Ortho: Shoulder Flashcards
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AC Joint Injury Treatment
Grade I, II: Sling, Ice, NSAIDS,1-2 Weeks = ROM, No Pain = Strengthen
Grade III: Sling 3-6 weeks, Surgery
Grade IV-VI: Surgery
AC Joint Injury
Force to acromion, “shoulder separation”
Grade I: Incomplete tear of ligaments
Grade II: Partial tear of AC ligaments, possibly CC ligaments
Grade III: Complete tear of AC and CC ligaments
Grade IV: Clavicle dislocated posteriorly
Grade V: Major subluxation, skin at risk
Grade VI: Clavicle dislocated inferiorly
Primary Impingement
Repetitive rotator cuff microtrauma
Tendinitis and bursitis to impingement
Secondary Impingement
Theory 1: -Rotator cuff weakness -Scapular stabilizer weakness -Rotator cuff fatigue -Increased superior head migration -Impingement -Superior head migration leads to bone spur Theory 2: -Instability -Intrinsic tension overload/superior head migration -Impingement
Impingement Stage I
Edema and Hemorrhage Under 25 Overuse Reversible Conservative
Impingement Stage II
Fibrosis and Tendonitis
Age 25-40
Pain with activity
Bursectomy, CA ligament resection, Subacromial decompression
Impingement Stage III
Bone Spurs and Tendon Rupture Over 40 Progressive disability Partial/complete tears Sumacromial decompression, Rotator cuff repair
Impingement Treatment
Rest NSAIDs Steroid injections PT Surgery
Rotator Cuff Tear
Bursal surface, Undersurface, Full thickness <1 cm = Small 1-3 cm = Moderate 3-5 cm = Large >5 cm = Massive
Rotator Cuff Tear Treatment
Surgery: Open, mini-open, arthroscopic, reconstruction, arthroplasty
TUBS
Traumatic
Unidirectional
Bankart
Surgery
AMBRII
Atraumatic Multidirectional Bilateral Rehab Inferior capsular shift Interval closure
Labral Tear
Open, arthroscopic
12wks to heal
Buford Complex
Normal variant
Thickened MGHL
Absent superior anterior labrum
Hill-Sachs Lesion
Defect on posterior humeral head
Reverse Hill-Sachs Lesion
Defect on anterior humeral head
SLAP
Superior Labrum Anterior Posterior
Type I: Degenerative tearing. DEBRIDE
Type II: Detatch from glenoid. REPAIR
Type III: Bucket handle tear. REPAIR
Type IV: Tear into biceps tendon. REPAIR
