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

2. Surface Anatomy

5. Normal shoulder

6. Normal shoulder: axillary view

7. Normal xray-scapular Y view

8. Gleno-Humeral dislocation Anterior:Posterior

9. Gleno-Humeral dislocation Inferior

10. Gleno-Humeral dislocation Y view of scapula

11. Gleno-Humeral dislocation

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

14. Gleno-Humeral dislocation Reduction technique

18. Minimally displaced fracture: non- operative management

19. 4 part fracture

20. 4 part fracture -Treatment

21. displaced fracture: closed or open reduction: fixation

22. Non-op vs operative

23. Fracture: shaft of humerus

25. Clavicle Fracture

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

27. Clavicle Fracture middle 1/3rd

28. Clavicle Fracture Lateral 1/3 rd

29. Clavicle Fracture

30. Clavicle Fracture comminuted,displaced

31. Clavicle Fracture x-ray 15 degree cranial

32. 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

33. Clavicle Fracture arm sling vs fig of 8

34. Clavicle Fracture open reduction internal fixation (ORIF)

35. Clavicle Fracture non-op vs orif

36. Clavicle Fracture non op vs orif

37. Clavicle Fracture non-op vs orif

39. Acromio-Clavicular Dislocation (A-C Joint dislocation)

40. Acromio-Clavicular Dislocation

45. 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:

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

47. Thank You!