The rotator cuff is formed by four muscles and tendons surrounding the shoulder joint giving it dynamic stability. There are many degrees of injury from mild tendon involvement, to partial or complete rupture, arthropathy, and massive rotator cuff rupture. Muscle atrophy and weakness can also be seen and tears may be accompanied by biceps tendon rupture or shoulder instability.
It is a common injury in the general population but especially with people or athletes who perform repeated overhead motions. There is also an increased risk with age.
The glenohumeral joint is one of the most mobile and complex joints in the body, with the greatest range of motion and the one that most frequently dislocates. Dislocation can be either acute or from recurrent instability and the most frequent complication of dislocation is its recurrence. There are different classifications to assess instability, depending on grade, chronology, trauma and direction of the dislocation.
This is an injury to the upper labrum. The labrum is a fibrocartilaginous ring that surrounds and adheres to the glenoid giving stability to the joint. The biceps tendon also attaches to the labrum.
Injuries can be in the front or in the back of the labrum and may involve the biceps tendon. It is common in athletes as an overload trauma or repetitive shoulder motion. Many however are the result of a slow wearing down of the labrum over time and an aging process.
This is an inflammation of the subacromial space in the shoulder joint due to compression of a rotator cuff structure against another near-lying structure such as the acromioclavicular joint or acromiocoracoid ligament. It is usually due to overuse of the shoulder, aging of the rotator cuff or alterations of the subacromial space and glenohumeral or scapulothoracic instability.
Treatment is similar to that of rotator cuff injuries.
This is a compression of the peripheral nerve from the C5-C6 brachial plexus branch. It is a motor nerve which innervates the supra and infraspinatus muscles, causing interruption of the nerve impulse. It is rare and difficult to treat, producing a diffuse deep pain in the shoulder radiating to the neck and arm, with atrophy of the muscles that it innervates. It may occur in association with paralabral cysts and rotator cuff tears.
These fractures are caused by indirect trauma and occasionally by direct seizures or electric shock. They are very frequent and account for 4-6% of all fractures. There may also be associated lesions of the axillary nerve. They are classified depending on location of the fracture and number of segments.
Treatment is always determined on a case by case basis.
Most of these fractures are caused by direct high energy trauma or by low energy trauma in elderly women. It can be classified according to skin integrity, fracture line, whether it is complete, if there is associated neurovascular injury and if it is due to a concomitant disease.
These fractures affect the distal part of the humerus and are classified as Extra-articular fractures, (supracondylar and transcondylar), Condylar fractures and Supra Intercondylar (intra-articular).