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https://www.readbyqxmd.com/read/29787402/a-pilot-study-of-a-novel-automated-somatosensory-evoked-potential-ssep-monitoring-device-for-detection-and-prevention-of-intraoperative-peripheral-nerve-injury-in-total-shoulder-arthroplasty-surgery
#1
Jason Chui, John M Murkin, Darren Drosdowech
INTRODUCTION: Peripheral nerve injury is a potentially devastating complication after total shoulder arthroplasty (TSA) surgery. This pilot study aimed to assess the feasibility of using an automated somatosensory evoked potential (SSEP) device to provide a timely alert/intervention to minimize intraoperative nerve insults during TSA surgery. METHODS: A prospective, single-arm, observational study was conducted in a single university hospital. The attending anesthesiologist monitored the study participants using the EPAD automated SSEP device and an intervention was made if there was an alert during TSA surgery...
May 21, 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29782307/cutaneous-manifestations-of-tuberous-sclerosis
#2
Mirjana Bakić, Marina Ratković, Branka Gledović, Balsa Vujović, Danilo Radunović, Vera Babić, Vladimir Prelević
Dear Editor, Tuberous sclerosis (TS) is an autosomal dominant multisystem disease, which occurs due to genetically determined hyperplasia of ectodermal and mesodermal cells. Clinical manifestations present on the skin and in the nervous system, kidneys, heart, and other organs. Recent studies estimate the incidence of TS at 1/6000 to 1/10,000 live births, and a prevalence in the general population of approximately 1 in 20,000 (1). There are two different genetic loci responsible for TS: 9q34 (TSC1-hamartin) and 16p13...
April 2018: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/29762283/five-to-ten-year-outcomes-of-operatively-treated-scapular-fractures
#3
Joscelyn M Tatro, Jeffrey A Gilbertson, Lisa K Schroder, Peter A Cole
BACKGROUND: The purpose of this study was to assess the 5 to 10-year clinical and patient-reported functional outcomes after open reduction and internal fixation (ORIF) of intra-articular and extra-articular scapular fractures. METHODS: We conducted a retrospective review of prospectively collected data on 106 patients who underwent ORIF of a scapular fracture at a single level-I trauma center between January 2005 and December 2010. Eight patients were excluded from the study because they had either severe neurologic injury or an isolated process fracture, and 66 patients (37 with an isolated extra-articular fracture and 29 with an intra-articular fracture) participated in the 5 to 10-year follow-up, yielding a follow-up rate of 67%...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29747540/anodal-transcranial-direct-current-stimulation-to-enhance-rehabilitation-in-individuals-with-rotator-cuff-tendinopathy-a-triple-blind-randomized-control-trial
#4
Amélie Fournier Belley, Catherine Mercier, Maude Bastien, Guillaume Léonard, Nathaly Gaudreault, Jean-Sébastien Roy
Study Design Triple-blind parallel-group randomized control trial. Background Anodal transcranial direct current stimulation (a-tDCS) has been shown to enhance the effects of sensorimotor training in neurological populations. For treatment of rotator cuff (RC) tendinopathy, sensorimotor training leads to reduce pain and increase function. Addition of a-tDCS during a rehabilitation program centered on sensorimotor training could improve treatment outcome. Objective To compare a group receiving a rehabilitation program centered on sensorimotor training with a-tDCS to a group receiving the same rehabilitation program with sham a-tDCS in individuals with RC tendinopathy...
May 10, 2018: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/29726799/cervical-corpectomy-for-resection-of-ventral-intramedullary-capillary-hemangioma-with-circumferential-involvement-of-the-anterior-spinal-artery-case-report
#5
Jonathan A Forbes, Nathan Teschan, Samuel Hayden Jones, Phillip Parry, Luke Simonet, Narayana K Swamy
There is limited evidence to suggest that anterior approaches for the resection of ventral intramedullary lesions of the cervical spinal cord may result in superior neurological outcomes compared with those following more traditional posterior approaches. To the authors' knowledge, no report of an anterior approach to resect a ventral intramedullary capillary hemangioma exists in the literature. In the following paper, the case of a 75-year-old male who presented with progressive neck and left shoulder pain, weakness of the left hand, myelopathy, and gait imbalance is reported...
