Reverse Humeral Avulsion Of The Glenohumeral Ligament: Successful Non-operative Treatment

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Reverse Humeral Avulsion Of The Glenohumeral Ligament: Successful Non-operative Treatment - Page #1

Author: Jacob Erickson, DO Co Author #1: Adam Pourcho, DO Co Author #2: Cara Prideaux, Co Author #3: Jay Smith, MD Patient Presentation: A 13 year-old right hand dominant male presented with posterior right shoulder pain and stiffness two days following a tubing accident. He believed his shoulder had been forced into hyperabduction and extension when he fell off the tube at high speeds. He denied subjective instability at the time of injury, but quickly developed posterior shoulder pain and stiffness. He rated his pain as 8/10, increased with overhead activity, and denied neurological symptoms. History: No pertinent medical history Physical Exam: Observation: No deformity. Keeps arm at side. Palpation: Tender posterior GHJ & rotator cuff. Range of motion: Active- painful active ELE limited to 150, with full but painful ER & IR in neutral. Passive- near normal in all planes, but posterior pain with end-range ELE. Manual muscle testing: Painful and moderately weak in ER in neutral, painful and minimally weak ELE at 90), and normal but painful IR and full can test. Special Tests: Posterior pain with scarf maneuver, posterior apprehension test and multiple other provocative tests (e.g. O'Brien's, Hawkins'), but no obvious instability. Negative impingement signs and anterior apprehension tests. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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