Shoulder Injuries Overview

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Questions and Answers

What is the most common type of dislocation mentioned?

  • Inferior dislocation
  • Lateral dislocation
  • Anterior dislocation (correct)
  • Posterior dislocation

What condition leads to the humeral head moving downward during dislocation?

  • Joint fully flexed
  • Joint fully adducted
  • Joint fully extended
  • Joint fully abducted (correct)

What mechanism of injury is typically associated with anterior inferior dislocation?

  • Gradual overuse
  • Infection leading to joint damage
  • Sudden violence applied to the humerus (correct)
  • Trauma from falling weights

What part of the shoulder capsule is primarily affected in anterior inferior dislocation?

<p>Inferior weak part of the capsule (C)</p> Signup and view all the answers

What occurs to the joint structure during anterior inferior dislocation?

<p>The humeral head tears the capsule (A)</p> Signup and view all the answers

What is the most commonly fractured bone in the body?

<p>Clavicle (B)</p> Signup and view all the answers

Which factor contributes to the clavicle being the most commonly fractured bone?

<p>Its location between the sternum and shoulder blade (A)</p> Signup and view all the answers

In terms of fracture frequency, how does the clavicle compare to other bones?

<p>It is the most frequently fractured bone. (C)</p> Signup and view all the answers

Which of the following statements regarding clavicle fractures is accurate?

<p>Clavicle fractures can occur from falls or direct trauma. (A)</p> Signup and view all the answers

What common event is likely to lead to a fracture of the clavicle?

<p>Direct impact during a sports activity (B)</p> Signup and view all the answers

What is the most commonly dislocated large joint?

<p>Shoulder joint (D)</p> Signup and view all the answers

Which of the following statements is true regarding shoulder dislocation?

<p>It is the most common dislocated large joint. (B)</p> Signup and view all the answers

Which joint is least likely to be dislocated compared to others mentioned?

<p>Hip joint (B)</p> Signup and view all the answers

In context of dislocations, what is a characteristic of the shoulder joint?

<p>It can dislocate both anteriorly and posteriorly. (D)</p> Signup and view all the answers

Shoulder dislocations are most common in which population?

<p>Teenagers and young adults (C)</p> Signup and view all the answers

What type of fracture may cause an injury to the axillary nerve?

<p>Surgical neck fracture (C)</p> Signup and view all the answers

Which structure is at risk of injury with a surgical neck fracture of the humerus?

<p>Axillary nerve (C)</p> Signup and view all the answers

What is a common consequence of a surgical neck fracture in the humerus?

<p>Injury to the axillary nerve (C)</p> Signup and view all the answers

Which of the following fractures is least likely to involve the axillary nerve?

<p>Fractured clavicle (A)</p> Signup and view all the answers

In the context of humeral fractures, which statement is true regarding the surgical neck?

<p>It connects the head of the humerus to the shaft. (C)</p> Signup and view all the answers

What characterizes a Smith's fracture?

<p>The distal segment is displaced anteriorly. (A)</p> Signup and view all the answers

How does a Smith's fracture compare to a Colle’s fracture?

<p>Smith's fracture involves anterior displacement, whereas Colle’s involves posterior displacement. (A)</p> Signup and view all the answers

Which statement about the distal segment in a Smith's fracture is true?

<p>It is displaced anteriorly. (D)</p> Signup and view all the answers

Which type of fracture is considered the reverse of a Smith's fracture?

<p>Colle’s fracture (C)</p> Signup and view all the answers

What is a common misinterpretation regarding Smith's fractures?

<p>They are often confused with Colle’s fractures. (B)</p> Signup and view all the answers

What does the dinner-fork deformity in the forearm and wrist resemble?

<p>The shape of a dinner fork (D)</p> Signup and view all the answers

In which direction is the distal fragment of the radius pulled during the dinner-fork deformity?

<p>Posteriorly and superiorly (C)</p> Signup and view all the answers

What is the clinical implication of a dinner-fork deformity?

<p>It suggests a fracture in the distal radius (C)</p> Signup and view all the answers

What best describes the anatomical position of the wrist in the dinner-fork deformity?

<p>Pulled posteriorly and superiorly (D)</p> Signup and view all the answers

Which of the following statements about the dinner-fork deformity is correct?

<p>It is often the result of a fall on an outstretched hand (D)</p> Signup and view all the answers

Flashcards

Common Shoulder Dislocation

The shoulder joint is the most frequently dislocated large joint.

Shoulder Joint

The joint predominantly dislocated among large joints.

Dislocation

Displacement of a joint.

Most Commonly Dislocated Large Joint

The shoulder joint is displaced more often than any other large joint.

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Joint

The connection between two or more bones.

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Anterior Inferior Dislocation

The most common type of shoulder dislocation, caused by a sudden force applied to the abducted arm, resulting in the humeral head moving downward and tearing the inferior capsule.

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Abduction

Moving the arm away from the body, like raising it out to the side.

