Shoulder Injuries by: Nanda K. Sinha, M.D.. Surface Anatomy.

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Presentation transcript:

Shoulder Injuries by: Nanda K. Sinha, M.D.

Surface Anatomy

Normal shoulder

Normal shoulder: axillary view

Normal xray-scapular Y view

Gleno-Humeral dislocation Anterior:Posterior

Gleno-Humeral dislocation Inferior

Gleno-Humeral dislocation Y view of scapula

Gleno-Humeral dislocation

Gleno-Humeral dislocation (shoulder dislocation) Anterior: Most common Posterior: Most missed Inferior: Most dramatic Superior: Acromion blocks superior displacement

Gleno-Humeral dislocation Reduction technique

Minimally displaced fracture: non- operative management

4 part fracture

4 part fracture -Treatment

displaced fracture: closed or open reduction: fixation

Non-op vs operative

Fracture: shaft of humerus

Clavicle Fracture

Medial ( inner) 1/3 rd uncommon Middle 1/3 rd most common Lateral (outer) 1/3rd

Clavicle Fracture middle 1/3rd

Clavicle Fracture Lateral 1/3 rd

Clavicle Fracture

Clavicle Fracture comminuted,displaced

Clavicle Fracture x-ray 15 degree cranial

Clavicle Fracture Indications for ORIF Shortening of 20 mm or more Open injury Impending skin disruption and irreducible fracture Vascular compromise Progressive neurologic loss Displaced lateral 1/3 rd fracture

Clavicle Fracture arm sling vs fig of 8

Clavicle Fracture open reduction internal fixation (ORIF)

Clavicle Fracture non-op vs orif

Clavicle Fracture non op vs orif

Clavicle Fracture non-op vs orif

Acromio-Clavicular Dislocation (A-C Joint dislocation)

Acromio-Clavicular Dislocation

Acromio-Clavicular Dislocation treatment 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:

Acromio-Clavicular Dislocation Non-operative treatment Sling Ice Pain medications Activity limitation Continue to monitor amount of displacement Rehabilitation once pain is controlled

Thank You!