The Shoulder

Front 1

Most common location of clavicle fracture?

Back 1

Middle > distal > proximal.

Front 2

Classifications of distal clavicle fractures?

Back 2

IIA: fx medial to intact conoid + trapezoid ligaments.
IIB: fx with conoid ruptured, trapezoid intact.
Type III: fx through the AC joint with ligaments intact.

Front 3

Treatment of clavicle fractures?

Back 3

Closed with figure of eight brace for: middle 1/3, proximal 1/3, distal type I, distal type III.

Open reduction for distal type II or open fracture or with vascular injury.

Front 4

Most common nervous injury with clavicle fracture?

Back 4

Medial cord/ulnar nerve.

Front 5

Big thing to consider with scapular fractures?

Back 5

Associated injuries to lungs, vasculature.

Front 6

Classification system name for scapular fractures?

Back 6

Idleberg fractures (of the glenoid).

Front 7

Idleberg fractures?

Back 7

Fractures of the glenoid:

I: anterior avulsion fx.
II: transverse thru glenoid, exits inf.
III: transverse through glenoid, exists sup.
IV: transverse through gelnoid, exits through scapular body
V: combination of II + IV

Front 8

Treatment of scapular fractures?

Back 8

Closed with sling for 2 weeks for most.

ORIF for intraarticular or displaced.

Front 9

Grades of AC separations?

Back 9

Grades:

1: AC sprain, ligaments intact.
2: AC tear, CC sprain
3: AC + CC tear, dislocated joint
4. III with clavicle post. into trap
5. III with clavicle >100% sup
6. III with clavicle inf

Front 10

Treatment of AC separations?

Back 10

Grades 1/2: sling x2 weeks
Grades 3: non op for most, op for athletes and laborers
Grades 4/5/6: ORIF

Front 11

Types of glenohumoral dislocations?

Back 11

Anterior:
1. TUBS
2. AMBRI (>80% recurrence)
Posterior:
1. s/p seizure

Front 12

Hill Sachs lesion?

Back 12

1. Found s/p ant. shoulder dislocation.
2. Cortical depression of the humoral head.
3. Highly associated with recurrent dislocations.

Front 13

Bankart lesion?

Back 13

Anterinferior glenoid labrum tear s/p ant shoulder dislocation.

Front 14

Most common direction of shoulder dislocation?

Back 14

Anterior.

Front 15

Milch technique for reduction of shoulder dislocation?

Back 15

With the dislocated arm, VERY slowly reach back behind head to attempt to grasp contralateral scapula.

Variation: VERY slow baseball pitch.

Front 16

Stimson technique for reduction of shoulder dislocation?

Back 16

1. Patient lies on side of bed prone, with effected shoulder falling off side of bed.
2. Patient flexes elbow to 90°.
3. Physician lies on floor, applies gentle traction to proximal forearm.

Front 17

Hippocratic technique for reduction of shoulder dislocation?

Back 17

1. Patient lies supine.
2. Abduct arm 30°.
3. Physician grabs wrist of patient, applies traction.
4. Physician places foot in shoulder to apply counter traction.

NOT AN ADVISABLE MANEUVER. Very high rate of complications: brachial plexus injury, additional fractures, vascular injury.

Front 18

How does age predict shoulder dislocation frequency?

Back 18

(age) α (frequency)-1

Front 19

Most commonly dislocated joint?

Back 19

Shoulder.

Front 20

Most commonly torn ligament?

Back 20

Supraspinatus.