by kuc


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Front Back
Fracture of proximal humerus - E
Usually elderly. F:M = 2:1
Fracture of proximal humerus - A
Fall from standing height, RTA
Fracture of proximal humerus - Rx
Collar + cuff, physio, if comminuted may need open reduction and internal fixation or hemiarthroplasty
Shoulder dislocation - P
Most commonly anterior and inferior dislocation
Shoulder dislocation - A
Trauma. Posterior can occur in epileptic fit.
Shoulder dislocation - S+S
Pain, decreased movement, arm held internally rotated and adducted
Shoulder dislocation - Cx
Axillary nerve damage. Must document nerve function at deltoid before reduction.
Shoulder dislocation - Ix
X-Rays: AP and axial (or Y view)
Shoulder dislocation - Rx
Emergency reduction, consent, modified Kocher\\\'s technique, broad arm sling, re-examine axillary nerve function
Acute calcifying tendonitis in rotator cuff - P
Involves supraspinatus tendon
Acute calcifying tendonitis in rotator cuff - S+S
Presents with acutely painful shoulder after vigorous activity
Acute calcifying tendonitis in rotator cuff - Ix
X-Ray often shows calcification in the tendon
Acute calcifying tendonitis in rotator cuff - Rx
Usually resolves with non-operative treatment
Chronic tendonitis in rotator cuff - P
Tendon compressed against coracoacromial arch (painful arc syndrome or impingement syndrome)
Chronic tendonitis in rotator cuff - E
Usually middle-aged
Chronic tendonitis in rotator cuff - S+S
Pain in active abduction between 60 and 120 degrees
Chronic tendonitis in rotator cuff - Ix
MRI or USS
Chronic tendonitis in rotator cuff - Rx
Non-operative: physio, NSAIDs, joint injection. Operative: subacromial decompression +/- tendon repair
Biceps tendon rupture - S+S
Similar to rotator cuff disorders, but presents with \\\'Popeye\\\' sign (biceps retracted up the arm, creating a bulge)
Adhesive capsulitis (frozen shoulder) - A
Middle-aged patient with severe pain after trivial trauma
Adhesive capsulitis (frozen shoulder) - S+S
Severe pain, loss of range of active and passive movement, especially external rotation
Adhesive capsulitis (frozen shoulder) - Ix
X-Ray may show osteoporosis
Adhesive capsulitis (frozen shoulder) - Rx
Analgesia, NSAIDs, physio +/- manipulation under anaesthesia
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