shoulder injuries by: nanda k. sinha, m.d.. surface anatomy
TRANSCRIPT
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Shoulder Injuriesby: Nanda K. Sinha, M.D.
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Surface Anatomy
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Surface Anatomy
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Surface Anatomy
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Normal shoulder
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Normal shoulder: axillary view
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Normal xray-scapular Y view
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Gleno-Humeral dislocationAnterior:Posterior
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Gleno-Humeral dislocationInferior
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Gleno-Humeral dislocationY view of scapula
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Gleno-Humeral dislocation
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Gleno-Humeral dislocation
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Gleno-Humeral dislocation(shoulder dislocation)
• Anterior: Most common
• Posterior: Most missed
• Inferior: Most dramatic
• Superior: Acromion blocks superior displacement
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Gleno-Humeral dislocationReduction technique
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Gleno-Humeral dislocationReduction technique
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Gleno-Humeral dislocationReduction technique
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Gleno-Humeral dislocationReduction technique
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Minimally displaced fracture: non-operative management
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4 part fracture
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4 part fracture -Treatment
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displaced fracture: closed or open reduction: fixation
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Non-op vs operative
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Fracture: shaft of humerus
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Clavicle Fracture
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Clavicle Fracture
• Medial ( inner) 1/3rd
uncommon
• Middle 1/3rd
most common
• Lateral (outer) 1/3rd
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Clavicle Fracturemiddle 1/3rd
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Clavicle FractureLateral 1/3rd
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Clavicle Fracture
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Clavicle Fracturecomminuted,displaced
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Clavicle Fracturex-ray 15 degree cranial
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Clavicle FractureIndications for ORIF
• Shortening of 20 mm or more
• Open injury
• Impending skin disruption and irreducible fracture
• Vascular compromise
• Progressive neurologic loss
• Displaced lateral 1/3rd fracture
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Clavicle Fracturearm sling vs fig of 8
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Clavicle Fractureopen reduction internal fixation (ORIF)
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Clavicle Fracturenon-op vs orif
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Clavicle Fracturenon op vs orif
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Clavicle Fracturenon-op vs orif
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Clavicle Fracturenon-op vs orif
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Acromio-Clavicular Dislocation(A-C Joint dislocation)
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Acromio-Clavicular Dislocation
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Acromio-Clavicular Dislocation
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Acromio-Clavicular Dislocation
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Acromio-Clavicular Dislocation
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Acromio-Clavicular Dislocation
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Acromio-Clavicular Dislocationtreatment
• Grade 1 and 2: non operative
• Grade 4 and above: ORIF
• Grade 3: ( A-C Joint reducible by pushing up on the elbow at 90 degree)
Non –op vs ORIF:
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Acromio-Clavicular DislocationNon-operative treatment
• Sling
• Ice
• Pain medications
• Activity limitation
• Continue to monitor amount of displacement
• Rehabilitation once pain is controlled
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Thank You!