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Surgery III > surgery of the shoulder > Flashcards

surgery of the shoulder Flashcards

(76 cards)

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1
Q

define scapulohumeral joint luxation

A

loss or damage of supporting structures of joint cause separation of the humerus from scapula

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2
Q

what is the etiology of scapulohumeral luxation

A

trauma or congenital

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3
Q

what supports the scapulohumeral joint

A

joint capsule, glenohumeral ligaments, surrounding tendons

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4
Q

which scapulohermal luxations are most common and which are rare?

A

medial or lateral deviations most common, cranial and caudal luxations are rare

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5
Q

when do traumatic lateral humeral luxations occur

A

after lateral glenohumeral lig and infraspinatus tendon rupture

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6
Q

when do traumatic medial humeral luxations occur

A

tearing of medial glenohumeral ligament and subscapularis tendon

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7
Q

what concurrent injury is common with traumatic scapulohumeral luxations

A

thoracic traumas

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8
Q

what do congenital or development laxity of the capsule and ligaments cause?

A

medial displacement and MEDIAL luxation of humeral head

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9
Q

described the glenoid cavity in congenital scapulohumeral luxations

A

deformed or hypoplastic, glenoid dysplasia often bilateral

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10
Q

signalment of traumatic scapulohumeral luxations

A

any age or breed of dogs

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11
Q

signalment of congenital medial luxation of scapulomeral joint

A

small and mini breed dogs

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12
Q

hx of traumatic luxation pt

A

history or evidence of trauma

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13
Q

hx of congenital luxation pt

A

chronic forelimb lameness at young age w/o hx of trauma

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14
Q

how is a lateral scapulohumeral luxation PE performed

A

foot is rotated internally and greater tubercle palpable lateral

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15
Q

how is a medal scapulohumeral luxation PE performed

A

foot is rotated externally and greater tubercle palpated medial

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16
Q

if the glenoid cavity is deformed, what is impossible to perform on PE

A

reduction of humeral head may be impossible

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17
Q

how is scapulohumeral luxation diagnosed on radiograph

A

lateral and ventrodorsal rads of shoulder evaluated to confirm diagnosis

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18
Q

what are ddx of scapulohumeral luxations?

A

DJD, humeral osteoscarcoma, contracture of infraspinatus or supraspinatus tendons

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19
Q

how are scapulohumeral luxations medically managed

A

dogs with chronic medial luxation - exercise restriction and anti-inlammatories

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20
Q

what is attempted with traumatic luxations present soon after injury

A

closed reduction if no fractures with general anesthesia

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21
Q

if the lateral luxation is stable, which splint is applied

A

lateral spica splint applied 10-14 days

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22
Q

how is a medial luxation by trauma immobilized

A

velpeau sling

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23
Q

when is surgical treatment offered for scapulohumeral luxations?

A

if traumatic luxation is unstable after closed reduction, open reduction and stabilization, congenital luxations with severe lameness

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24
Q

what is this

A

capsulorrhaphy/prosthetic lig reconstruction with bone anchors for medial glenohumeral luxation

