Football and netball season A review of the apophysis and the acute shoulder: assessment. Simon Locke Sport and Exercise Physician
|
|
- Colin Cecil Griffin
- 5 years ago
- Views:
Transcription
1 Football and netball season A review of the apophysis and the acute shoulder: assessment Simon Locke Sport and Exercise Physician
2 Apophyseal injuries; How to diagnose and manage?
3 Goals for tonight Recognise Skeletal maturity assessment Assess Investigate Manage
4 Apophysis The apophysis is a normal bony outgrowth that arises from a secondary ossification centre and fuses with the bone in course of time. Apophysis a site of tendon or ligament attachment
5 Pelvic apophyses appearance/closing Site Appearance (yrs) Fusing complete (yrs) Iliac crest ASIS Ischium Rossi et al (2001) Average age avulsion fractures 13.8 years Schuett et (2015) Average age avulsion fractures 14.5 years
6 Maturity Risser staging
7 Mechanism apophyseal injuries Timing Peak Height Velocity (12 girls, 14 boys) Bone density weakest Bone grow before MT unit increasing stress at apophysis Acute Avulsion fractures Sprinting, kicking, jumping sports Overuse Long distance running Baseball pitching elbow Gymnastics *Rossi et al 2001
8 Case History Patient Male, 14yrs Event Footy training Sprinting or sprinting to kick Symptoms Sudden onset pain, limp or cannot continue Local tenderness Function loss ROM, strength
9
10 Injury site and prevalence ASIS 30% Males 75% AIIS 49% Males 82% IT 11% Males 82%
11 Relative Percentages of Pelvic Avulsion Fracture Locations Ischial tuberosity 54% AIIS 22% ASIS 19% Pubic Symphysis 3% Iliac Crest 1% Rossi F, Dragoni S. Acute Avulsion Fractures of the Pelvis in Adolescent Competitive Athletes. Skeletal Radiol. 2001;30(3):
12 Fracture type Associations Increasing age / maturity Risser stage 0 - AIIS avulsion 85% of all avulsion injuries Risser 4 ASIS, Iliac Crest 84% Sex (males) 76% of all avulsion fractures Schuett et al 2015
13 Fracture displacement 69% of all fractures displaced <10mm 24% of all fractures displace 10-20mm 7% displaced >20mm Schuett et al 2015
14 Prognosis Multiple fractures (14%) Bilateral avulsion injuries (6%) 98% conservative success Pain > 3 mos 14% (? Recurrence 7%) AIIS most likely 4.47 times Postulates sub spinal impingement, labral injury Non union (2%) Ischial tuberosity >20 mm displacement Schuett et al 2015
15 Assessment Age 14 yr male Sport Mechanism - sudden Examination Local tenderness, ROM, weakness) Plain Xray (AP pelvis, frog leg lateral) Fracture site, displacement Skeletal Maturity Risser Triradiate physis status
16 Management Conservative 98% heal NWB crutches 4-6 weeks Rehabilitation ROM, strength Gradual return to sport (fitness) Return to sport (10-12 weeks)
17 Surgical indications Risk appears 2% Displacement >20mm Persistent pain and disability >3 mos Schuett et al 2015
18 ASIS Avulsion Fracture
19 Ischial Avulsion Fracture 11 yr male sprinting
20 Shoulder Injuries: Acute dislocating Instability
21 Clinical Problem 22 yo footballer Occupation electrician subcontractor/ own business 1 st Dislocated last weekend Relocated in ER Current management IR When can I return to footy? Definitive management Recurrence risk Impact on occupation Football importance
22 Why Bother? Are shoulder and upper limb injuries common? Dislocation Instability How do they happen? Approach to investigations Xr, MR Treatment