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Humeral Head

The top of the upper arm bone, the part that fits into the shoulder socket.

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Capsule

A tough, fibrous sac surrounding a joint, holding the bones together.

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Tears in the Capsule

The capsule surrounding the shoulder joint can tear during a dislocation, allowing the humeral head to slip out of place.

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Clavicle Fracture

A break in the collarbone, the bone connecting the shoulder to the chest.

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Most Common Bone Fracture

The clavicle, or collarbone, is the bone that breaks most often in the body.

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Why Clavicle Fractures are Common

The clavicle is vulnerable to fractures due to its exposed position and its role in absorbing force.

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Clavicle Position

The clavicle is located between the shoulder blade and the breastbone, making it susceptible to breaks.

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Force Absorption

The clavicle acts like a shock absorber, taking the brunt of force during falls and impacts.

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Surgical Neck Fracture

A break in the narrow area just below the head of the humerus, the bone in your upper arm.

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Axillary Nerve

A nerve that runs near the shoulder joint and controls the muscles that help you rotate your arm outward.

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Injury to Axillary Nerve

Damage to the axillary nerve can cause weakness or difficulty in rotating the arm outward.

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How can a Surgical Neck Fracture affect the Axillary Nerve?

A fracture in the surgical neck of the humerus can put pressure on the nearby axillary nerve, potentially damaging it.

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What are the consequences of Axillary Nerve Damage?

Damage to the axillary nerve can lead to weakness or paralysis of the muscles involved in rotating the arm outward, causing difficulty in lifting or rotating the arm.

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Dinner-fork Deformity

A characteristic deformity of a fractured distal radius, where the forearm and wrist resemble the shape of a dinner fork due to the posterior and superior displacement of the distal fragment.

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Distal Radius Fracture

A break in the lower end of the radius bone, often causing the dinner-fork deformity.

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Posterior Displacement

The broken fragment of the radius moves backwards (posteriorly) in a distal radius fracture.

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Superior Displacement

The broken fragment of the radius moves upwards (superiorly) in a distal radius fracture.

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Distal Fragment

The part of the broken radius that is furthest from the elbow.

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Smith's Fracture

A type of wrist fracture where the distal end of the radius bone is displaced forward (anteriorly).

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Distal Radius

The lower end of the radius bone in the forearm.

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Reversed Colle's Fracture

A wrist fracture where the distal radius bone is displaced forward, the opposite of a Colle's fracture.

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Colle's Fracture

A common wrist fracture where the distal radius bone is displaced backward (posteriorly).

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Study Notes

Shoulder Dislocation

  • Most common type is anterior inferior dislocation
  • Caused by sudden force, with the arm fully abducted
  • Humeral head moves inferiorly, displacing it below the glenoid fossa
  • Inferior capsule tears due to the displacement
  • Axillary nerve can be damaged

Posterior Dislocation

  • Less common than anterior dislocation
  • Classified as less common

Fracture of the Clavicle

  • Most common fractured bone in the body
  • Typically caused by a fall onto the shoulder or outstretched hand
  • Usually fractures at the junction of the medial and lateral thirds
  • Lateral fragment is compressed by the weight of the arm
  • Medial fragment is pulled upwards by the sternomastoid muscle
  • Supraclavicular nerves can be involved, causing persistent neck pain

Fracture of the Humerus

  • Surgical neck fractures: Can damage the axillary nerve
  • Fractures of the shaft:
    • Proximal to deltoid insertion: proximal fragment adducted by pectoralis major, latissimus dorsi, and teres major; distal fragment pulled proximally by deltoid, biceps, and triceps.
    • Distal to deltoid insertion: proximal fragment abducted by deltoid; distal fragment pulled proximally by biceps and triceps.
    • Radial nerve can be injured

Fracture of the Lower End of Humerus

  • Supracondylar fracture: Common in children; can injure the median nerve
  • Medial epicondyle fracture: Can injure the ulnar nerve

Pulled Elbow

  • Radial head is pulled out of the annular ligament
  • Common in children when lifted by the upper limb

Tennis Elbow

  • Caused by partial tear of the extensor muscles origin near the lateral epicondyle (common extensor tendon)
  • Due to excessive use of these muscles, like in tennis

Golfer's Elbow

  • Caused by partial tear of flexor muscles origin near the medial epicondyle (common flexor tendon)
  • Due to excessive use of these muscles, like in golfing

Fracture of the Radius

  • Colle's fracture:
    • Fall onto the outstretched hand, common in patients over 50
    • Distal radius fragment pulled posteriorly and superiorly
    • Creates a "dinner fork" deformity
  • Smith's fracture:
    • Reverse Colle's fracture
    • Distal radius fragment is displaced anteriorly

References

  • MOORE Clinically Oriented, Seventh Edition
  • Clinical Anatomy by Regions, Snell, Ninth Edition
  • Prof. Mohey Hulail, Zagazig University
  • Lecture of Dr. Zeenat Zaidi

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