen shoulder
adhesive capsulitis
shoulder pain, which improves but then shoulder becomes progressively stiff. all movements of shoulder are restricted
then thawing of stiffness and movement returns (but not always back to normal)
primary vs secondary adhesive capsulitis
primary - idiopathy
secondary - post traumatic
treatment frozen shoulder/adhesive capsulitis
physiotherapy
steroid injections
if no improvement can have surgery
traumatic vs degenerative rotator cuff tear
traumatic - younger people
degenerative - older people
rotator cuff tear confirmatory tests
USS
MRI
treatment of rotator cuff tears
acute - early surgery
chronic - surgery if symptomatic, depends on patient (size, time, age)
superior capsular reconstruction
option for massive, irreparable rotator cuff tears
medial epicondilitis
golfers elbow
lateral epicondilitis
tennis elbow
features and treatment of medial/lateral epicondylitis
middle age
repetitive tasks
tendon may be torn at insertion of bone, inflamed
Rx rest, analgesics, physio, maybe surgery
