MOI, S&S, AND TREATMENT INJURIES TO THE SHOULDER.
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Transcript of MOI, S&S, AND TREATMENT INJURIES TO THE SHOULDER.
M O I , S & S , A N D T R E AT M E N T
INJURIES TO THE SHOULDER
FRACTURE OF CLAVICLE
• MOI: direct blow or FOTOSA (falling on the outstretched arm)• S&S: step off
deformity, visible or palpable• Common in
athletes who are still maturing
TREATMENT OF FRACTURED CLAVICLE
• Immobilize in a sling until healing process is complete• Surgery with plates
and pins may be required if the two ends are to far apart to heal properly.
ACROMIOCLAVICULAR JOINT SPRAIN/DISLOCATION
• MOI: FOTOSA, fall on tip of shoulder, direct blow to acromion process• Tear of
acromioclavicular ligament and coracoclavicular ligament
AC JOINT DISLOCATION
• 1st degree acromioclavicular lig. Stretched/torn• 2nd degree – AC lig
torn and coracoclavicular lig stretched/partial torn• 3rd degree – AC and
CC ligaments torn
IMAGE OF FOTOSA
• Humeral head is forced superiorly into glenoid humeral joint
HUMERAL DISLOCATION
• MOI: blow to shoulder when humerus is abducted and externally rotated• Anterior/inferior
dislocation is most common; posterior is rare!
HUMERAL DISLOCATION
• S&S: visual deformity, drop off from deltoid• Tingling down the
arm
SHOULDER DISLOCATION
• The athlete many times will want the shoulder to “hang” in order to release the pain and numbing sensation.
REDUCTION OF DISLOCATION
• Many times the humeral head will self reduce but if not have a PROFESSIONAL reduce the shoulder so as not to impinge blood vessels and nerve routes to the arm!
POTENTIAL NERVE IMPINGEMENT
• Median nerve can be trapped under the humeral head upon reduction
TREATMENT OF SHOULDER DISLOCATIONS
• 9 out of 10 dislocations reoccur• Surgery required
for recurrent subluxations and dislocations
• Immobilize for 3-4 weeks• Rehabilitation to
strengthen the rotator cuff muscles
STERNOCLAVICULAR DISLOCATION
• Tear of sternoclavicular ligament• Treatment:
immobilization with sling
STERNOCLAVICULAR JOINT DISLOCATION
• MOI: direct blow or compression to the shoulder joint – humeral head• S&S: visual
deformity, instability
BICIPITAL TENDONITIS
• Swimmers shoulder• MOI: overuse injury
caused by repetitive movement, lifting or overload• Rest, ice, massage,
stretching• Pain flexion and
supination
IMPINGEMENT SYNDROME
• MOI: overuse injury to the rotator cuff.• supraspinatus
tendon becomes impinged under the acromion process
IMPINGEMENT RANGE OF MOTION
• Pain upon 60-120 degree abduction
TREATMENT OF IMPINGEMENT
• ICE• ULTRASOUND• NSAIDS and REST• CORTISONE
INJECTIONS FOR CHRONIC PAIN
• COMPLICATIONS: frozen shoulder due to scar tissue that forms due to using scapula instead of humerus to move the shoulder joint.
SLAP LESION
• S=superior• L=labral• A=anterior• L=lesion
• Tear of the labrum, cartilage that deepens the socket
SLAP LESION
• A SLAP lesion is a tear that occurs where the biceps tendon meets the labrum
MOI AND S&S OF SLAP LESIONS
• MOI:• FOTOSA• Direct blow• Sudden pull –
lifting overhead• Repetitive use –
throwing, pitching, lifting
• S&S:• Clicking/locking• Pain anterior
shoulder• Pain overhead
activities• Decrease ROM• Increase
subluxation/dislocation
FOUR TYPES OF SLAP LESIONS
• TYPE I – frayed labrum
• TYPE II – biceps tendon and labrum detached from glenoid fossa
• TYPE III – flap of the labrum hangs down into the joint, locking
• TYPE IV – labrum has a tear that extends into bicep tendon
SLAP LESION
• Frayed labrum
TREATMENT OF SLAP LESION
• REST, NSAIDS, PT• Surgery to clean
out debris or remove / stitch torn labrum• MRI with dye to
determine site and length of tear.
FORMER STUDENT INJURIES