23 Shoulder injuries are common in athletes!!
24 QAS Screening injury Prevalence Figure 4: Proportion of QAS athletes with current injuries by anatomical site 47.5% 28.7% 23.8% Head, neck and spine Shoulder girdle and upper limb Pelvis, hip and lower limb
25 Shoulder Injuries in elite College Football (NFL) Shoulder Injury Injury (%) Surgery (%,Y) AC separation Anterior Instability RC tendon Clavicle # 4 0 Posterior Instability 4 78 SLAP 2 40 RC tear SC separation 2 0 MD Instability 2 50 Kaplan AJSM 2005
26 Injury Risk Previous shoulder injury Reported Observed Increasing player experience Athletes have multiple injuries 1.3 per injured player* *Kaplan AJSM 2005
27 Shoulder Anatomy Acromion AC Joint Clavicle Ligaments Subscapularis Tendon Biceps Tendon Coracoid Shoulder Joint
28 Anterior Dislocation mechanism Arm forced into extension, abduction and external rotation (ABER) Ant. capsule stretched torn Humeral head slips anteriorly Acute Injury - Intense pain / Paraesthesia Chronic Injury - Recurrent dislocation Subluxation
29 Anterior Dislocation Sharp contour of shoulder joint Prominent acromion
30 Anterior Dislocation Anterior displacement of humerus Defect of humeral head (HS lesion) Chip fracture of inferior rim of glenoid (Bankart) Glenoid Labrum tear on MRI
31 Natural History Anterior Dislocation Recurrence Age 85-90% recurrence young adults 90% <20 65% (Hovelius) 30% >30 (Simonet and Coldfield) Sport High risk
32 Recurrence after initial dislocation Robinson, C. M. et al. J BJS 2006
33 Anterior Dislocation Treatment Reduction Analgesia ice, analgesics Immobilization ER Surgery Rehabilitation
34 Immobilisation In ER Basic Science Cadaver study, MR Coaptation zone adduction +IR to 30º ER MR Bankart lesion and glenoid closer in ER Clinical Study Recurrence** Immobilisation 3/52 Follow-Up 15.9 mths All (40 yrs) IR (30%), ER (0%) Young (<29 yrs) IR (45%), ER (0%) Apprehension Sign +ve IR (14%), ER (5%) *Itoi JBJS 1999,2001 **Itoi Am Acad OS 2003
35 Acute Dislocation Treatment Decisions Reduction anterior Immobilisation (Recurrence rate) Yes (90%) versus No IR (45%) versus ER (0%)* Surgery, Risk Factors Age, Sport *McCarty Clin Sports Med23,2004
36 Treatment Options Conservative Surgical anterior instability Open versus arthroscopy Quality of life post treatment (work, family) Prospective studies of Recurrence rates Surgery recurrence 4-15% Non Operation recurrence (age related) 30-80%
37 Instability - Clinical problem 22yo footballer electrician (subcontractor/owner) Tackled opponent with arm outside Felt shoulder move Pain on front of shoulder Questions: When can I play again? What treatment do I need?
38 Shoulder Instability Injuries Anterior Inferior Posterior Multidirectional Instability (MDI)
39 Recurrence following self report of instability Self reported PH of instability: Dislocation HR 5.5( ) Instability HR 3.6 ( ) Most common in 1 st 2 years after initial event Cameron et al JBJS 2013
40 Return To Play No Surgery* Is a safe return possible? Is there a difference between dislocation and subluxation injury? Is there a risk of further injury? Can the athlete protect themselves? Do they meet return to play criteria? No Pain Normal ROM Normal Strength, Function, Sports, Skills *McCarty Clin Sports Med23,2004
41 Final scenario Footballer 30 yrs age (final season) Married 2 children (2,4yrs) Own business What is your management? How do I get the best outcome for my patient?
My shoulder popped out what now?
My shoulder popped out what now? Richard Dallalana Epworth Shoulder Symposium June 2017 Shoulder Dislocation First event Best approach? Manual Reduction Should it be put back on field? - YES Prone lying
More informationReview shoulder anatomy Review the physical exam of the shoulder Discuss some common causes of acute shoulder pain Discuss some common causes of
Review shoulder anatomy Review the physical exam of the shoulder Discuss some common causes of acute shoulder pain Discuss some common causes of chronic shoulder pain Review with some case questions Bones:
More informationApophysis. Apophyseal Avulsion. Apophyseal avulsion injuries 3/2/2017
Apophysis 0 Differentiate from Epiphysis: The end of long bones which undergo endochondral ossification to produce longitudinal growth of the bones. i.e. growth plates 0 Apophysis refers to any eminence,
More informationShoulder Labral Tear and Shoulder Dislocation
Shoulder Labral Tear and Shoulder Dislocation The shoulder joint is a ball and socket joint with tremendous flexibility and range of motion. The ball is the humeral head while the socket is the glenoid.