May 4, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29664508/oral-self-mutilation-in-lesch-nyhan-syndrome-case-report
#6
Andrés Campolo González, Alex Vargas Díaz, Daniel Fontboté Riesco, Marta Hernández Chávez
INTRODUCTION: Lesch-Nyhan syndrome (LNS) is an inherited recessive X-related disorder caused by the deficiency of the enzyme hypoxanthin-guanine phosphorribosyl transferase (HPRT). Compul sive self-mutilation and dystonia occurs before the first year of age and is expressed by persistent bites on the oral mucosa, lips, tongue, fingers, and shoulders. The dental intervention performed on most of these patients is multiple tooth extraction to prevent serious secondary lesions. OBJECTIVE: To present a clinical case of LNS and describe pediatric dentistry management in patients with self-mutilating behavior...
February 2018: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29657846/reverse-total-shoulder-arthroplasty
#7
Filippo Familiari, Jorge Rojas, Mahmut Nedim Doral, Gazi Huri, Edward G McFarland
Since the introduction of reverse total shoulder arthroplasty (RTSA) in 1987 (in Europe) and 2004 (in the United States), the number of RTSAs performed annually has increased.Although the main indication for RTSA has been rotator cuff tears, indications have expanded to include several shoulder conditions, many of which involve dysfunction of the rotator cuff.RTSA complications have been reported to affect 19% to 68% of patients and include acromial fracture, haematoma, infection, instability, mechanical baseplate failure, neurological injury, periprosthetic fracture and scapular notching...
February 2018: EFORT Open Reviews
https://www.readbyqxmd.com/read/29613929/long-term-outcomes-of-glenohumeral-arthrodesis
#8
Eric R Wagner, Richard McLaughlin, Shumaila Sarfani, Robert H Cofield, John W Sperling, Joaquin Sanchez-Sotelo, Bassem T Elhassan
BACKGROUND: Glenohumeral arthrodesis is associated with a high rate of complications. Although patients experience reasonable pain relief and shoulder stability, they experience marked limitations in their upper-extremity function. The purpose of this study was to examine the clinical outcomes of glenohumeral arthrodesis. METHODS: Twenty-nine patients with 29 affected shoulders underwent primary glenohumeral arthrodesis between 1992 and 2009. Surgical indications included rotator cuff arthropathy and pseudoparalysis (n = 7), neurologic injuries (n = 12), chronic infection (n = 3), recurrent dislocations (n = 3), and proximal humeral or shoulder girdle tumors (n = 4)...
April 4, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29608485/new-rhizotomy-procedure-for-primary-spasmodic-torticollis
#9
Chunhui Hua, Benfang Pu, Kaizhang Liu, Zhenyu Huang, Changhua Li, Changyi Zhao, Xinyuan Li
OBJECTIVE: Spasmodic torticollis (ST) is an idiopathic neurologic disorder affecting the muscles of the neck. Surgery is a preferred treatment, when conservative treatments or Botulinum neurotoxin injections fail to relieve the symptoms. Our objective here is to report the outcome of a new surgical method for treating ST patients in our department. METHODS: The new procedure consists of rhizotomy of the spinal accessory nerve (SAN) and C1-C2 nerve roots, coagulation of the distal end of SAN (Group A)...
March 30, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29605518/shoulder-arthroplasty-for-sequelae-of-obstetrical-brachial-plexus-injury
#10
Jean-David Werthel, Bradley Schoch, Mark Frankle, Robert Cofield, Bassem T Elhassan
PURPOSE: Shoulder arthroplasty following obstetrical brachial plexus injury (OBPI) is technically challenging because glenoid morphology, muscle balance, and humeral version are substantially altered compared with the neurologically intact shoulder. The purpose of this study is to report the outcome of shoulder arthroplasty in a group of patients with end-stage arthritis secondary to OBPI. MATERIALS AND METHODS: Seven patients with OBPI and secondary glenohumeral arthritis were treated with shoulder arthroplasty between 1976 and 2014...
