Ortho 2 Exam 2 (LLAF and shoulder) --> Shoulder Conditions (AC and SC Joint Injuries)

what is an AC joint injury?

- shoulder separation

- more common in males

are AC or SC joint injuries more common?

AC

traumatic mechanism to AC joint injury

- direct fall on tip of shoulder

- FOOA

atraumatic mechanism to AC joint injury

- repetitive overhead activities (especially swimming, throwing, tennis)

what are symptoms of an AC joint injury

- localized AC pain (especially with cross body motions)

how to observe AC joint injury

- look for the step off deformity at AC joint (grades II+-IV)

what mobility impairments are there with AC joint injuries?

- horizontal add

- (+) cross arm test

- (+) AC sheer test

- tenderness to palpation

- hypermobility / instability

what are the indications for non-surgical AC joint treatment?

- grades I-II

- grade III is controversial

> depends on pty activity level

what is non-surgical treatment for AC injuries?

- immobilization

> grades I and II: 0-2 weeks

> grades III and IV: 2-6 weeks

- pain control

- ther ex

> mobility and strength

- bracing

what bracing can be done for non-surgical AC joint injuries?

- AC donut pad

> protects the joint by having padding around the joint so that contact does not go straight through the joint but is rather spread out around it

indications for AC joint surgery

- severe type III

- types IV-V

epidemiology of SC joint injuries

- less common than AC

- more common in young men

what SC joint injury is more common: anterior or posterior dislocation injury?

anterior

SC joint is an attachment of shoulder to axial skeleton, so it effects shoulder complex motion

how many types of SC joint injuries are there?

- 3 types

- type 2 and 3 both have A and B

mechanism of SC joint injuries

- traumatic

> MVA

> sports

what are the SC joint pathologies? (4)

- retrosternal dislocation (EMERGENCY)

- ligament sprain

- joint arthritis

- disc injury

interventions for SC joint injury

- immobilization with sling (days to weeks depending on grade)

- pain control

- progressive ROM (early focus is avoiding stress on joint at end range)

- strengthening (initially isometric within pain tolerance, progress to isotonic)