More information3/18/18. Adolescent Hip Injuries. Adolescents with Hip Injuries DISCLOSURES
Adolescent Hip Injuries Henry Bone Ellis, Jr., MD DFW Sports Medicine Symposium March 24, 2018 DISCLOSURES Royalties and stock options Consulting income Smith and Nephew Other support Research on Osteochondritis
More informationRehabilitation Guidelines for Labral/Bankert Repair
Rehabilitation Guidelines for Labral/Bankert Repair The true shoulder joint is called the glenohumeral joint and consists humeral head and the glenoid. It is a ball and socket joint. Anatomy of the Shoulder
More informationManagement of Anterior Shoulder Instability
Management of Anterior Shoulder Instability Angelo J. Colosimo, MD Head Orthopaedic Surgeon University of Cincinnati Athletics Director of Sports Medicine University of Cincinnati Medical Center Associate
More informationSHOULDER INSTABILITY
SHOULDER INSTABILITY Your shoulder is the most flexible joint in your body, allowing you to throw fastballs, lift a heavy suitcase, scratch your back, and reach in almost any direction. Your shoulder joint
More informationCommon Surgical Shoulder Injury Repairs
Common Surgical Shoulder Injury Repairs Mr Ilia Elkinson BHB, MBChB, FRACS (Ortho), FNZOA Orthopaedic and Upper Limb Surgeon Bowen Hospital Wellington Hospital Objectives Review pertinent anatomy of the
More informationThrowing Injuries and Prevention: The Physical Therapy Perspective
Throwing Injuries and Prevention: The Physical Therapy Perspective Andrew M Jordan, PT, DPT, OCS Staff Physical Therapist, Cayuga Medical Center Physical Therapy and Sports Medicine ajordan@cayugamed.org
More informationAnterior Shoulder Instability
Anterior Shoulder Instability Anterior shoulder instability typically results from a dislocation injury to the shoulder joint when the humeral head (ball) of the humerus (upper arm bone) is displaced from
More informationCommon Apophyseal Problems in the Athlete
Disclosure Common Apophyseal Problems in the Athlete Mark Halstead, MD November 19, 2009 Faculty Disclosure Information In the past 12 months, I have no relevant financial relationships with the manufacturer
More informationExternal Rotation Brace Combined with a Physiotherapy Program for First Time Anterior Shoulder Dislocators; a 2 Year Follow Up
External Rotation Brace Combined with a Physiotherapy Program for First Time Anterior Shoulder Dislocators; a 2 Year Follow Up 2010 Bi-Annual SESA Closed Conference DISCLAIMER None of the authors have
More informationFirst-Time Anterior Shoulder Dislocation: Is it time to take a stand?
Evaluation and Treatment of the Injured Athlete Martha s Vineyard July 22nd, 2018 First-Time Anterior Shoulder Dislocation: Is it time to take a stand? Robert A. Arciero, MD Professor, Orthopaedics University
More informationOrthopedics - Dr. Ahmad - Lecture 2 - Injuries of the Upper Limb
The shoulder and the upper arm Fractures of the clavicle 1. Fall on the shoulder. 2. Fall on outstretched hand. In mid shaft fractures, the outer fragment is pulled down by the weight of the arm and the
More informationBody Planes. (A) Transverse Superior Inferior (B) Sagittal Medial Lateral (C) Coronal Anterior Posterior Extremity Proximal Distal
Body Planes (A) Transverse Superior Inferior (B) Sagittal Medial Lateral (C) Coronal Anterior Posterior Extremity Proximal Distal C B A Range of Motion Flexion Extension ADDUCTION ABDUCTION Range of Motion
More informationShoulder Instability. Fig 1: Intact labrum and biceps tendon
Shoulder Instability What is it? The shoulder joint is a ball and socket joint, with the humeral head (upper arm bone) as the ball and the glenoid as the socket. The glenoid (socket) is a shallow bone
More informationSHOULDER INSTABILITY
SHOULDER INSTABILITY Dr.KN Subramanian M.Ch Orth., FRCS (Tr & Orth), CCT Orth(UK) Consultant Orthopaedic Surgeon, Special interest: Orthopaedic Sports Injury, Shoulder and Knee Surgery, SPARSH Hospital
More informationPatient ID. Case Conference. Physical Examination. Image examination. Treatment 2011/6/16
Patient ID Case Conference R3 高逢駿 VS 徐郭堯 55 y/o female C.C.: recurrent right shoulder dislocation noted since falling down injury 2 years ago Came to ER because of dislocation for many times due to minor
More informationShoulder Joint Examination. Shoulder Joint Examination. Inspection. Inspection Palpation Movement. Look Feel Move
Shoulder Joint Examination History Cuff Examination Instability Examination AC Joint Examination Biceps Tendon Examination Superior Labrum Examination Shoulder Joint Examination Inspection Palpation Movement
More informationThe Shoulder Complex. Anatomy. Articulations 12/11/2017. Oak Ridge High School Conroe, Texas. Clavicle Collar Bone Scapula Shoulder Blade Humerus
The Shoulder Complex Oak Ridge High School Conroe, Texas Anatomy Clavicle Collar Bone Scapula Shoulder Blade Humerus Articulations Sternoclavicular SC joint. Sternum and Clavicle. Acromioclavicular AC
More informationSLAP Lesions Assessment & Treatment
SLAP Lesions Assessment & Treatment Kevin E. Wilk,, PT, DPT Glenoid Labral Lesions Introduction Common injury - difficult to diagnose May occur in isolation or in combination SLAP lesions: Snyder: Arthroscopy
More informationWEEKEND 2 Shoulder. Shoulder Active Range of Motion Assessment
Virginia Orthopedic Manual Physical Therapy Institute - 2016 Technique Manual WEEKEND 2 Shoulder Shoulder Active Range of Motion Assessment - Patient Positioning: Standing, appropriately undressed so that
More informationRehabilitation Guidelines for Anterior Shoulder Reconstruction with Arthroscopic Bankart Repair
UW HEALTH SPORTS REHABILITATION Rehabilitation Guidelines for Anterior Shoulder Reconstruction with Arthroscopic Bankart Repair The anatomic configuration of the shoulder joint (glenohumeral joint) is
More informationTHE HIP. Cooler than cool, the pinnacle of what is "it". Beyond all trends and conventional coolness.