March 29, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29581657/effects-of-anterior-weight-shifting-methods-on-sitting-balance-in-wheelchair-dependent-patients-with-spinal-cord-injury
#11
Han Seong Choe, Dong-Ki Min, Jeoungah Ahn
[Purpose] This study aimed to compare changes in the center of pressure between healthy subjects and patients with spinal cord injury and to provide basic information to these patients for improving their sitting balance. [Subjects and Methods] A total of 12 healthy subjects without histories of neurological or psychiatric disorders and 12 patients with spinal cord injuries were recruited. In all subjects, a change in the center of pressure during the performance of the modified functional reach test was measured using a Force Sensing Array system while the subjects were seated in a wheelchair...
March 2018: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/29528838/a-rare-case-of-axillary-artery-pseudoaneurysm-due-to-shoulder-dislocation-treated-with-percutaneous-thrombin-injection
#12
Sotirios Giannakakis, Ioannis Sachmpazidis, Anastasios Papapetrou, George Galyfos, Georgios Sachsamanis, Gerasimos Papacharalampous, Chrisostomos Maltezos
The incidence of combined neurovascular injuries among patients with high-energy shoulder trauma ranges from 27% to 44%. However, the presentation of an axillary artery pseudoaneurysm (PSA) due to shoulder dislocation without an associated osseous fracture is a very rare condition. Moreover, treatment of combined neurologic and vascular injuries of the shoulder remains controversial. Additionally, minimally invasive treatments such as thrombin injection have been mainly evaluated in patients with iatrogenic femoral artery PSAs...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29500507/-paresis-of-the-brachial-plexus-after-anterior-shoulder-luxation-traumatic-damage-or-compression-due-to-hematoma
#13
F Liska, L Lacheta, A B Imhoff, A Schmitt
After traumatic anterior shoulder dislocation and self-reduction, the patient initially showed an inconspicuous clinical course. At the time of presentation in the emergency room the upper limb neurological status was reported to be normal. After discharge, paresis of the brachial plexus of the left arm occurred within 8 h. A subsequently performed computed tomography (CT) scan revealed a hematoma close to the brachial plexus, which was treated by surgical decompression and resulted in symptom relief. This case report describes a rare but significant complication after anterior shoulder dislocation, which should not be underestimated in the setting of a surgical emergency admission...
May 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29475786/injury-to-the-axillary-and-suprascapular-nerves-in-rotator-cuff-arthropathy-and-after-reverse-shoulder-arthroplasty-a-prospective-electromyographic-analysis
#14
Yaiza Lopiz, Alberto Rodriguez-González, Susana Martín-Albarrán, Hector Marcelo, Carlos García-Fernández, Fernando Marco
BACKGROUND: Neurologic pre- and postoperative injuries to the axillary and/or suprascapular nerve (SSN) have a higher incidence than expected and may lead to significantly decreased functional outcomes and increased risk of reverse shoulder arthroplasty (RSA) failure. METHODS: Patients who underwent a RSA for rotator cuff tear arthropathy (RCTA) were included from December 2014 to December 2015. This study focused on the clinical (Constant score), radiographic, and pre- and postoperative electromyographic evaluations at 3 and 6 months...
February 20, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29471558/indication-technique-and-long-term-results-after-shoulder-arthrodesis-performed-with-plate-fixation
#15
Ulrich Irlenbusch, Olaf Rott, Lars Irlenbusch
AIM: Arthrodesis of the shoulder joint is a radical event, so it is difficult to explain its significance to patients. It has been the last resort in hopeless cases. Knowledge of long-term results and evaluation of advantages and disadvantages seems to be helpful in this regard. METHODS: Eleven patients with mean age of 45 (31 - 58) years were operated between 2000 and 2013. All patients could be included in the investigation (FU mean 8.5 [3 - 16] years; 8 male and 3 female; right 9, left 2)...
