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Flashcards in Questions Deck (26)
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1
Q

Name 2 ways to decrease scapular notching with RTSA

A

inferior placement and inferior tilt of the glenoid component

2
Q

where does the COR move with RTSA and what does this do?

A

Medial and inferior which tensions the deltoid
- true medial would be medial to the GH joint -lateral placement would be between the GH joint and the COR of the humeral head; this helps to tension the rotator cuff more but doesn’t tension the deltoid as much

3
Q

with ER lag and teres minor dysfunction, what must the patient have to consider a latissmus dorsi transfer?

A

subscapularis function

4
Q

what nerves are at risk with LD transfer for massive irreparable cuff tears?

A

radial nerve runs along the anterior surface just 2.3 cm medial to the inferior aspect of the humeral insertion; the axillary and lower subscapular nerve are more proximal and medial and at risk with muscle belly mobilization

5
Q

what are the post operative limitations with TEA?

A

-lifetime weightbearing restriction of 5 lbs or less; no immediate triceps strengthening

6
Q

what is the most common complication of interscalene blocks?

A

-temporary paresthesias to the affected arm

7
Q

Glenohumeral arthrodesis is a good operation for someone with a ____ shoulder but intact ____ and ____

A
  • flail
  • elbow and wrist
  • **the goal of fusion is to have the shoulder in a position that the hand can still reach the mouth
8
Q

what is released with a rotator interval release? what must be seen superiorly to know that you are fully released?

A
  • SGHL and CHL

- CAL

9
Q

what are 2 situations where you wouldn’t want to use a unstrained compared to a semiconstrained total elbow?

A
  1. ligamentous instability

2. rheumatoid arthritis

10
Q

what is the most common complication of arthroscopic capsular release for adhesive capsulitis? how is this prevented?

A
  • recurrent stiffness

- immediate ROM and PT

11
Q

in patients with OA, what is a PE finding that is a clue that wear is more posterior than just central?

A

loss of external rotation

12
Q

list 4 predictors of humeral head ischemia in order from greatest to least for proximal humerus fractures

A
  1. calcar length less than 8 mm
  2. disrupted medial hinge
  3. humeral head angulation greater than 45 degrees
  4. head split fracture
13
Q

what happens to intra-capsular volume on MRI with adhesive capsulitis?

A

decreased

14
Q

what are the 3 components of the medial elbow ligamentous complex? what are the bundles of the anterior band and when are they tight? does the posterior band subdivide?

A
  • anterior, posterior, transverse
  • anterior bundle, posterior bundle, oblique
    (anterior bundle is isometric while the posterior bundle of the anterior band tightens during flexion)
  • no
15
Q

what nerve is most at risk during a laterjet and why is this? what nerve is at risk during graft fixation?

A
  • musculotaneous, as you put retractors around the conjoined tendon
  • axillary
16
Q

where do partial distal bicep tears occur?

A

radial

17
Q

what is the order of injuries with terrible triads as far as soft tissues: anterior capsule, MCL, LUCL?

A
  • LUCL, anterior capsule, MCL
18
Q

with a pec transfer for subscapularis insurrficiency, where is the transfer relative to the conjoint tendon and what nerve can this tether?

A
  • deep

- musculotaneous

19
Q

what is the position for shoulder fusion?

A
  • 20 abduction 30 FF 40 IR
20
Q

shoulder hemiarthroplasty indications

A
  • OA in young patient with preserved glenoid
  • AVN
  • PH fracture in young patient
21
Q

what is the rate of RCT’s with primary shoulder OA undergoing arthroplasty? what group of patients is this much higher?

A
  • < 10%

- RA

22
Q

with adhesive capsulitis, what is the MRI finding on the coronal sequences?

A
  • loss of the normal axillary recess
23
Q

what is the mclaughlin procedure? who might benefit from this?

A
  • transfer of the LT and subscapularis into the reverse hill sachs defect from someone that had a posterior shoulder dislocation
  • posterior shoulder dislocation (electric shock or seizure)
24
Q

what is the cutoff for glenoid retroversion that can be safely eccentrically reamed?

A

15 degrees

25
Q

what has more complications, RTSA for cuff tears and cuff arthropathy or converting an ATSA to RTSA?

A
  • ATSA to RTSA
26
Q

what is the distance from the upper border of the pectoralis major insertion to the top of the humeral head?

A
  • 56 mm