Transcript Shoulder Injuries

Shoulder Injuries
Clavicle
By: Nathaniel Patterson
Anatomy Of the Shoulder
• There are Three Main Bones in the
Shoulder
– The Clavicle
– The Scapula
– Humoreus
The Clavicle
• The clavicle is an S-shaped bone that attaches
the trunk to the upper extremity (the only bone
to do so through bony articulations).
The Scapula
• The Scapula (Shoulder Blade)
– The Scapula forms the posterior part of the
shoulder girdle.
The Humerus
• The Humerus is the
bone that connects
to the lower arm, and
to the shoulder.
Muscles
• The Rotator Cuff
– The rotator cuff is a set of four muscles that
are responsible for the movement of the
arm and gives the shoulder stability.
• SUPRASPINATUS
– Abducts arm and stabilizes shoulder
joint
• INFRASPINATUS
– Laterally rotates arm
and stabilizes
shoulder joint
• SUBSCAPULARIS
– Medially rotates arm
and stabilizes
shoulder joint
• TERES MINOR
– laterally rotates arm
and stabilizes
shoulder joint
Deltoid and Teres Major
• Deltoid
– Abducts arm, anterior fibers flex and medial
rotate, posterior fibers extend and lateral
rotate
• Teres Major
– Medially rotates and adducts arm. Stabilizes
shoulder joint
Deltoid
Teres Major
Ligaments
• the acromioclavicular ligament is superior to
the joint and links the lateral end of the clavicle
and the acromion.
• the coracoclavicular ligament, a stronger
ligament, does not attach to the acromion, but
rather attaches the clavicle to the scapula at
the coracoid process.
– the conoid ligament lies medially. It spans from
the conoid tubercle of the clavicle to the coracoid
process.
– the trapezoid ligament is the lateral portion of the
ligament. It spans from the trapezoid line on the
clavicle to the coracoid process.
Bursae
• Bursae reduce friction in areas where
tendons (or skin) slide across bones,
ligaments or other tendons.
Dislocated Shoulder
• There are 2 types of dislocations
– A partial dislocation (subluxation) means the
head humerus is partially out of the socket
(glenoid).
– A complete dislocation means it's all the
way out.
• Both partial and complete dislocation
cause pain and unsteadiness in your
shoulder. Your muscles may have
spasms from the disruption, and this can
make it hurt more. When your shoulder
dislocates time and again, you have
shoulder instability
Signs and Symptoms
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swelling
numbness
weakness
Bruising
Sometimes dislocation may tear
ligaments or tendons in your shoulder.
Once in awhile, the dislocation may
damage your nerves.
Treatment
• A Doctor or trained Professional will
place the ball of the humerus back in the
socket.
Rehab
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Immobilization
A sling
Ice
If it happens consistently the doctor
might prescribe a brace, sometimes
surgery is needed to correct the problem
Rotator cuff tear
• Are a common source of shoulder pain.
• Damage increases with age.
Surgical and Non Surgical
Options
•
Non-operative (conservative)
treatment
Operative - Rotator cuff repair
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Open
Mini-open
All-arthroscopic
Non-Operative
•
Injections
– Injecting medicines to help strengthen
the area.
•
Activity modification (avoidance of
activities that cause symptoms)
• Advantages
• Patient avoids surgery and its inherent
risks:
• Infection
• Permanent stiffness
• Anesthesia complications
• Disadvantages
• Strength does not improve
• Tears may increase in size over time
• Patient may need to decrease activity
level
Operative
•
The 3 Main Types
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Open repair
Mini-open repair
All-arthroscopic repair
After rotator cuff repair, 80 percent to 95
percent of patients achieve a satisfactory
result, defined as adequate pain relief,
restoration or improvement of function,
improvement in range of motion
Potential Complications
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Nerve injury (1 percent to 2 percent)
Infection (1 percent):
Deltoid Detachment (less than 1
percent):
Stiffness (less than 1 percent):
Tendon re-tear (6 percent
Rehab.
• Following rotator cuff surgery, therapy
progresses in stages. Passive range of
motion exercises are begun with a
therapist; pendulum exercises may be
taught as well. Progressive strengthening
and range of motion exercises continue
during the next 6 to 12 weeks. Most
patients have a functional range of motion
and adequate strength by 4 to 6 months
after surgery.