The Axillary nerve supplies the Deltoid muscle & the muscle is responsible for shoulder abduction movement. In clinical practice to test nerve motor function: test resisted shoulder abduction with arm at 90° abducted position.
A: Unifocal, extra-articular, 2-part, intact blood supply
B: Bifocal, extra-articular, possible injury to blood supply
C: Articular, involving anatomic neck, high risk of necrosis
Proximal humerus fracture risk factors for AVN include:
Hertel criteria predicting increased risk of humeral head AVN. An intact hinge with a longer intact metaphyseal component, the less likelihood of AVN.
Nondisplaced greater tuberosity fracture can be managed nonoperatively with immobilization.
Arm sling and wrath/collar and cuff/shoulder immobilizer for 2-3 weeks
Shoulder abduction cushion takes off tension on Supraspinatus tendon & greater tuberosity
Greater tuberosity fracture
Greater tuberosity surgical screw fixation
Fixation: screw fixation
Plate and screw fixation
Principles of shoulder joint replacement:
Phases of rehabilitation:
Pendulum shoulder range of motion
Hand grip exercise