Shoulder Injuries

(copyright 2008 worldortho)

Shoulder dislocations:
Fx surgical neck post reduction;
patient with PRIOR hemi-plegia,
radial nerve palsy

Typical presentation of Typical posture of POSTERIOR

shoulder;
ANTERIOR shoulder (left) arm locked in internal rotation
dislocation

(partial)Brachial plexus palsy Patient voluntarily dislocation shoulder

Post reduction ( posteriorly (Beware: these patients do
poorly
Excessive traction) with surgery)

Winging of the scapula Rotator cuff tear SLAP lesion(see Fig.

below)
Following shl dislocation
(damage to long. th. N)
®Acromio-clavicular ® Anterior sterno-clavicular
dislocation,
Dislocation, rarely operate
(may require surgery)

Avulsion pectoralis Rupture long head biceps (rarely

operate)
Major muscle. With
large haematoma

Key to A/C injuries

Only operate on Types 5 & 6 (“ ear-ticklers”)

Pitching action
Checking for anterior or posterior translation of shoulder in instability.

Posterior

Hippocratic way to reduce shoulder Y-appearance of lateral

scapula
+ve impingement sign for rotator cuff pain
Yergason’s test: resisted supination with flexed elbow=bicipital
tendinitis.

Resect wedge-shaped acromial fragment in acromioplasty

(better to rasp from lateral aspect)
Lift-off test for subscapularis pathology( pain/rupture)