THE HIP Cooler than cool, the pinnacle of what is "it". Beyond all trends and conventional coolness. Objectives Hip anatomy Causes of hip pain Hip exam Anatomy Bones Ilium Anterior Superior Iliac Spine
More informationShoulder Instability and Tendon Injuries
Shoulder Instability and Tendon Injuries Shoulder Update Spire Hospital Leeds November 2017 Simon Boyle Consultant Shoulder and Elbow Surgeon Simon Boyle York and Leeds Nuffield Trained in Yorkshire, Annecy,
More informationRehabilitation Guidelines for Anterior Shoulder Reconstruction with Open Bankart Repair
UW HEALTH SPORTS REHABILITATION Rehabilitation Guidelines for Anterior Shoulder Reconstruction with Open Bankart Repair The anatomic configuration of the shoulder joint (glenohumeral joint) is often compared
More informationMRI SHOULDER WHAT TO SEE
MRI SHOULDER WHAT TO SEE DR SHEKHAR SRIVASTAV Sr. Consultant- Knee & Shoulder Arthroscopy Sant Parmanand Hospital Normal Anatomy Normal Shoulder MRI Coronal Oblique Sagital Oblique Axial Cuts Normal Coronal
More informationRehabilitation Guidelines for Open Latarjet Anterior Shoulder Stabilization
UW HEALTH SPORTS REHABILITATION Rehabilitation Guidelines for Open Latarjet Anterior Shoulder Stabilization The anatomic configuration of the shoulder joint (glenohumeral joint) is often compared to a
More informationApophysiolysis of the pelvic area in adolescents.
Apophysiolysis of the pelvic area in adolescents. Poster No.: C-0077 Congress: ECR 2014 Type: Educational Exhibit Authors: R. Derks, R. E. Westerbeek, R. Van Dijk; Deventer/NL Keywords: Musculoskeletal
More informationDisclosure. Traumatic Anterior Shoulder Instability 7/23/2018. Orthopaedics for the Primary Care Practitioner & Rehabilitation Therapist
Orthopaedics for the Primary Care Practitioner & Rehabilitation Therapist Christopher E. Baker M.D. Sports Medicine Shoulder Reconstruction Traumatic Anterior Shoulder Instability Disclosure Speaking/Consulting
More informationThe Shoulder. Anatomy and Injuries PSK 4U Unit 3, Day 4
The Shoulder Anatomy and Injuries PSK 4U Unit 3, Day 4 Shoulder Girdle Shoulder Complex is the most mobile joint in the body. Scapula Clavicle Sternum Humerus Rib cage/thorax Shoulder Girdle It also includes
More informationTreatment of Primary Anterior Shoulder Dislocation: Conflicting Study Outcomes. Prof. C. Milgrom Hadassah University Hospital Jerusalem, Israel
Treatment of Primary Anterior Shoulder Dislocation: Conflicting Study Outcomes Prof. C. Milgrom Hadassah University Hospital Jerusalem, Israel I. Natural history of shoulder dislocation and traditional
More informationDiagnostic and Management Approach to the Painful Shoulder
Diagnostic and Management Approach to the Painful Shoulder Introduction What conditions causing shoulder pain commonly present in General Practice? Subacromial impingement Rotator cuff tears AC joint pathology
More informationThis presentation is the intellectual property of the author. Contact them at for permission to reprint and/or distribute.
January 19, 2012 John W. Hinchey, MD Dept of Orthopaedic Surgery Shoulder & Elbow Service This live activity is designated for a maximum of 1 AMA PRA Category 1 Credit tm. Physicians should claim only
More informationShoulder Instability
J F de Beer, K van Rooyen, D Bhatia Shoulder Instability INSTABILITY means that the shoulder dislocates completely (dislocation) or partially (subluxation). Anatomy The shoulder consists of a ball (humeral
More informationAnatomy GH Joint. Glenohumeral Instability. Components of Stability. Components of Stability 7/7/2017. AllinaHealthSystem
Glenohumeral Instability Dr. John Steubs Allina Sports Medicine Conference July 7, 2017 Anatomy GH Joint Teardrop or oval shape Inherently unstable Golf ball and tee analogy Stabilizers Static Dynamic
More informationCOMMON KNEE AND SHOULDER INJURIES IN THE YOUNG ATHLETE. Outline 5/11/2017
COMMON KNEE AND SHOULDER INJURIES IN THE YOUNG ATHLETE IRVING RAPHAEL MD Syracuse Orthopedic Specialists Former S.U. Head Team Physician May 19, 2017 Meniscal Injuries anatomy Exam Treatment ACL Injuries
More informationElbow Injuries in Young Athletes!
