Shoulder Conditions

Question 1

What are the types of shoulder dislocation?

Answer 1

Anterior
Posterior
Inferior

Question 2

What is the most common type of shoulder dislocation?

Answer 2

Anterior

Question 3

What are the subtypes of anterior dislocations?

Answer 3

Subcoracoid

Subglenoid

Question 4

What is a subcoracoid dislocation?

Answer 4

Head of humerus lies anterior to glenoid fossa, inferior to coracoid

Question 5

What is a subglenoid dislocation?

Answer 5

Head of humerus lies antero-inferior to glenoid

Question 6

How does an anterior dislocation occur?

Answer 6

Humeral head dislocates antero-inferiorly
Disruption of gleno-humeral ligaments

Head pulled anteriorly by muscles

• subscapularis
• pec major

Question 7

What is the mechanism of an anterior dislocation?

Answer 7

‘Hand behind head’

• abduction
• external rotation

Direct blow to posterior shoulder

Question 8

What is the clinical presentation of an anterior dislocation?

Answer 8

Arm = slightly abducted
Flattened shoulder
Acromion prominent

Question 9

What is a Bankart lesion?

Answer 9

Tear of glenoid labrum +/- glenoid fracture

Question 10

What is a Hill-Sachs lesion?

Answer 10

Indention fracture of posterior humeral head against anterior lip of glenoid fossa

Question 11

What is the mechanism of a posterior dislocation?

Answer 11

Violent muscle contraction
Blow to anterior shoulder
Arms flexed across body and pushed posteriorly

Question 12

What is the clinical presentation of a posterior dislocation?

Answer 12

Squaring of shoulder
Arm = adducted + internally rotated
Prominent coracoid process anteriorly

Question 13

What is the mechanism of an inferior dislocaton?

Answer 13

Hyperadduction injury

Question 14

What are complications of shoulder disslocation?

Answer 14

Recurrent dislocation 
Axillary artery damage
Nerve injuries 
Fractures 
Rotator cuff tears

Question 15

Which part of the clavicle is most likely to fracture?

Answer 15

Middle 1/3

Question 16

What is the common mechanism for a clavicle fracture?

Answer 16

FOOSH

Question 17

What happens to the medial segment of the clavicle?

Answer 17

Elevated by SCM

Question 18

What happens to the lateral segment of the clavicle ?

Answer 18

Depressed as trapezius unable to hold it up

Question 19

What happens to the arm in a clavicle fracture?

Answer 19

Pulled medially by pec major

Question 20

How is a clavicle fracture managed?

Answer 20

Most managed conservatively

Question 21

What are indications for surgical fixation of a clavicle fracture?

Answer 21

Complete displacement
Severe displacement - with skin tenting 
Open fracture 
Neurovascular compromise 
Floating shoulder

Question 22

What is a floating shoulder?

Answer 22

Clavicle fracture + glenoid neck fracture

Question 23

What are complications of a clavicle fracture?

Answer 23

Non-union
Malunion
Infection

Nerve damage

• suprascapular
• supraclavicular

Damage to apex of lung = pneumothorax

Question 24

What is a rotator cuff tear?

Answer 24

Tear of one or more rotator cuff tendon

Question 25

What is the most common site of rotator cuff tear?

Answer 25

Supraspinatus under coracoacromial arch

Question 26

What are risk factors for a rotator cuff tear?

Answer 26

``` Increasing age Recurrent overhead activity Recurrent heavy lifting OA of shoulder Abnormally shaped acromion ```

Question 27

What is the clinical presentation of a supraspinatus tear?

Answer 27

Anterolateral shoulder pain Brought on by activity Weakness of shoulder abduction

Question 28

What is impingement syndrome?

Answer 28

Rotator cuff tendons rub on coracoacromial arch

Question 29

What causes impingement syndorme?

Answer 29

Narrowing of subacromial space - thickening of coracoacromial ligament - inflammation of supraspinatus ligament - subacromial osteophytes

Question 30

What are the symptoms of impingement syndrome?

Answer 30

Pain Weakness Reduced range of movement

Question 31

What is the painful arc?

Answer 31

60-120 degrees

Question 32

What is calcific supraspinatus tendonitis?

Answer 32

Hydroxyapatite crystals in supraspinatus tendon

Question 33

What is adhesive capsulitis also known as?

Answer 33

Frozen shoulder

Question 34

What is adhesive capsulitis?

Answer 34

Glenohumeral joint is inflammed and stiff

Question 35

What are risk factors for adhesive capsulitis?

Answer 35

``` Female Shoulder trauma Epilepsy with tonic seizures Diabetes mellitus Connective tissue disease ```

Question 36

How is adhesive capsulitis managed?

Answer 36

Physio Analgesia Anti-inflammatory treatment