Abos - Shoulder And Humerus:shoulder:pathologic States: Lmpingement Syndromes: Key Points

Front 1

With subacromial impingement syndrome, what blood flow changes
are seen in the critical zone?

Back 1

Increased vascularity

Front 2

What patient population is classically at risk for internal impingement?

Back 2

Overhead athlete

Front 3

What is the characteristic change seen in internal rotation with internal
impingement?

Back 3

Decreased

Front 4

What are the other characteristic exam findings?

Back 4

Posterior shoulder pain with external rotation and abduction

Front 5

What are the two characteristic intraarticular findings of internal impingement?

Back 5

Posterior superior labrum frayed
Partial thickness articular—sided tear of infraspinatus

Front 6

What is the f1rst—line treatment of internal impingement?

Back 6

Nonoperative rehabilitation

Front 7

lf nonoperative treatment is unsuccessful, what are the next two steps?

Back 7

Arthroscopic repair of torn labrum or cuff
Release posterior capsule to increase internal rotation

Front 8

What nerve is at risk with a posterior capsular release?

Back 8

Infraspinatus motor branch

Front 9

If all else fails, what is the treatment of last resort? Goal?

Back 9

Humeral derotation osteotomy
Goal: decrease retroversion to approximately 30 degrees

Front 10

What patients are particularly at risk for infraspinatus atrophy in the absence of a cyst?

Back 10

Volleyball and baseball players

Front 11

What is the treatment of choice for this condition?

Back 11

Rehabilitation (nonoperative)