SHOULDER AND ELBOW TEACHING SEPTEMBER – OCTOBER 2012 SHOULDER AND ELBOW TEACHING DR.KR. PRATHAP KUMAR MB, FRCS(Tr&Orth), FRCS, D’ORTH, Dip ATLS FELLOWSHIP SHOULDER SURGERY(MANCHESTER) FELLOWSHIP HAND SURGERY(LIVERPOOL) ASSISTANT PROFESSOR, DEPT OF ORTHOPAEDICS, SNIMS, KOCHI CONSULTANT SHOULDER AND ELBOW SURGEON SUNRISE HOSPITAL, KOCHI FORMERLY CONSULTANT SHOULDER & UPPERLIMB SURGEON, DARLINGTON AND COUNTY DURHAM UNIVERSITY HOSPITAL, ENGLAND

www.shoulder4u.com prathap@shoulder4u.com SNIMS KOCHI DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

WHAT IS A SHOULDER JOINT? SNIMS KOCHI WHAT IS A SHOULDER JOINT? DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

SHOULDER JOINT COMPLEX SNIMS KOCHI SHOULDER JOINT COMPLEX DR.KR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

COMMON SHOULLDER PROBLEMS SNIMS KOCHI COMMON SHOULLDER PROBLEMS GLENO-HUMERAL JOINT OTHER SHOULDER PROBLEMS INSTABILITY IMPINGEMENT FROZEN SHOULDER ROTATOR CUFF DISEASE OSTEO-ARTHRITIS STERNO-CLAVICULAR JOINT ARTHRITIS / INSTABILITY ACJ DISLOCATION / ARTHRITIS SCAPULO-THORACIC DYSFUNCTION DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

AGE RELATED GLENO-HUMERAL JOINT PATHOLOGY SNIMS KOCHI AGE RELATED GLENO-HUMERAL JOINT PATHOLOGY INSTABILITY 15-30Yrs IMPINGEMENT 30-60Yrs FROZEN SHOULDER 30-60Yrs ROTATOR CUFF DISEASE 50 +Yrs OSTEO-ARTHRITIS 60 +Yrs DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

AMBRI TUBS INSTABILITY SNIMS KOCHI DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

INFERIOR CAPSULAR SHIFT SNIMS KOCHI INSTABILITY AMBRI ATRAUMATIC MULTIDIRECTIONAL BILATERAL REHABILITATION INFERIOR CAPSULAR SHIFT TUBS TRAUMATIC UNILATERAL BANKARTS SURGERY DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS(GEN), D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

LIGAMENT HYPERLAXITY BENIGN FAMALIAL HYPERLAXITY MARFANS OSTEOGENESIS SNIMS KOCHI LIGAMENT HYPERLAXITY BENIGN FAMALIAL HYPERLAXITY MARFANS OSTEOGENESIS IMPERFECTA 4. EHLERS DANLOS DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

BEATON SCORE HYPER EXTENSION LITTLE FINGER HYPER FLEXON OF THUMB SNIMS KOCHI BEATON SCORE HYPER EXTENSION LITTLE FINGER HYPER FLEXON OF THUMB HYPER EXTENSION OF ELBOW HYPER EXTENSION KNEE HYPER FLEXON OF SPINE TOTAL 9 POINTS 5/9 SCORE DR.KR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

TRAUMATIC INSTABILITY SNIMS KOCHI TRAUMATIC INSTABILITY DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

TYPES OF DISLOCATION SHOULDER SNIMS KOCHI TYPES OF DISLOCATION SHOULDER ANTERIOR INFERIOR SUBCORACOID POSTERIOR DR.KR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

ANTERIOR DISLOCATION FLEXON –ABDUCTION 15-25 YRS BANKARTS LESION SNIMS KOCHI ANTERIOR DISLOCATION FLEXON –ABDUCTION 15-25 YRS BANKARTS LESION HILLSACHS LESION DR.KR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

RADIOGRAPH SNIMS KOCHI DR.KR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

STABILISORS OF GLENO-HUMERAL JOINT SNIMS KOCHI STABILISORS OF GLENO-HUMERAL JOINT STATIC DYNAMIC DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

LIGAMENTS SGHL MGHL AIGHL PIGHL CAL CHL SNIMS KOCHI DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

SNIMS KOCHI DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

SNIMS KOCHI DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

SNIMS KOCHI DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

KOCHERS HIPPOCRATES SNIMS KOCHI DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

POST. DISLOCATION EPILEPSY ELECTRIC SHOCK DIRECT INJURY - BOXING SNIMS KOCHI POST. DISLOCATION EPILEPSY ELECTRIC SHOCK DIRECT INJURY - BOXING DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

RECURRENT INSTABILITY SNIMS KOCHI RECURRENT INSTABILITY BANKARTS HILLSACHS INSTABILITY GLENOID BONE LOSS DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