Elbow Injuries in Young Athletes! Andrew Martin DO, MBA, CAQSM! Director Sports Medicine Campbell University! Head Team Physician, Associate Professor Sports Medicine Disclosures None based on the content
More informationSports Medicine: Shoulder Arthrography. Christine B. Chung, M.D. Professor of Radiology Musculoskeletal Division UCSD and VA Healthcare System
Sports Medicine: Shoulder Arthrography Christine B. Chung, M.D. Professor of Radiology Musculoskeletal Division UCSD and VA Healthcare System Disclosure Off-label use for gadolinium Pediatric Sports Injuries
More informationTypes of shoulder Dislocation: Shoulder dislocation. 1. Anterior 2. Posterior 3. Luxatio erecta (inferior dislocation)
Types of shoulder Dislocation: Shoulder dislocation 1. Anterior 2. Posterior 3. Luxatio erecta (inferior dislocation) Anterior Dislocation: head is dislocated anterior to the glenoid Most common among
More informationChronic Shoulder Instability
Chronic Shoulder Instability The shoulder is the most moveable joint in your body. It helps you to lift your arm, to rotate it, and to reach up over your head. It is able to turn in many directions. This
More informationShoulder Injuries: Treatments that Work, Do Not Work, and When ENOUGH is Enough? Mark Ganjianpour, M.D. Beverly Hills, CA April 20, 2012
Shoulder Injuries: Treatments that Work, Do Not Work, and When ENOUGH is Enough? Mark Ganjianpour, M.D. Beverly Hills, CA April 20, 2012 Multiaxial ball and socket Little Inherent Instability Glenohumeral
More informationRehabilitation Guidelines for Arthroscopic Capsular Shift
UW HEALTH SPORTS REHABILITATION Rehabilitation Guidelines for Arthroscopic Capsular Shift The anatomic configuration of the shoulder joint (glenohumeral joint) is often compared to a golf ball on a tee.
More informationShoulder and Elbow ORTHOPAEDIC SYPMPOSIUM APRIL 8, 2017 DANIEL DOTY MD
Shoulder and Elbow ORTHOPAEDIC SYPMPOSIUM APRIL 8, 2017 DANIEL DOTY MD Shoulder Articulations Glenohumeral Joint 2/3 total arc of motion Shallow Ball and Socket Joint Allows for excellent ROM Requires
More informationI (and/or my co-authors) have something to disclose.
Shoulder Anatomy And Biomechanics Nikhil N Verma, MD Director of Sports Medicine Professor, Department of Orthopedics Rush University Team Physician, Chicago White Sox and Bulls I (and/or my co-authors)
More informationShoulder Injuries. Glenoid labrum injuries. SLAP Lesions
Shoulder Injuries functional anatomy clinical perspective impingement rotator cuff injuries glenoid labrum injuries dislocation Glenoid labrum injuries SLAP lesions stable or unstable traction/compression
More informationP.O. Box Sierra Park Road Mammoth Lakes, CA Orthopedic Surgery & Sports Medicine
P.O. Box 660 85 Sierra Park Road Mammoth Lakes, CA 93546 SHOULDER: Instability Dislocation Labral Tears The shoulder is the most mobile joint in the body, but to have this amount of motion, it is also
More informationChronic Shoulder Disorders
Chronic Shoulder Disorders Dr. Mustafa Elsingergy Consultant orthopedic surgeon Dallah Hospita Prof. Mamoun Kremli Almaarefa Medical College Contents INTRINSIC Shoulder Pain Due to causes in the shoulder
More informationApply this knowledge into proper management strategies and referrals
1 2 3 Lower Extremity Injuries Jason Kennedy, M.D. Disclosures I have no financial/ industry disclosures. Objectives Identify common lower extremity injury patterns in the child and adolescent Apply this
More informationOBJECTIVES. Therapists Management of Shoulder Instability SHOULDER STABILITY SHOULDER STABILITY WHAT IS SHOULDER INSTABILITY? SHOULDER INSTABILITY
Therapists Management of Shoulder Instability Brian G. Leggin, PT, DPT, OCS Lead Therapist, Penn Therapy and Fitness at Valley Forge Adjunct Assistant Professor, Department of Orthopaedics, University
More informationShoulder Injury Evaluation.
Shoulder Injury Evaluation www.fisiokinesiterapia.biz Basic Anatomy & Kinesiology 3 Bone Structures Clavicle Scapula Humerus Evaluation Principles Always follow a standard progression Determine the target
More informationThe suction cup mechanism is enhanced by the slightly negative intra articular pressure within the joint.
