Shoulder Instability Shoulder Instability Presented by: Dr.Abdulrahman Algarni Dr.Abdulrahman...

14
Shoulder Instability Shoulder Instability Presented by Presented by : : Dr.Abdulrahman Algarni Dr.Abdulrahman Algarni

description

Anatomy and biomechanics Static and Dynamic Restriants. Static include glenoid labrum,articular conformity,negative pressure,capsule and capsuloligamentous structures. The Ant capsule is tight during Ext Rot & the Post during Int Rot.

Transcript of Shoulder Instability Shoulder Instability Presented by: Dr.Abdulrahman Algarni Dr.Abdulrahman...

Page 1: Shoulder Instability Shoulder Instability Presented by: Dr.Abdulrahman Algarni Dr.Abdulrahman Algarni.

Shoulder InstabilityShoulder Instability

Presented byPresented by : :

Dr.Abdulrahman AlgarniDr.Abdulrahman Algarni

Page 2: Shoulder Instability Shoulder Instability Presented by: Dr.Abdulrahman Algarni Dr.Abdulrahman Algarni.

��Shoulder is the most commonly Shoulder is the most commonly dislocated joint .In 95% the dislocated joint .In 95% the displacement is anterior and the displacement is anterior and the remainder is posterior or remainder is posterior or multidirectional.multidirectional.

Page 3: Shoulder Instability Shoulder Instability Presented by: Dr.Abdulrahman Algarni Dr.Abdulrahman Algarni.

Anatomy and biomechanicsAnatomy and biomechanicsStatic and Dynamic Restriants . Static and Dynamic Restriants .

Static include glenoid Static include glenoid labrum,articular conformity,negative labrum,articular conformity,negative pressure,capsule and pressure,capsule and capsuloligamentous structures. The capsuloligamentous structures. The Ant capsule is tight during Ext Rot & Ant capsule is tight during Ext Rot & the Post during Int Rot. the Post during Int Rot.

Page 4: Shoulder Instability Shoulder Instability Presented by: Dr.Abdulrahman Algarni Dr.Abdulrahman Algarni.

These include CHL and SGHL:limit Inf These include CHL and SGHL:limit Inf Trans & Ex Rot(Add),Post Trans & Ex Rot(Add),Post Trans(Flex,Add,Int Rot) . MGHL limit Trans(Flex,Add,Int Rot) . MGHL limit Inf Trans(Add,Ex Rot) ,Ex Rot (Add), Inf Trans(Add,Ex Rot) ,Ex Rot (Add), Ant-Post Trans (45 Abd,Ex Rot).Ant-Post Trans (45 Abd,Ex Rot).

Page 5: Shoulder Instability Shoulder Instability Presented by: Dr.Abdulrahman Algarni Dr.Abdulrahman Algarni.

The IGHLC is the primary restraint to The IGHLC is the primary restraint to Ant,Pos,and Inf Trans (45-90 Abd). Ant,Pos,and Inf Trans (45-90 Abd). The Dynamic restraints include joint The Dynamic restraints include joint concavity compression produced by concavity compression produced by synchronised contraction of Rotator synchronised contraction of Rotator Cuff.Cuff.

Page 6: Shoulder Instability Shoulder Instability Presented by: Dr.Abdulrahman Algarni Dr.Abdulrahman Algarni.

Anterior InstabilityAnterior Instability

Page 7: Shoulder Instability Shoulder Instability Presented by: Dr.Abdulrahman Algarni Dr.Abdulrahman Algarni.

Posterior InstabilityPosterior InstabilityMany cases are atraumatic . Acute Many cases are atraumatic . Acute

post dislocation is rare ,history of post dislocation is rare ,history of epilpsy or severe electric shock +/- epilpsy or severe electric shock +/- fracture of the proximal humerus or fracture of the proximal humerus or indentation.indentation.

Page 8: Shoulder Instability Shoulder Instability Presented by: Dr.Abdulrahman Algarni Dr.Abdulrahman Algarni.

DiagnosisDiagnosisIn the acute stage : held in Int Rot & In the acute stage : held in Int Rot &

resist Ex Rot. AP X-Ray : light-bulb resist Ex Rot. AP X-Ray : light-bulb appearance of proximal humerus and appearance of proximal humerus and Axillary veiw if abduction is possible.Axillary veiw if abduction is possible.

Page 9: Shoulder Instability Shoulder Instability Presented by: Dr.Abdulrahman Algarni Dr.Abdulrahman Algarni.

Recurrent instability is almost always a Recurrent instability is almost always a posterior subluxation when the arm posterior subluxation when the arm is held in Flex & Int Rot. is held in Flex & Int Rot. + posterior drawer test + posterior drawer test + posterior apprehension + posterior apprehension test test

Page 10: Shoulder Instability Shoulder Instability Presented by: Dr.Abdulrahman Algarni Dr.Abdulrahman Algarni.

TreatmentTreatmentMany cases are best treated by Many cases are best treated by

physiotherapy. Surgery is indicated physiotherapy. Surgery is indicated with recurrent traumatic or with recurrent traumatic or persistent atrumatic instability with persistent atrumatic instability with no gross joint laxity. Recurrence is no gross joint laxity. Recurrence is upto 50%.upto 50%.

Page 11: Shoulder Instability Shoulder Instability Presented by: Dr.Abdulrahman Algarni Dr.Abdulrahman Algarni.

These include : These include : -Posterior capsulorraphy. -Posterior capsulorraphy. -Posterior bone block. -Posterior bone block. -Posterior glenoid osteotomy -Posterior glenoid osteotomy with excessive glenoid retroversion. with excessive glenoid retroversion.