SNIMS KOCHI DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

SNIMS KOCHI DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

SLAP SUPERIOR BICEPS ACROMION LABRAL ANTERO POSTERIOR COROCOID SLAP SNIMS KOCHI SLAP SUPERIOR LABRAL ANTERO POSTERIOR LESION BICEPS ACROMION COROCOID SLAP LABRUM DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

FROZEN SHOULDER SNIMS KOCHI DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

WHAT IS IT? All movements reduced PAIN AND STIFFNESS MIDDLE AGED WOMEN SNIMS KOCHI WHAT IS IT? All movements reduced PAIN AND STIFFNESS MIDDLE AGED WOMEN External rotation less than 10 degrees Functionally disabled Periarthritis / Adhesive Capsulitis / Capsulitis DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

1ST PHASE – FREEZING 3MONTHS 2ND PHASE – FROZEN 3-9MONTHS SNIMS KOCHI 18 TO 24 MONTHS 1ST PHASE – FREEZING 3MONTHS 2ND PHASE – FROZEN 3-9MONTHS 3RD PHASE –THAWING 9-24 MONTHS DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

1. Inflammatory synovitis 2. Proliferative synovitis SNIMS KOCHI 1. Inflammatory synovitis 2. Proliferative synovitis 3. Maturation of the capsule, with reduced vascularity. 4. Burnt out synovium with a dense scar appearance. DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

CAPSULE AND LIGAMENTS CONTRACTURE CORACO-HUMERAL LIGAMENT SNIMS KOCHI CAPSULE AND LIGAMENTS CONTRACTURE CORACO-HUMERAL LIGAMENT DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

ASSOCIATION DIABETES DUPUYTREN’S TENNIS / GOLFERS ELBOW DEQUIREVAINS SNIMS KOCHI ASSOCIATION DIABETES DUPUYTREN’S TENNIS / GOLFERS ELBOW DEQUIREVAINS PLANTAR FACITIS FIBROFACITIS CARDIAC HYPERLIPIDAEMIA THYROID PROBLEMS EPILEPSY DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

DIABETES AND FROZEN SHOULDER SNIMS KOCHI DIABETES AND FROZEN SHOULDER MORE SEVERE 10-20% ASSOCIATION 2-4 TIMES INCREASED RISK TYPE I DM 36% LIFE TIME RISK 10% BILATERAL DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

MANAGEMENT COUNCILLING ANALGESIC PHYSIOTHERAPY JOINT INJECTIONS SNIMS KOCHI MANAGEMENT COUNCILLING ANALGESIC PHYSIOTHERAPY JOINT INJECTIONS JOINT DISTENSION MUA CAPSULAR RELEASE OPEN / ARTHROSCOPIC DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

SNIMS KOCHI DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

SUBACROMIAL IMPINGEMENT SNIMS KOCHI SUBACROMIAL IMPINGEMENT DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

WHAT IS IT? SUB ACROMIAL BURSA SNIMS KOCHI WHAT IS IT? SUB ACROMIAL BURSA TIP OF GR TUBEROSITY AGAINST ANTERO-LATERAL EDGE OF ACROMION SUPRASPINATOUS IN BETWEEN DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

SNIMS KOCHI DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

SYMPTOMS AND SIGNS MIDDLE AGED PAIN ON OVERHEAD ACTIVITIES PAINFUL ARC SNIMS KOCHI SYMPTOMS AND SIGNS MIDDLE AGED PAIN ON OVERHEAD ACTIVITIES PAINFUL ARC IMPINGEMENT SIGN IMPINGEMENT TEST RADIGRAPH DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

MANAGEMENT ANALGESICS PHYSIOTHERAPY SUBACROMIAL INJECTION SNIMS KOCHI MANAGEMENT ANALGESICS PHYSIOTHERAPY SUBACROMIAL INJECTION ARTHROSCOPIC SUBACROMIAL IMPINGEMENT DR.KR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

SNIMS KOCHI DR.KR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

CALCIFIC TENDINITIS MIDDLE AGED ACUTE ONSET EXTREME PAIN SNIMS KOCHI CALCIFIC TENDINITIS MIDDLE AGED ACUTE ONSET EXTREME PAIN A/C INFLAMMATION OF SS TENDON DD: SEPTIC ARTHRITIS ASPIRATION / STEROID INJECTION ARTHROSCOPIC SAD +/- REMOVAL OF CALCIUM DR.KR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

www.shoulder4u.com prathap@shoulder4u.com SNIMS KOCHI DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON

SNIMS KOCHI QUESTIONS DR.PRATHAPKUMAR MB, FRCS(Tr&Orth), FRCS, D’Orth CONSULTANT SHOULDER AND ELBOW SURGEON