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Review Question - QID 543

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QID 543 (Type "543" in App Search)
A 68-year-old woman undergoes a hemiarthroplasty for a proximal humerus fracture through a deltopectoral approach. What range of motion exercise should not be utilized in the immediate postoperative period due to concerns about lesser tuberosity fixation?

Pendulums

1%

10/670

Passive internal rotation of the shoulder to the plane of the body

21%

140/670

Active forearm supination

1%

5/670

Passive external rotation of the shoulder past 30 degrees

71%

476/670

Passive forward flexin of the shoulder to 90 degrees

3%

19/670

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Frankle et al found that passive external rotation of the shoulder placed the most stress on the lesser tuberosity fixation. The subscapularis tendon inserts on the lesser tuberosity and is the deforming force when placed under tension during external rotation. They also found that non-anatomic tuberosity reduction of 4-part proximal humerus fractures treated with hemiarthroplasty increased torque and impaired external rotation kinematics.

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