February 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29457651/progressive-recruitment-of-contralesional-cortico-reticulospinal-pathways-drives-motor-impairment-post-stroke
#16
Jacob G McPherson, Albert Chen, Michael D Ellis, Jun Yao, C J Heckman, Julius P A Dewald
KEY POINTS: Activation of the shoulder abductor muscles in the arm opposite a unilateral brain injury causes involuntary increases in elbow, wrist and finger flexion in the same arm, a phenomenon referred to as the flexion synergy. It has been proposed that flexion synergy expression is related to reduced output from ipsilesional motor cortex and corticospinal pathways. In this human subjects study, we provide evidence that the magnitude of flexion synergy expression is instead related to a progressive, task-dependent recruitment of contralesional cortex...
April 1, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29428293/impact-of-spine-alignment-on-the-rotator-cuff-in-long-term-wheelchair-users
#17
Yasser Kentar, Manuela Brunner, Thomas Bruckner, Andreas Hug, Patric Raiss, Felix Zeifang, Markus Loew, Haidara Almansour, Michael Akbar
BACKGROUND: We investigated the impact of poor seated posture on the prevalence of rotator cuff tears (RCTs) among wheelchair-dependent individuals with long-standing paraplegia. METHODS: The study included 319 patients. Lateral radiographs of the spine were collected from a database and analyzed to assess the global spinopelvic alignment (SPA). Magnetic resonance images of both shoulders were obtained to detect the presence of cuff tears. Patients were divided into 2 groups: Group RCT-I included all patients with cuff tears (right, left, or bilateral), whereas group RCT-II consisted exclusively of patients with bilateral cuff tears...
February 8, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29403305/spotlight-on-topographical-pressure-pain-sensitivity-maps-a-review
#18
REVIEW
Francisco Alburquerque-Sendín, Pascal Madeleine, César Fernández-de-Las-Peñas, Paula Rezende Camargo, Tania Fátima Salvini
Mechanical hyperalgesia defined as decreased pressure pain thresholds (PPTs) is commonly associated with pain. In this narrative review, we report the current state of the art within topographical pressure sensitivity maps. Such maps are based on multiple PPT assessments. The PPTs are assessed by an a priori defined grid with special focus on both spatial and temporal summation issues. The grid covers the muscle or the body region of interest using absolute or relative values determined from anatomical landmarks or anthropometric values...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29367654/prevalence-of-upper-extremity-pain-in-a-population-of-people-with-paraplegia
#19
Y Kentar, R Zastrow, H Bradley, M Brunner, W Pepke, T Bruckner, P Raiss, A Hug, H Almansour, M Akbar
STUDY DESIGN: Cross-sectional study. OBJECTIVES: To determine the prevalence, patterns, and predictors of musculoskeletal pain in the upper extremity joints among wheelchair-dependent individuals with post-traumatic paraplegia. Secondarily, to document most common reported causes of upper extremity pain. SETTING: Centre for Orthopaedics, Trauma Surgery and Spinal Cord Injury, Germany. METHODS: The study was done by means of a structured questionnaire, which was mailed to the individuals who had been treated between 1990 and 2007 for newly sustained or pre-existing, accident-related paraplegia (n = 670)...
January 24, 2018: Spinal Cord
https://www.readbyqxmd.com/read/29356952/massive-rotator-cuff-tear-when-to-consider-reverse-shoulder-arthroplasty
#20
REVIEW
Thomas R Sellers, Adham Abdelfattah, Mark A Frankle
PURPOSE OF REVIEW: The purpose of this review is to discuss the indications for reverse shoulder arthroplasty (RSA) in the treatment of massive rotator cuff tear (MCT), review the reported outcomes in the literature, and outline our approach and surgical technique for treating these patients. RECENT FINDINGS: While RSA remains a successful and well-accepted treatment for cuff tear arthropathy (CTA), management of MCT in the absence of arthritis is controversial...
March 2018: Current Reviews in Musculoskeletal Medicine
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