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

Shoulder Injuries by: Nanda K. Sinha, M.D. Surface Anatomy. Surface Anatomy. Surface Anatomy. Normal shoulder. Normal shoulder: axillary view. Normal xray-scapular Y view. Gleno-Humeral dislocation Anterior:Posterior. Gleno-Humeral dislocation Inferior.

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

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  1. Shoulder Injuriesby: Nanda K. Sinha, M.D.

  2. Surface Anatomy

  3. Surface Anatomy

  4. Surface Anatomy

  5. Normal shoulder

  6. Normal shoulder: axillary view

  7. Normal xray-scapular Y view

  8. Gleno-Humeral dislocationAnterior:Posterior

  9. Gleno-Humeral dislocationInferior

  10. Gleno-Humeral dislocationY view of scapula

  11. Gleno-Humeral dislocation

  12. 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 dislocationReduction technique

  15. Gleno-Humeral dislocationReduction technique

  16. Gleno-Humeral dislocationReduction technique

  17. Gleno-Humeral dislocationReduction 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

  24. Clavicle Fracture

  25. Clavicle Fracture • Medial ( inner) 1/3rd uncommon • Middle 1/3rd most common • Lateral (outer) 1/3rd

  26. Clavicle Fracturemiddle 1/3rd

  27. Clavicle FractureLateral 1/3rd

  28. Clavicle Fracture

  29. Clavicle Fracturecomminuted,displaced

  30. Clavicle Fracturex-ray 15 degree cranial

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

  32. Clavicle Fracturearm sling vs fig of 8

  33. Clavicle Fractureopen reduction internal fixation (ORIF)

  34. Clavicle Fracturenon-op vs orif

  35. Clavicle Fracturenon op vs orif

  36. Clavicle Fracturenon-op vs orif

  37. Clavicle Fracturenon-op vs orif

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

  39. Acromio-Clavicular Dislocation

  40. Acromio-Clavicular Dislocation

  41. Acromio-Clavicular Dislocation

  42. Acromio-Clavicular Dislocation

  43. Acromio-Clavicular Dislocation

  44. Acromio-Clavicular Dislocationtreatment • 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:

  45. Acromio-Clavicular DislocationNon-operative treatment • Sling • Ice • Pain medications • Activity limitation • Continue to monitor amount of displacement • Rehabilitation once pain is controlled

  46. Thank You!

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