SHOULDER INSTABILITY Stability A. The stability of the shoulder is improved by depth of the glenoid. This is determined by: 1. Osseous glenoid, 2. Articular cartilage of the glenoid, which is thicker at
More informationChristopher A Brown, MD Sports Medicine Orthopedist. Duke Orthopedic Residency Sports Medicine Fellowship Stanford
Christopher A Brown, MD Sports Medicine Orthopedist Duke Orthopedic Residency Sports Medicine Fellowship Stanford Office Geneva Newark Opening Canandaigua and Penfield Topics Of Discussion Shoulder dislocation
More informationOrthopaedic and Spine Institute 21 Spurs Lane, Suite 245, San Antonio, TX Tel#
Orthopaedic and Spine Institute 21 Spurs Lane, Suite 245, San Antonio, TX 78240 www.saspine.com Tel# 210-487-7463 PATIENT GUIDE TO SHOULDER INSTABILITY LABRAL (BANKART) REPAIR / CAPSULAR SHIFT WHAT IS
More informationThe shoulder that won t get better.
The shoulder that won t get better. www.fisiokinesiterapia.biz Shoulder Injuries Acute Chronic Acute shoulder injuries Instability Labral pathology (SLAP lesions) Fractures (clavicle, scapula, humerus)
More informationCase Report Iliac Crest Avulsion Fracture in a Young Sprinter
Case Reports in Orthopedics Volume 2015, Article ID 302503, 4 pages http://dx.doi.org/10.1155/2015/302503 Case Report Iliac Crest Avulsion Fracture in a Young Sprinter L. Casabianca, 1 R. Rousseau, 1 P.
More informationManagement of Humeral Bone Loss in Anterior Shoulder Instability. Scott D. Mair, MD University of Kentucky Sports Medicine
Management of Humeral Bone Loss in Anterior Shoulder Instability Scott D. Mair, MD University of Kentucky Sports Medicine Disclosure Smith and Nephew Endoscopy fellowship support Importance Bone loss (glenoid
More informationChallenges in Return to Play. Emily Harold, MD
Challenges in Return to Play Emily Harold, MD Learning Objectives Learn pediatric evidence regarding return to activity Develop strategies to aid in return to play decision making Goals of return to play
More informationMSK Radiology Interesting Case Presentation
MSK Radiology Interesting Case Presentation Sitt Ching Man Jacqueline 27 th Feb 2015 Patient 1: YPY F/27 Professional badminton player C/o sudden onset of right shoulder pain after a very vigorous match
More informationPage 1. Shoulder Injuries in Sports.
www.schulterteam.ch Shoulder Injuries in Sports Matthias A Zumstein Shoulder, Elbow and Orthopaedic Sports Medicine Department of Orthopedic Surgery and Traumatology University of Berne, Switzerland matthias.zumstein@insel.ch
More informationRicki Shah, M.D., Nirav Shelat, D.O., Georges Y. El-Khoury, M.D., D. Lee Bennett, M.A., M.B.A., M.D.
vulsion Injuries of the Pelvis Ricki Shah, M.D., Nirav Shelat, D.O., Georges Y. El-Khoury, M.D., D. Lee ennett, M.., M..., M.D. Division of Musculoskeletal Radiology, University of Iowa Hospitals & linics,
More informationPOSTERIOR INSTABILITY OF THE SHOULDER Vasu Pai
POSTERIOR INSTABILITY OF THE SHOULDER Vasu Pai Posterior instability is less common among cases of shoulder instability, accounting for 2% to 10% of all cases of instability. More common in sporting groups:
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Abduction pillow, ultrasling, 880, 881, 882, 883 Adolescents, shoulder instability in. See Shoulder, instability of, pediatric and adolescent.
More informationJoint G*H. Joint S*C. Joint A*C. Labrum. Humerus. Sternum. Scapula. Clavicle. Thorax. Articulation. Scapulo- Thoracic
A*C Joint Scapulo- Thoracic Articulation Thorax Sternum Clavicle Scapula Humerus S*C Joint G*H Joint Labrum AC Ligaments SC Ligaments SC JOINT AC Coracoacromial GH GH Ligament Complex Coracoclavicular
More informationAnterior Inferior Iliac Spine Avulsion Fracture in an Adolescent Runner: A Case Report
Iliac spine avulsion fracture of adolescent 35 Anterior Inferior Iliac Spine Avulsion Fracture in an Adolescent Runner: A Case Report Lu-Wen Chen 1, Szu-Erh Chan 2 Anterior inferior iliac spine avulsion
More informationShoulder Pain: Diagnosis and Management
Shoulder Pain: Diagnosis and Management Thomas J. Gill, M.D. Director, Boston Sports Medicine and Research Institute Associate Professor of Orthopedic Surgery Tufts Medical School www.bostonsportsmedicine.com
More informationRotator Cuff Pathology. Shoulder Instability. Adhesive Capsulitis. AC Joint Dysfunction
Shoulder Pain Red Flags Unexplained deformity or swelling Significant weakness not due to pain Suspected malignancy Fever/chills/malaise Significant/unexplained sensory/motor deficit Pulmonary or vascular
More informationPosterior Shoulder Instability
Posterior Shoulder Instability Robert A. Arciero, MD Professor of Orthopaedics University of Connecticut USA Classification of Posterior Instability Dislocation -acute -chronic- fixed or locked Subluxation
More information4/12/2016. Goals. Anatomy. Basic Anatomy. Biomechanics. Function. Traumatic Rupture of Proximal Biceps: In-season Rehabilitation and Management
Goals Traumatic Rupture of Proximal Biceps: In-season Rehabilitation and Management Thomas F. LaPorta, MD To understand the anatomy of the biceps at the shoulder To present the mechanism, signs and symptoms,
More informationShoulder Pathologies
Shoulder Pathologies In its early stages, AC joint osteoarthritis usually causes pain and tenderness in the front of the shoulder around the joint. The pain is often worse when the arm is brought
More informationR. Frank Henn III, MD. Associate Professor Chief of Sports Medicine Residency Program Director
R. Frank Henn III, MD Associate Professor Chief of Sports Medicine Residency Program Director Disclosures No financial relationships to disclose 1. Labral anatomy 2. Adaptations of the throwing shoulder
More informationSHOULDERS MADE DR DR CHRIS MILNE SPORTS PHYSICIAN
SHOULDERS MADE SHOULDERS MADE SIMPLE SIMPLE Yeah Right DR DR CHRIS MILNE MILNE SPORTS PHYSICIAN SPORTS PHYSICIAN Yeah Right SHOULDER ANATOMY OUTLINE History Examination Investigations MY SHOULDER HURTS!