Page 12: Shoulder Instability Shoulder Instability Presented by: Dr.Abdulrahman Algarni Dr.Abdulrahman Algarni.

Multidirectional InsabilityMultidirectional InsabilityUsually atraumatic ,bilateral , Usually atraumatic ,bilateral ,

associated with ligamentous laxity associated with ligamentous laxity and sometimes weakness of shoulder and sometimes weakness of shoulder muscles.muscles.

Page 13: Shoulder Instability Shoulder Instability Presented by: Dr.Abdulrahman Algarni Dr.Abdulrahman Algarni.

Clinical FeaturesClinical Features- Difficult to diagnose with certainty , - Difficult to diagnose with certainty ,

but is suggested when both anterior but is suggested when both anterior & posterior drawer , apprehension & posterior drawer , apprehension test and sulcus sign are positive test and sulcus sign are positive often with joint laxity elsewhere .often with joint laxity elsewhere .

Page 14: Shoulder Instability Shoulder Instability Presented by: Dr.Abdulrahman Algarni Dr.Abdulrahman Algarni.

TreatmentTreatment- Physiotherapy - Physiotherapy

-Surgical treatment : -Surgical treatment : -Arthroscopic thermal capsular -Arthroscopic thermal capsular shrinkage -Inferior capsular shift .shrinkage -Inferior capsular shift .


Clinical Instability of the Lumbar Spine: Diagnosis and ... Instability of the Lumbar Spine: Diagnosis and Intervention ... clinical instability of the lumbar ... instability were

Clinical Instability of the Lumbar Spine: Diagnosis and ... Instability of the Lumbar Spine: Diagnosis and Intervention ... clinical instability of the lumbar ... instability were

Common Adult Fractures Dr. Abdulrahman Algarni, MD, SSC (Ortho), ABOS Assistant Professor Consultant Orthopedic and Arthroplasty Surgeon.

Common Adult Fractures Dr. Abdulrahman Algarni, MD, SSC (Ortho), ABOS Assistant Professor Consultant Orthopedic and Arthroplasty Surgeon.

BRAIN TUMORS Dr.Abdulrahman Al-Shudifat Neurosurgery Department.

BRAIN TUMORS Dr.Abdulrahman Al-Shudifat Neurosurgery Department.

Software Instability

Software Instability

Elbow instability

Elbow instability

Carpal instability

Carpal instability

Baroclinic Instability

Baroclinic Instability

OVERVIEW AND PRINCIPLES OF RESUSCITATION Collected by Dr.AbdulRahman Alnemri, MD Senior consultant Neonatologist OVERVIEW AND PRINCIPLES OF RESUSCITATION.

OVERVIEW AND PRINCIPLES OF RESUSCITATION Collected by Dr.AbdulRahman Alnemri, MD Senior consultant Neonatologist OVERVIEW AND PRINCIPLES OF RESUSCITATION.

ATLANTOAXIAL INSTABILITY

ATLANTOAXIAL INSTABILITY

Genetic instability

Genetic instability

Shoulder Instability

Shoulder Instability

Dr. Abdulrahman Algarni, MD, SSC (Ortho), ABOS Assistant Professor Consultant Orthopedic and Arthroplasty Surgeon.

Dr. Abdulrahman Algarni, MD, SSC (Ortho), ABOS Assistant Professor Consultant Orthopedic and Arthroplasty Surgeon.

Respiratory Problems in the Newborn Infant: Evaluation and Etiology Dr.AbdulRahman Alnemri, MD Assistance professor Head of Neonatal unit pediatric Department,

Respiratory Problems in the Newborn Infant: Evaluation and Etiology Dr.AbdulRahman Alnemri, MD Assistance professor Head of Neonatal unit pediatric Department,

©Abdullah Mohammed AlGarni 2014 - EPrints€¦ · ©Abdullah Mohammed AlGarni 2014 . iv Dedicated to my family . v ACKNOWLEDGMENTS At the beginning, all praises to ALLAH for helping

©Abdullah Mohammed AlGarni 2014 - EPrints€¦ · ©Abdullah Mohammed AlGarni 2014 . iv Dedicated to my family . v ACKNOWLEDGMENTS At the beginning, all praises to ALLAH for helping

Abdullah Algarni February 23,2009. Parallel Architectures - SISD - SIMD - MIMD - Shared memory systems -Distributed memory machines Physical Organization.

Abdullah Algarni February 23,2009. Parallel Architectures - SISD - SIMD - MIMD - Shared memory systems -Distributed memory machines Physical Organization.

Degenerative Joint Disease Dr. Abdulrahman Algarni, MD, SSC (Ortho), ABOS Assist. Professor, King Saud University Consultant Orthopedic and Arthroplasty.

Degenerative Joint Disease Dr. Abdulrahman Algarni, MD, SSC (Ortho), ABOS Assist. Professor, King Saud University Consultant Orthopedic and Arthroplasty.

Slope Instability

Slope Instability

Exam Corner - online.boneandjoint.org.uk · I. Carpal instability dissociative b II. Carpal instability non-dissociative d III. Carpal instability complex f IV. Carpal instability

Exam Corner - online.boneandjoint.org.uk · I. Carpal instability dissociative b II. Carpal instability non-dissociative d III. Carpal instability complex f IV. Carpal instability

Thermal Instability

Thermal Instability

Acute Joint Dislocation Dr. Abdulrahman Algarni, MD, SSC (Ortho), ABOS Assist. Professor, King Saud University Consultant Orthopedic and Arthroplasty Surgeon.

Acute Joint Dislocation Dr. Abdulrahman Algarni, MD, SSC (Ortho), ABOS Assist. Professor, King Saud University Consultant Orthopedic and Arthroplasty Surgeon.