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Flashcards in Shoulder McGee Deck (65)
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1

AMBRI

Atraumatic Multidirectional Bilateral Rehabilitation (as appropriate) and rarely Inferior capsular shift surgery - Not typically recommended for surgery & May be a primary instability factor for Secondary Impingement

2

TUBS

Traumatic Unilateral anterior with a Bankart lesion responding to Surgery

3

Empty can vs full can which is better for testing supraspinatus?

Full Can position tests supraspinatus strength better than Empty Can - Empty can position: strength tends to be limited by pain

4

Rotator Cuff avascular zone

Glenohumeral 0°: poor vascularity to RC tendons & 30-45° Abduction: vascularity to RC tendons optimized

5

Primary Anterior Stabilizers of Glenohumeral Joint

GH 0°: Subscapularis, GH 45°: Subscapularis & Middle Glenohumeral Ligament, GH >90°: Inferior Glenohumeral Ligament & Biceps Brachii

6

Primary mechanism of anterior Glenohumeral dislocation

Trauma; indirect blow with shoulder in abduction, extension, & ER

7

Primary mechanism of posterior Glenohumeral dislocation

Axial loading of arm with shoulder in adduction, flexion, & IR, trauma to front of the shoulder, FOOSH

8

Traumatic dislocations can be associated with what nerve injuries

Axillary

9

Humeral shaft fractures can be associated with what nerve injuries

radial

10

What RTC repair has a slower progression due to weaker fixation of repair

Arthroscopic

11

What RTC repair has a vertical split between anterior and middle deltoid, but allows early initiation of deltoid AROM

Mini-Open

12

What RTC repair has a Deltoid detachment/release from clavicle or acromion, and has no deltoid AROM for 6-8 weeks

Open

13

RTC describe small, medium, and large tears:

5cm (large)

14

Describe basic guidelines for miniopen repair for RTC for sling, ROM, and istonic exercise for a small tear

Sling 7-10 days; Full ROM 4-6 weeks, 2-3 wks for isotonic ex

15

Describe basic guidelines for miniopen repair for RTC for sling, ROM, and istonic exercise for a medium tear

Sling 2-3 weeks; Full ROM 8-10 weeks, 3-4 weeks for isotonic ex

16

Describe basic guidelines for miniopen repair for RTC for sling, ROM, and istonic exercise for a larger tear

Sling 2-3 weeks; Full ROM 10-14 weeks, 3-4 weeks for isotonic ex

17

Which has a lower reoccurrance rate for instability surgery open or arthoscopic?

Open: standard procedure (recurrence rate <5%) vs Arthroscopic: slower rehab (recurrence rate 8-17%)

18

What type of surgery is used for instability?

Bankart and capsular shift (which spends more time in a immobilizer)

19

What directions can shoulder instability exist?

Ant, post, and multidirectional

20

Describe a Type I SLAP injury:

Degenerative fraying of superior labrum, Biceps attachment intact, Biceps anchor intact

21

Describe a Type I SLAP surgery

Superior labrum is debrided

22

Describe a Type I SLAP rehab

Pendulum after 1 week NO ER > neutral/extension of arm behind body x 4 weeks No stressful biceps activity x 3 months

23

Describe a Type II SLAP injury:

Biceps anchor pulled away from glenoid

24

Describe a Type II SLAP surgery

Lesion repaired with tacks, staples, or suture anchors

25

Describe a Type II SLAP rehab

More conservative than type I - Sling x 3 weeks

26

Describe a Type III SLAP injury:

Bucket-handle tear of superior labrum, Biceps anchor intact

27

Describe a Type III SLAP surgery

Torn fragment is resected

28

Describe a Type III SLAP rehab

Same as Type 1

29

Describe a Type IV SLAP injury:

Similar to Type 3- Tear extends to biceps tendon & Torn biceps tendon and labrum displaced into joint

30

Describe a Type IV SLAP surgery

30% tendon torn Older patient: labrum debrided, tendon tenodesis Young patient: arthroscopic suture repair