More informationUpper Extremity Injuries in Youth Baseball: Causes and Prevention
Upper Extremity Injuries in Youth Baseball: Causes and Prevention Biomechanics Throwing a baseball is an unnatural movement Excessively high forces are generated at the elbow and shoulder Throwing requires
More informationRehabilitation Protocol: Arthroscopic Anterior Capsulolabral Repair of the Shoulder - Bankart Repair Rehabilitation Guidelines
Rehabilitation Protocol: Arthroscopic Anterior Capsulolabral Repair of the Shoulder - Bankart Repair Rehabilitation Guidelines Department of Orthopaedic Surgery Lahey Hospital & Medical Center, Burlington
More informationGlenohumeral Joint Instability. Static Stabilizers of the GHJ. Static Stabilizers of the GHJ. Static Stabilizers of the GHJ
1 Glenohumeral Joint Instability GHJ Joint Stability: Or Lack Thereof! Christine B. Chung, M.D. Assistant Professor of Radiology Musculoskeletal Division UCSD and VA Healthcare System Static Stabilizers
More informationShoulder Case Studies
Shoulder Case Studies Eden Raleigh Orthopaedic Surgeon Shoulder & Knee Surgery Ph: 9421 1900 0402697115 dredenraleigh@gmail.com My Background Specialising in Shoulder and Knee Surgery Main focus on Arthroscopic/Sports
More informationGlenohumeral Joint Instability: An Athlete s Perspective
Anatomic Considerations Glenohumeral Joint Instability: An Athlete s Perspective Michael D. Loeb, MD Texas Orthopedics, Sports Medicine, and Rehabilitation Associates Austin, Texas Static Stabilizers Osseous
More informationA Patient s Guide to Shoulder Dislocations
A Patient s Guide to Shoulder Dislocations 20295 NE 29th Place, Ste 300 Aventura, FL 33180 Phone: (786) 629-0910 Fax: (786) 629-0920 admin@instituteofsports.com DISCLAIMER: The information in this booklet
More informationAcute Orthopaedic Injuries Developing a Diagnostic Approach to the Shoulder
Acute Orthopaedic Injuries Developing a Diagnostic Approach to the Shoulder WWW.FISIOKINESITERAPIA.BIZ Overview To be able to quickly categorize shoulder injuries To take appropriate history and conduct
More informationP V S MEMORIAL HOSPITAL LTD.