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25
when is the biceps tendon transposed for sx treatment of scapulohumeral luxation?
make an incision in joint capsule and move tendon medially, secure with bone screw and spiked washer
26
in cases with severe joint dysplasia or DJD, which is performed
salvage procedures are performed - arthrodesis or glenoid excision
27
how are lateral luxations supported post op?
spica spint 10-14 days
28
how are medial luxations supported post op?
velpeau sling 10-14 days
29
when do rehab exercises begin for scapulohumeral luxations?
after removal of the splints
30
when should uncontrolled activity be limited after scapulohumeral luxation repair
6-12 weeks
31
what are complications with scapulohumeral luxations
reluxation
32
what is prognosis after closed reduction if joint is stable
good for return of limb function
33
what is prognosis after closed reduction if joint is unstable
guarded, open reduction and joint stabilization considered
34
what is the prognosis after closed reduction with congenital or developmental medial luxation?
guarded
35
when it's not possible to maintain reduction, what should be performed
salvage procedure
36
what is shoulder instability?
pathologic increase of ROM of joint
37
what is shoulder instability due to
tearing or stretching of medial or lateral supportive structures of shoulder joint
38
what does injury from low grade chronic trauma or acute blunt trauma result in for shoulder instability
instability and subluxation of joint
39
damaged structures may include what during shoulder instability injuries
medial or lateral glenohumeral ligaments and subscapularis tendon, poss biceps tendon
40
signalment of dogs with shoulder instability
mostly active dogs, older animals after years of exercise, mod chronic lameness
41
PE findings of shoulder instability for gait analysis
mod WB lameness
42
PE findings of shoulder instability with ortho exam
palpation may show increased angles of abduction with medial shoulder instability
43
how can the limb be manipulated to evaluate medial shoulder instability
abduction
44
how is a definitive dx made for shoulder instability
arhtroscopy
45
what are arthroscopic findings of shoulder instability?
medial glenohumeral lig, lateral glenohumeral lig, or subscapularis tendon tearing or laxity; tearing of biceps tendon
46
dogs with concurrent bicipital tendinopathy may have what on rads?
osteophytosis and sclerosis of bicipital groove
47
ddx of shoulder instability
ocd, biceps disease, oa, trauma, neoplasia
48
medical management for shoulder instability
rest and PT in mild cases
49
what are rehab programs designed to do for shoulder instability
maintain ROM while strengthening muscles
50
how is surgical tx of shoulder instability performed
with arthroscopic or open surgery
51
what are arthroscopic assisted techniques for shoulder instability
arthroscopic assisted anchor and suture, tightrope stabilization, radiofrequency shrinkage (historic only)
52
what is open surgery for shoulder instability
placement of suture anchors at sites of origin and insertion of medial gelnohumeral lig
53
arthroscopic view of medial aspect of shoulder shows what structures
subscapularis tendon, medial glenohumeral ligament tearing
54
describe postop care of TR stabilization
hobbles for 6-12 weeks, dogleggs therapeutic and rehab productions
55
how long is activity restricted after TR stabilization
8 weeks minimum
56
when should the pt be reevaluated after TR stabilization
lameness eval and joint palpation q 4 weeks, full athletic function 16 weeks post op
57
describe post op care after open surgery for shoulder instability
velpeau sling 1-2 weeks
58
what are complications of velpeau sling
contracture of the carpus, reevaluate pt q2-4 weeks
59
prognosis of shoulder instability tx
variable depending on severity of soft tissue injuries
60
primary bicipital tendon disease
overuse or chronic repetitive
61
secondary bicipital tendon disease
response to other articular disease, loose fragment, acute trauma
62
signalment of pt with bicipital tendinopathy
middle to older aged med to large breed dogs
63
clinical signs of bicipital tendinopathy
chronic intermittent or progressive lameness
64
PE of bicipital tendinopathy
shoulder pain, direct palpation of biceps tendon of origin
65
what does a skyline view radiographs help visualize for bicipital tendinopathy
visualize irregularities and mineralization
66
what is mostly used to dx bicipital tendinopathy?
ultrasonography
67
medical tx for bicipital tendinopathy
oral NSAIDS ineffective, 1-2 intra-articular injections of long acting corticosteroid, rest is critial
68
what percent of patients respond to medical management of bicipital tendinopathy
50% repsond to medical management
69
what is a tenodesis
open approach, secure tendon to proximal humerus, good result
70
what is a tenotomy
arhtroscopy, cut tendon at origin
71
what is suprsaspinatus tendionpathy?
dystrophic calcification of tendon can be found in asymptomatic dogs
72
etiology of supraspinatus tendionapthy
unknown, uncommon
73
rads of supraspinatus tendionpathy
mineralization bilaterally
74
supraspinatus tendinopathy may cause impingement of biceps tendon which requires
MRI, clinical signs related to both conditions
75
medical management of supraspinatus tendinopathy
rest and nsaids
76
surgical tx of supraspinatus tendionpathy
surgical excision of calcified tissue, excise diseased tissue if impingement on biceps tendon

Surgery III (14 decks)

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