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Surgery 1 - Third Year BHMS

Contents

Surgery 1 - Third Year BHMS

Contents

CoursesBHMSSurgery 1 - Third Year BHMSINJURY AROUND SHOULDER AND FRACTURE OF HUMERUS

INJURY AROUND SHOULDER AND FRACTURE OF HUMERUS

Content

Anatomy of Shoulder and Humerus

  • The shoulder joint is a synovial ball-and-socket joint formed by the articulation of the head of the humerus and the glenoid cavity of the scapula.
  • The humerus is the longest bone in the upper limb, extending from the scapula to the elbow.
  • The shoulder joint is stabilized by the rotator cuff muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) and the glenohumeral ligaments.

Classification of Shoulder Injuries and Humerus Fractures

  • Shoulder injuries:
    • Acute injuries: fractures, dislocations, and soft tissue injuries.
    • Chronic injuries: osteoarthritis, tendinitis, and bursitis.
  • Humerus fractures:
    • Intracapsular fractures: fractures that occur within the shoulder joint capsule.
    • Extracapsular fractures: fractures that occur outside the shoulder joint capsule.

Clinical Signs

  • Shoulder injuries:
    • Pain and tenderness in the shoulder region.
    • Limited range of motion and weakness in the shoulder joint.
    • Abnormal mobility and instability of the shoulder joint.
  • Humerus fractures:
    • Pain and tenderness in the upper arm.
    • Limited range of motion in the elbow and shoulder joint.
    • Deformity and swelling in the upper arm.

Emergency Management

  • Stabilization of the shoulder joint using a sling or a splint.
  • Immobilization of the affected limb using a cast or a splint.
  • Administration of pain relief medication.
  • Evaluation and management of any associated injuries.

Complications

  • Shoulder injuries:
    • Adhesive capsulitis (frozen shoulder).
    • Osteoarthritis.
    • Rotator cuff tears.
  • Humerus fractures:
    • Compartment syndrome.
    • Nerve damage (radial nerve, axillary nerve, or brachial plexus).
    • Vascular damage (artery or vein).

Clinical Examination

  • Inspection: evaluation of the shoulder joint and upper arm for deformity, swelling, and bruising.
  • Palpation: evaluation of the shoulder joint and upper arm for tenderness and swelling.
  • Range of motion: evaluation of the shoulder joint and elbow for limited mobility.
  • Strength testing: evaluation of the shoulder joint and upper arm for weakness.
  • Neurovascular examination: evaluation of the radial nerve, axillary nerve, and brachial plexus for damage.

Investigations

  • X-ray: evaluation of the shoulder joint and upper arm for fractures and dislocations.
  • CT scan: evaluation of the shoulder joint and upper arm for complex fractures.
  • MRI: evaluation of the shoulder joint and upper arm for soft tissue injuries (ligaments, tendons, and muscles).
  • Arthrography: evaluation of the shoulder joint for tears in the rotator cuff and labrum.

Treatment

  • Conservative management:
    • Immobilization using a sling or a splint.
    • Pain relief medication.
    • Physical therapy to restore range of motion and strength.
  • Surgical management:
    • Reduction of dislocations and fractures.
    • Repair of soft tissue injuries (ligaments, tendons, and muscles).
    • Replacement of the shoulder joint (arthroplasty).

Homoeopathic Therapeutic Approach

  • Arnica montana: for pain and inflammation.
  • Rhus toxicodendron: for stiffness and limited mobility.
  • Bryonia alba: for pain and inflammation.
  • Hypericum perforatum: for nerve damage and numbness.
  • Phosphorus: for trauma and shock.

Indications

  • Acute shoulder injuries and fractures.
  • Chronic shoulder injuries and osteoarthritis.
  • Soft tissue injuries (ligaments, tendons, and muscles).
  • Nerve damage and numbness.
  • Trauma and shock.