American Shoulder and Elbow Surgeons
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Technique guide are not considered high yield topics for orthopaedic standardized exams including the ABOS, EBOT and RC.
Following open pectoralis major transfer to address chronic subscapularis insufficiency, which of the following movements would most likely show weakness if an iatrogenic nerve injury occurred during the pectoralis transfer?
Shoulder external rotation
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A 75-year-old retired carpenter has had 2 years of increasing left shoulder pain and intermittent swelling of the left shoulder as shown in Figure A. He is right-hand dominant and an avid bowler. He denies constitutional symptoms. Physical examination reveals 80 degrees of active forward flexion and 170 degrees of passive range of motion. Palpation of the left shoulder reveals subcutaneous fluid with no distinct mass. A radiograph is shown in Figure B. What is the next most appropriate step in management?
Biopsy and referral to orthopaedic oncologist
Reverse total shoulder arthroplasty
Arthrocentesis of the shoulder with aspirate submitted for cell count and differential
Conventional unconstrained total shoulder arthroplasty
Cervical spine MRI to evaluate for the presence of a syrinx
A 75-year-old, right-hand-dominant female has a chronic rotator cuff tear and shoulder pain for 10 years which has failed conservative treatment. A radiograph is shown in Figure A. Your examination and further imaging will help you to decide between which of the following pairs of surgical options for this patient?
hemiarthroplasty or total shoulder arthroplasty
reverse total shoulder or total shoulder arthroplasty
hemiarthroplasty or reverse total shoulder arthroplasty
total shoulder arthroplasty or glenohumeral arthrodesis
total shoulder arthroplasty or scapulothoracic arthrodesis
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Superior Capsular ReconstructionRobert U. Hartzler, MD(ASES,2)
HPI - 50M, RHD.
Known history of rotator cuff tear about 2 years ago.
History of 3 prior right shoulder surgeries (? RCR).
History of successful RCR on opposite (left) shoulder >1.5 years ago.
+ painful ADLS, + night pain, + pain with overhead activities.
Difficulty raising his right arm in forward flexion and abduction. Significant weakness.
How would you manage this patient?