Department of Traumatology and Hand Surgery University of Medical Sciences in Poznan Head of Department: Prof. Władysław Manikowski Head of Department:

Department of Traumatology Department of Traumatology and Hand Surgeryand Hand Surgery

Department of Traumatology Department of Traumatology and Hand Surgeryand Hand Surgery

University of Medical SciencesUniversity of Medical Sciences in Poznan in PoznanUniversity of Medical SciencesUniversity of Medical Sciences in Poznan in Poznan

Head of Department:Head of Department:Prof. Władysław ManikowskiProf. Władysław ManikowskiHead of Department:Head of Department:Prof. Władysław ManikowskiProf. Władysław Manikowski

Przemysław Lubiatowski MD, PhDPrzemysław Lubiatowski MD, PhD

Upper Extremity

Examination

Upper Extremity

Examination

Taking history

Physical examination

Taking history

Physical examination

EXAMINATIONEXAMINATIONEXAMINATIONEXAMINATION

Taking historyTaking history

Knowledge of the disease process

Main complaints (pain)

Onset, Duration

Dominant hand

Prior therapy

Knowledge of the disease process

Main complaints (pain)

Onset, Duration

Dominant hand

Prior therapy


Physical examinationPhysical examination

Look

Feel

Move

X-ray

Look

Feel

Move

X-ray


Main complaint- pain- instability

- stiffness, limitation of ROM, snapping, crepitation

Age> 70 y.o.< 30 y.o.

Onset of symptomsTreatment



Age> 70 y.o.< 30 y.o.


Rotator cuff tearRotator cuff tear

instabilityinstability

HISTORYHISTORYHISTORYHISTORY



Age> 70 y.o.< 30 y.o.




Age> 70 y.o.< 30 y.o.







Age> 70 y.o.< 30 y.o.




Age> 70 y.o.< 30 y.o.





Evaluation systems

specific

- Simple Shoulder Test

- UCLA

- ASES

general health

- SF-36

Evaluation systems

specific

- Simple Shoulder Test

- UCLA

- ASES

general health

- SF-36


Painac. to ASES

Painac. to ASES


Do you have pain in your shoulder ? Yes no

Mark location of pain

Do you have pain at night ? yes no

Do you take pain killers ? yes no

Do you take narcotic drugs ? Yes no

How many tablets per day ? Quantity

How severe is you pain ?

no as severe as possible

0 10

Instabilityac. to ASES

Instabilityac. to ASES

Do you have feeling of instability ? (as if your shoulder would drop of)

Yes No

How unstable is your shoulder (mark the line) ?

very very

stable unstable

0 10


Look

Palpation

Look

Palpation

PHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATIONPHYSICAL EXAMINATION

Range of motionRange of motion






0

0 –1 cm

1 - 2 cm

> 2 cm

Instability drawer test

- anterior

- sitting, laying

Instability drawer test

- anterior

- sitting, laying


Instability sulcus sign- sitting, laying

Instability sulcus sign- sitting, laying


Instability

Evaluation under anesthesia

Instability

Evaluation under anesthesia


Instability (apprehension test)- sitting, laying

Instability (apprehension test)- sitting, laying


Instability (relocation test)- sitting, laying

Instability (relocation test)- sitting, laying


Impingement syndrome

Neer’s Test


Neer’s Test



Hawkins’ Test


Hawkins’ Test



Painful arch test


Painful arch test


lidocaine

Test with lidocaine

Impingement syndrome (biceps brachii)

Yergason’s Test Speed Test

Impingement syndrome (biceps brachii)

Yergason’s Test Speed Test


Documents

Department of Traumatology and Hand Surgery University of Medical Sciences in Poznan Head of Department: Prof. Władysław Manikowski Head of Department: