Flashcards in Glenohumeral Joint Dislocation Deck (33)
Loading flashcards...
1
GH joint is what kind of joint
ball and socket, multidirectional
2
Function holds the tendon of the biceps brachii in place during GH movement
Transverse humeral ligament
3
most common before age
40
4
ligaments and capsule
give away
younger patients
5
can lead to an avulsion
fracture ie flap fracture
older patients
6
______ shoulder dislocations account for
approximately 95% of all acute shoulder dislocations
anterior
7
4 subtypes of shoulder dislocations
▪ sub-coracoid
▪ sub-clavicular
▪ sub-glenoid
▪ intrathoracic
8
primarily due to weakness of theRecurrent anterior shoulder dislocations are
middle and superior gleno-humeral ligaments
via: Foramen of Weitbrecht****
9
▪ caused by arm being forced into external
rotation and horizontal abduction with the
shoulder flexed to 90 degrees ▪ m/c in men 18-25
Anterior dislocation
10
falling on
outstretched arm ▪ Bilaterally with electric shock and epileptic
seizures
rare - 4%
posterior dislocation
11
▪ needs considerable vertical force of the
humerus
▪ usually associated with suprahumeral fracture
superior dislocation
12
▪ Severe Hyperabduction
trauma ▪ Humeral head contacts the
acromion which acts as a
fulcrum and forces the head
inferiorly ▪ Can remain locked in
hyperabduction
Inferior (Luxatio Erecta) dislocation
13
▪ anterior jt pain ▪ history of trauma ▪ interruption of normal shoulder contour with a
posterior bony prominence ▪ paresthesia / numbness in arm ▪ dead arm syndrome
anterior dislocation
14
▪ posterior shoulder pain ▪ most common sign - stuck in IR. No ER ▪ prominence of anterior acromium
posterior dislocation
15
patient’s arm
at side and doctor pulls down
on elbow while palpating GH
joint and feels increased
motion
sulcus test
16
Pt reaches across body, places hand on
opposite shoulder and pulls elbow towards chest. Dr
can apply A-P pressure on flexed elbow. Positive if
unable to finish test.
Dugas' test
17
adduction across
chest at 45 degrees and forward flexion at 90
degrees
Posterior Apprehension
18
(SLAP)
Superior Labrum Anterior to Posterior
19
Common in throwing athletes who present with a ▪ Mechanism - a crushing injury of the labrum between the humeral head and glenoid
SLAP lear
20
physical exam for SLAP
positive "clunk" test
21
typically you need what kind of image to spot SLAP tear
MRI w/ contrast
22
Fraying of the superior labrum with firm attachment of the labrum to the glenoid. Typically degenerative.
type 1 slap
23
Detachment of the superior labrum and the origin of the tendon of the long head of the biceps from the glenoid resulting in instability of the labral- biceps anchor
type II slap
24
Bucket-handle tear of the labrum with intact biceps insertion.
type III slap
25
Impaction fracture
of the humeral head on the
inferior glenoid rim. MRI is
extremely sensitive and
specific in locating lesion.
hill-sachs lesion
26
Avulsion
of the inferior glenoid rim at
the insertion of the triceps
muscle
bankart lesion
27
tx:
▪ gentle supported pendulum exercises
▪ Isometric exercises with arm at side
▪ Maintain fitness in other arm
Early post reduction (up to 3 weeks)
28
tx:
▪ Tubing exercises as tolerated
stim
▪ No abduction beyond 45 degrees
▪ no ER beyond neutral
▪ Increase proprioception/ sensory motor
Early capsular Healing (3-6 weeks)
29
tx:
beyond neutral or abduction beyond 90 degrees.
▪ Do not work end ROM unless stiff
▪ closed chain proprioception
▪ supervised resisted training, but not in ER
Intermediate Rehab
30