SHOULDER XRAYS Instability Series o True AP (Grashey s) o Axillary o Stryker Notch view o True AP in Internal rotation o Scapular Y view o West Point view for Bony Bankart ( looks like modif axillary view)
More informationStefan C Muzin, MD PM&R Attending Physician, Beth Israel Deaconess Medical Center, Harvard Medical School Onsite Physiatrist, GE Aviation, Lynn, MA
Stefan C Muzin, MD PM&R Attending Physician, Beth Israel Deaconess Medical Center, Harvard Medical School Onsite Physiatrist, GE Aviation, Lynn, MA Consultant, OEHN (Occupational and Environmental Network)
More informationEVALUATION OF ACUTE SHOULDER INJURIES. Douglas J. Moran, MD Orthopaedic Sports Medicine
EVALUATION OF ACUTE SHOULDER INJURIES Douglas J. Moran, MD Orthopaedic Sports Medicine DISCLOSURES None of the planners or presenters of this session have disclosed any conflict or commercial interest
More informationSHOULDER INSTABILITY
Disclaimer This movie is an educational resource only and should not be used to manage Orthopaedic health. All decisions about the management of Shoulder Instability must be made in conjunction with your
More informationLower Extremity Sports Injuries
Lower Extremity Sports Injuries AAP Musculoskeletal Boot Camp Sigrid F. Wolf, MD Pediatric Sports Medicine Fellow Northwestern University Lurie Children s Hospital Disclosure I have no relevant financial
More informationRN(EC) ENC(C) GNC(C) MN ACNP *** MECHANISM OF INJURY.. MOST IMPORTANT ***
HISTORY *** MECHANISM OF INJURY.. MOST IMPORTANT *** Age - Certain conditions are more prevalent in particular age groups (i.e. Full rotator cuff tears are more common over the age of 45, traumatic injuries
More informationUPPER EXTREMITY INJURIES. Recognizing common injuries to the upper extremity
UPPER EXTREMITY INJURIES Recognizing common injuries to the upper extremity ANATOMY BONES Clavicle Scapula Spine of the scapula Acromion process Glenoid fossa/cavity Humerus Epicondyles ANATOMY BONES Ulna
More informationThe Shoulder. By Patrick Ryan, Bobby Law, Jack Beaty, Alex Newhouse and Chuck Nelson
The Shoulder By Patrick Ryan, Bobby Law, Jack Beaty, Alex Newhouse and Chuck Nelson Learning Objectives/Agenda Review the anatomy of the shoulder Describe the main diseases of the shoulder Describe the
More informationIntern Arthroscopy Course 2015 Shoulder Arthroscopy Cases
Intern Arthroscopy Course 2015 Shoulder Arthroscopy Cases Mary Lloyd Ireland, M.D. University of Kentucky Dept. of Orthopaedic Surgery & Sports Medicine Lexington, KY Broken screw s/p Bristow procedure
More informationSHOULDER INJURIES Mr. McKay Athletic Training. References: BY. GA EUL JUNG
SHOULDER INJURIES Mr. McKay Athletic Training References: BY. GA EUL JUNG Shoulder Joint Bones of the Shoulder Ball & Socket joint consisting of: Scapula Humerus Clavicle Sternum Joints of the Shoulder
More informationHAGL lesion of the shoulder
HAGL lesion of the shoulder A 24 year old rugby player presented to an orthopaedic surgeon with a history of dislocation of the left shoulder. It reduced spontaneously and again later during the same match.
More informationGlenohumeral Capsule Tears in Baseball Pitchers
Glenohumeral Capsule Tears in Baseball Pitchers Christopher S. Ahmad, MD Professor Orthopedic Surgery Chief Sports Medicine Head Team Physician New York Yankees New York City Football Club Disclosure 1.
More informationAcute Management of Shoulder Dislocation. Mr. Paul Halliwell Royal Surrey County Hospital, Guildford.
Acute Management of Shoulder Dislocation Mr. Paul Halliwell Royal Surrey County Hospital, Guildford. Acute: Injury to rehab. Management: Hx, O/E, x-ray, Rx Shoulder: Glenohumeral Dislocation: Complete
More informationRecurrent Shoulder Dislocation.
Recurrent Shoulder Dislocation www.fisiokinesiterapia.biz Anatomy of the Shoulder Shoulder Dislocations Case Study Rehabilitation Pick List Anatomy of the Shoulder Articulations Sternoclavicular Acromioclavicular
More information---Start of Pediatric and Adolescent Upper Extremity Fractures---
Presented by: Mary Lloyd Ireland Professor Dept. of Orthopaedic Surgery and Sports Medicine University of Kentucky Lexington KY www.marylloydireland.com ---Start of Pediatric and Adolescent Upper Extremity
More informationFirst practical session. Bones of the gluteal region
First practical session 2017 Bones of the gluteal region The Hip bone The hip bone is made of: 1 The ilium: superior in position 2 The ischium:postero-inferior in position 3 The pubis: antero-inferior
More informationLawrence Gulotta Gillian Lieberman, MD October Gillian Lieberman, MD. Shoulder Imaging. Lawrence V. Gulotta, HMS IV 10/16/02
October 2002 Shoulder Imaging Lawrence V. Gulotta, HMS IV 10/16/02 Goals Review Anatomy of the Shoulder -Dynamic Stabilizers -> Rotator Cuff -Static Stabilizers -> Labrum and Capsule Systematic Approach
More informationThe Cryo/Cuff provides two functions: 1. Compression - to keep swelling down. 2. Ice Therapy - to keep swelling down and to help minimize pain. Patien
The Cryo/Cuff provides two functions: 1. Compression - to keep swelling down. 2. Ice Therapy - to keep swelling down and to help minimize pain. Patients, for the most part, experience less pain and/or
More informationMastering the Musculoskeletal Exam UCSF Essentials of Women s Health July 7, 2016 Carlin Senter, M.D. Henry Crevensten, M.D.
Mastering the Musculoskeletal Exam UCSF Essentials of Women s Health July 7, 2016 Carlin Senter, M.D. Henry Crevensten, M.D. I have nothing to disclose Outline Knee exam Shoulder exam Knee Anatomy The
More information