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shoulder neurology

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
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...
March 2, 2018: Der Unfallchirurg
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
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
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...
February 19, 2018: Journal of Physiology
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
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
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
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...
January 22, 2018: Current Reviews in Musculoskeletal Medicine
Maksud Mubarak Devale, Gaurav Jatin Kadakia, Vicky Ghewarchand Jain, Rohit Prakash Munot
Electrical current can cause neurological damage directly or by conversion to thermal energy. However, electrical injury causing isolated brachial plexus injury without cutaneous burns is extremely rare. We present a case of a 17-year-old boy who sustained accidental electrical injury to left upper extremity with no associated entry or exit wounds. Complete motor and sensory loss in upper limb were noted immediately after injury. Subsequently, the patient showed partial recovery in muscles around the shoulder and in ulnar nerve distribution at 6 months...
May 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
Christian K Spies, Melanie Schäfer, Martin F Langer, Thomas Bruckner, Lars P Müller, Frank Unglaub
AIM OF THE STUDY: The aim of the study was to investigate functional and patient-rated outcome parameters after endoscopic assisted release of the ulnar nerve for cubital tunnel syndrome. METHODS: One hundred of 204 consecutive patients between 2006 and 2011 met the inclusion/exclusion criteria. Fifty-one of these patients were recruited and evaluated clinically and by questionnaire testing retrospectively after a mean follow-up of 82 months (range: 60-116). RESULTS: Neurological parameters (two-point-discrimination, application of Semmes-Weinstein monofilaments, Tinel's test), grip, and three-point pinch strength were not significantly different from the contralateral extremity at the time of examination, whereas key pinch strength was significantly weaker...
January 16, 2018: International Orthopaedics
Ricardo Monreal
PURPOSE: The one-bone forearm arthrodesis has been performed to change the position of the forearm in children with fixed supination deformity due to upper extremity neurologic deficit. In this article, we present a retrospective review of children with late obstetric brachial plexus palsy who underwent palliative surgery to correct severe supination contracture by one-bone forearm osteodesis and biceps re-routing. This technique has not been described previously. MATERIALS AND METHODS: In this retrospective study, four consecutive patients with upper extremity weakness and severe supination contracture who underwent forearm osteodesis in neutral or slight pronation and biceps re-routing...
January 12, 2018: International Orthopaedics
Rongguang Ao, Yalong Zhu, Jianhua Zhou, Zhen Jian, Jifei Shi, Cheng Li, Wankun Hu, Baoqing Yu
BACKGROUND: Traumatic sternoclavicular joint dislocations are rare; closed reduction is the primary treatment. The failure of closed reduction or a prominent insult to the skin may require surgery to ensure the best possible outcome. METHODS: The records of 5 patients operated at our institution for sternoclavicular joint dislocation were reviewed. All patients were treated with open reduction and single 3.5-mm locking plate was used for fixation. Outcomes were evaluated with the Constant Shoulder Score (CSS) and Disability of the Arm, Shoulder, and Hand (DASH) questionnaire...
January 9, 2018: BMC Musculoskeletal Disorders
Jong-Beom Park, Sung Shik Kang, Jin S Yeom
RATIONALE: Traumatic C1-2 dislocation associated with contiguous or noncontiguous cervical spine injury is rare. Moreover, there have been no reports describing traumatic C1-2 dislocation associated with multiple contiguous and noncontiguous cervical injuries. PATIENT CONCERNS: The authors present a case of a 20-year-old male with painful limitation of motion of the neck. This complex cervical injury occurred due to hyperextension of the head in a rotated position...
December 2017: Medicine (Baltimore)
Carl W Jones, Vinu M George, Thin F Hong
BACKGROUND: Scapula fractures are rare injuries that are generally treated nonoperatively. When surgery is performed, it is commonly undertaken through the posterior approach, which can be invasive and unforgiving on the soft tissues. We describe an alternative safe approach between teres major and minor that remains deep to a fascial sling formed by the combined infraspinatus and teres minor fasciae and deep to the primary nerve to teres minor, which is a terminal branch of the axillary nerve...
January 2, 2018: Journal of Shoulder and Elbow Surgery
Hussam Abou-Al-Shaar, Michael Karsy, Vijay Ravindra, Evan Joyce, Mark A Mahan
Particularly challenging after complete brachial plexus avulsion is reestablishing effective hand function, due to limited neurological donors to reanimate the arm. Acute repair of avulsion injuries may enable reinnervation strategies for achieving hand function. This patient presented with pan-brachial plexus injury. Given its irreparable nature, the authors recommended multistage reconstruction, including contralateral C-7 transfer for hand function, multiple intercostal nerves for shoulder/triceps function, shoulder fusion, and spinal accessory nerve-to-musculocutaneous nerve transfer for elbow flexion...
January 2018: Neurosurgical Focus
N Malca, K Serror, M Mimoun, S Chatelain, J Kaplan, M Chaouat, O Marco, D Boccara
Our retrospective study of burn patients presents a three-step treatment of heterotopic ossification: excision surgery, early rehabilitation, and analgesia. We included patients admitted to the department for treatment of postburn heterotopic ossification between January 1, 1979, and September 30, 2015. The mean age at the time of the burn was 43.3 years. Men accounted for the majority of burn patients who developed an osteoma (70.8%). The mean total skin area burned was 38.4%. No osteoma justifying surgery was found for any patient with a total burned skin area less than 19%...
December 27, 2017: Annales de Chirurgie Plastique et Esthétique
Jonathan J Noble, Nicola Rd Fry, Carly R Bingham, Rebecca H East, Adam P Shortland
A novel clinically practical upper limb model is introduced that has been developed through clinical use in children and adults with neurological conditions to guide surgery to the elbow and wrist. This model has a minimal marker set, minimal virtual markers, and no functional joint centres to minimise the demands on the patient and duration of data collection. The model calculates forearm supination independently from the humerus segment, eliminating any errors introduced by poor modelling of the shoulder joint centre...
December 1, 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
D Hirano, T Taniguchi
OBJECTIVES: The purpose of this study was to investigate the incidence and type of skin injuries and joint contractures of the upper extremities in individuals with Rett syndrome. METHODS: In 2016, a questionnaire regarding skin injuries and joint contractures was sent to 1016 directors of schools for special needs education and 204 directors of departments of rehabilitation [consisting of 130 facilities for persons with severe motor and intellectual disabilities (SMID), 73 wards for patients with SMID, and the National Hospital Organisation and National Centre Hospital, National Centre of Neurology and Psychiatry] in Japan...
January 2018: Journal of Intellectual Disability Research: JIDR
Johanna Jonsdottir, Rune Thorsen, Irene Aprile, Silvia Galeri, Giovanna Spannocchi, Ettore Beghi, Elisa Bianchi, Angelo Montesano, Maurizio Ferrarin
PURPOSE: Motor recovery of persons after stroke may be enhanced by a novel approach where residual muscle activity is facilitated by patient-controlled electrical muscle activation. Myoelectric activity from hemiparetic muscles is then used for continuous control of functional electrical stimulation (MeCFES) of same or synergic muscles to promote restoration of movements during task-oriented therapy (TOT). Use of MeCFES during TOT may help to obtain a larger functional and neurological recovery than otherwise possible...
2017: PloS One
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