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Self-Assessment Questions

Orthopaedic Surgery

Shoulder Instability: Review Questions

Mark D. Miller, MD

Dr. Miller is an Associate Professor of Orthopaedic Surgery and Co-Director of Sports Medicine, Department of Orthopaedics, University of Virginia, Charlottesville, VA.


Choose the single best answer for each question.

1. A 20-year-old male athlete with no prior history of shoulder problems sustains a traumatic anterior shoulder dislocation while snowboarding. Which of the following ranges represents his risk for recurrent anterior shoulder instability if his injury is left untreated?
  1. 0% to 20%
  2. 21% to 40%
  3. 41% to 60%
  4. 61% to 80%
  5. Greater than 80%
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2. Which of the following statements is true regarding acute posterior dislocation of the shoulder?

  1. It has a risk for recurrent instability similar to that of anterior shoulder dislocation
  2. It is associated with greater tuberosity fractures
  3. It is more common than acute anterior shoulder dislocation
  4. It should be immobilized in a sling and swath following a reduction
  5. It should be suspected in patients with a history of seizure or shock
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3. Patients older than 40 years who have anterior shoulder dislocations must be evaluated for which of the following possible complications?

  1. Bankart lesion
  2. Hill-Sachs lesion
  3. Lesser tuberosity fracture
  4. Musculocutaneous nerve injury
  5. Rotator cuff tear
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4. An 18-year-old female swimmer reports shoulder instability. On physical examination, she has systemic hyperlaxity, positive responses on anterior and posterior drawer tests, and a positive sulcus sign. Initial management should consist of which of the following?
  1. Anterior/inferior capsular shift
  2. Arthroscopic Bankart repair and capsular plication
  3. Rotator cuff strengthening exercises
  4. Thermal capsulorrhaphy
  5. Ultrasonography and other imaging modalities
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5. Which of the following initial imaging studies should be performed in a patient with a suspected shoulder dislocation?

  1. Anteroposterior (AP) radiography in internal and external rotation
  2. AP, scapular lateral, and axillary lateral radiography
  3. Computed tomographic scan
  4. Magnetic resonance imaging
  5. Ultrasonography
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