– 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
– Discussion: – indicated for SI joint disruptions and for some sacral fractures; – Operative Technique: – radiographs: – surgical stratedgy: – if anterior pelvic injury: – note that the biggest … 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
– History: (questions for modified Simple Shoulder Test); – Can patient… – comfortably place are at side? – sleep on side? – eat with utensil – dress … 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
– 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: – w/ in joint capsule, variable ligs (superior, middle, & IGHL), are primary components of static restraint in glenohumeral joint. – glenoid version: – Biomechanical Evaluation of Glenoid Version and Dislocation Direction on the Influence of Anterior Shoulder Instability and Development of Hill-Sachs Lesions – Scapulohumeral Ligaments: (5 … Read more
– See: Total Shoulder Replacement – Technique: – deliver the proximal humerus: – anteriorly dislocate the humeral head by extending, abducting, and externally rotating the arm; – a blunt Homan retractor is then placed behind the humeral head to maintain its dislocated position; … Read more
– Discussion: – its essential to restore anatomic length of humerus to provide proper amount of tension in deltoid so that patient will maintain the ability to forward flex; – in the case of a hemiarthroplasty performed for 4 part frx, length will always have to be regained; … Read more
– Discussion: – serratus anterior arises from upper eight ribs, inserts on vertebral border of scapula, is innervated by long thoracic nerve, and functions to draw scapula forward in sports such as a jab in boxing; – paralysis produces characteristic prominence (“medial winging”) of vertebral border of the scapula; … Read more