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51 Cards in this Set
- Front
- Back
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most common cause of problems with stability in throwers
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late cocking early acceleration phases
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weight lifter shoulder problem
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osteolysis distal clavicle
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loss of external rotation
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sign of posterior instability
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Pectoralis rupture
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axillary webbing
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Hornblowers sign
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posterior cuff, typically massive irreparable tear
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Arthroscopy indications
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best positioning for labral work (beach vs lateral)
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posterior labral better in lateral decubitus
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AMBRI
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atraumatic multidirectional bilateral Rehabilitation; surgery inferior capsular shift
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Treatment acute anterior dislocation
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Splint in ER; Rehab vs Bankart repair... boards currently want conservative treatment before bankart repair
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Bony Bankart indication for surgery
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ORIF if > 20-25% glenoid involvement
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ALPSA
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anterior labral periosteal sleeve avulsion
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HAGL
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Humeral avulsion of glenohumeral ligament- may require open repair
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Inverted pear lesion
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Defect >25%; requires bone graft- tricortical ICBG or coracoid (Latterjet)
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Rotator interval closure
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don’t do for routine recurrent anterior instability- more for inferior instability
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Acute treatment of posterior dislocation
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once relocated, immobilize in ER
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Calcific tendonitis- treatment
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treat injections, observations, physical therapy; if non-op fails, arthroscopic evacuation of calcium deposits
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Suprascapular notch vs spinoglenoid notch- nerve compression
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suprascapular notch affects supra and infraspinatus, spinoglenoid notch (associated with SLAP) affects only infraspinatus
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Axillary nerve compression in overhead throwing athletes
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quadrilateral space compression- deltoid and teres minor
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Subscapularis rupture- findings
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increased ER, positive liftoff, displaced biceps tendon medially, Comma sign (avulsed SGHL seen with chronic subscap rupture)
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SLAP tears
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Glenohumeral internal rotation deficit
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in pitches, treatment is to work on internal rotation/physical therapy
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Biceps tendinosis: treatment
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if >10-50% do tenotomy or tenodesis. Tenotomy alone in older patients OK, otherwise tenodesis
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AC separation- indications and treatment
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non-op unless type V; would do anatomic reconstruction
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Adhesive capsulitis- indications
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common in diabetics, key is loss of ER; Treatment if therapy x 3-6 months, LOA/MUA only after 6 months non-op
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Winging due to Serratus
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Medial winging (LTN), observe initially- very long nerve takes time to recover
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Winging due to trapezius
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Lateral winging (CN XI), Tx is nerve exploration, trap strengthening; surgery would be transfer med scapular muscles and transfer laterally
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Little leaguers shoulder
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SH injury to prox hum physis; treatment is non-op- rest x 12 weeks.
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Clavical fractures- operative indications
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open fracture, displacement w/ 2 cm or more, floating shoulder, Type II distal Fracture (CC ligament injury equivalent)
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Pearl for glenoid evaluation in TSA
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posterior glenoid wear
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Indications for Reverse
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irreparable cuff tear, superior escape, adequate deltoid, older patient
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Landmarks for placement of humeral component in TSA
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GT 3-5mm below top of humeral head
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Most common complication of acute anterior dislocator
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recurrent dislocation
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early rehab post cuff repair
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limited passive ROM
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Clavicle fracture non-union
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plate osteosynthesis with bone grafting
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Distal biceps rupture- functional loss
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loss 40% supination strength
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Lateral epicondylitis- treatment
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debride ECRB
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Dynamic stabilizers medial elbow
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postero-lateral rotatory instability elbow
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LUCL and UCL; pivot-shift test
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Elbow dislocation- most common sequelae
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loss of extension
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Elbow dislocation- treatment
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immobilization x one week, then start motion
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OCD of capitellum
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lateral pain w/ throwing, loss of extension, mecanical symptoms; treatment non-operative early
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DeQuervain’s tendons
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APL and EPB
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Wrist arthroscopy: indications
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TFCC, Lig injury
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Jersey finger
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treatment if
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UCL injury in skiiers
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Stress in 30 degrees; need to treat open b/c of Stener lesion
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Stener lesion
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Volar plate injury post disloc
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buddy tape x 4-6 weeks
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Mallet finger treatment
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splint DIP in hyperextension x 6 weeks
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Bennett’s Fracture deforming forces
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APL, APB, Adductor pollicis
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axillary nerve relationship to acromion
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5cm distal to lateral edge of acromion
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Irreparable cuff tear: features
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fatty atrophy, retraction to glenoid, decreased acromio-humeral distance, proximal migration
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