Data Trace Editor – Discussion: – see discussion shoulder arthroplasty and technical considerations with fracture – operative considerations: hemiarthroplasty vs total shoulder arthroplasty – considered in young pt w/ OA, posttraumatic dz (w/ no have glenoid involvement nor erosion), AVN, or massive RTC tear; – approximate survival rate at 10 years is about 80%; … Read more
Positioning: – beach chair position is comfortable for both the patient and the surgeon and allows the option of converting to an open procedure (if necessary); – patients need to be seated with the torso raised to 70 deg with a foled sheet placed on the medial border of the affected scapula … Read more
– See: – Diff Dx of Shoulder Pain: – Shoulder Examination Tests (from shoulderdoc.co.uk) – History: (questions for modified Simple Shoulder Test); – C-Spine: – r/o radiculopathy as well as axillary nerve hypaesthesia; – Spurling’s manuever: – mechanical stress, such as excessive vertebral motion, may exacerbate … Read more
(see also: Physical Exam; Radiographic Studies for the Shoulder) Abductors of the Shoulder Acromioclavicular Joint / Acromioclavicular Joint Separation Acromioplasty Adhesive Capsulitis Anterior Inferior Glenohumeral Ligament Anterior Instability Anterior Shoulder Reconstruction Arteries of the Upper Limb Arthroscopy of the Shoulder Arthodesis of the Shoulder Arthroplasty of the Shoulder Bankart Lesion Blood Supply to the Humerus Biceps Tendonopathy … Read more
– See: – Obstetrical Paralysis – Erb’s Palsy – Discussion: – following Erb’s palsy, shoulder may end up with medial rotation-adduction contracture w/ or w/o shoulder subluxation; – due to overpull of the subscapularis, pectoralis major and minor, latissimus, and teres major … Read more
– Classic Neer Impingment Sign: (see impingement syndrome) – is tested by having the patient place his hand on the unaffected shoulder and gradually forward flexing the shoulder; – impingement sign is elicited w/ pt seated and the examiner standing; – scapular rotation is prevented w/ one hand while … Read more
– Discussion: – impingement syndrome describes pain in subacromial space when the humerus is elevated or internally rotated; – during humeral flexion, the supraspinatus tendon and bursa become entrapped between the anteroinferior corner of the acromion (and CA ligament) and the greater tuberosity; – this syndrome is thought to precipitate attritional changes in the rotator … Read more
– History: (questions for modified Simple Shoulder Test); – Can patient… – comfortably place are at side? – sleep on side? – eat with utensil – dress … Read more
– Associated Injuries: – Bankart lesion – up to 90% of first time dislocators will have this lesion; – fracture dislocation: – fracture of humeral head, neck, or greater tuberosity; – associated greater tuberosity frx may actually have less … Read more
– Rotator Interval Capsule: – rotator interval is a triangular portion of shoulder capsule which lies between the supraspinatus and subscapularis tendons; – capsular anatomy: (Static Stabilizers / Capsule of the Shoulder) – interval capsule is reinforced by the superior glenohumeral and coracohumeral ligaments; – references: – Capsular ligaments … Read more