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Shoulder anatomy

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https://www.readbyqxmd.com/read/29613881/in-vivo-evaluation-of-subacromial-and-internal-impingement-risk-in-asymptomatic-individuals
#1
Margaret S Coats-Thomas, Daniel F Massimini, Jon J P Warner, Amee L Seitz
OBJECTIVE: The study aim was to evaluate subacromial and internal impingement risk between shoulders (dominant/non-dominant) during dynamic motion using subject-specific anatomy and precise in vivo kinematics. DESIGN: In a prospective cross-sectional study, 9 subjects underwent bilateral MR (N=18 shoulders) and fluoroscopic imaging during external rotation at 90° abduction (ER) and elevation. Subject-specific bone models were created and distances from footprint to (a) acromion and (b) glenoid were measured to evaluate risk...
April 2, 2018: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29575005/axillary-sonography-of-the-shoulder-an-adjunctive-approach
#2
Paul Michelin, Julie Legrand, Kenneth S Lee, Grégoire Leleup, Mathilde Etancelin, Christopher Banse, Jean-Nicolas Dacher, Fabrice Duparc
Sonography of the shoulder is widely used to assess various disorders, including tendinous diseases of the rotator cuff and the long head of the biceps brachii muscle. The shoulder is commonly explored through anterior, superior, and posterior approaches, but the inferior axillary approach is rarely considered in the literature. However, this technique allows the direct visualization of relevant anatomic structures. The aim of this pictorial essay is, first, to technically describe this approach and the normal musculoskeletal sonographic anatomy of the region and, second, to present the sonographic findings of shoulder disorders that may be helpfully explored this technique...
March 25, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29547446/long-term-retention-of-musculoskeletal-ultrasound-training-during-residency
#3
Robert W Irwin, Jeffrey Smith, S Barry Issenberg
The Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Physical Medicine and Rehabilitation (ABPMR) developed milestones for evaluation of resident physicians that include proper musculoskeletal ultrasound (MSUS) examination of major joints. To date, there have been no published data demonstrating acquisition and retention of these skills and correlation with the milestone evaluation. The investigators developed and implemented a curriculum in musculoskeletal ultrasound examination for Physical Medicine and Rehabilitation (PM&R) residents at a large academic medical center...
March 15, 2018: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29502699/editorial-commentary-shoulder-anatomy-finding-the-axillary-nerve-measure-twice-cut-once
#4
EDITORIAL
Wesley M Nottage
Most descriptions of shoulder anatomy note that the axillary nerve lies approximately 5 cm below the anterolateral corner of the acromion, and the nerve has been reported to range from 2 to 7 cm from the acromial edge, depending on the patient and measuring technique. The safe trans-deltoid operable area has been described as up to 4 cm below the acromion. A useful clinical guide I use is that the inferior extent of the subacromial bursa ends above the axillary nerve.
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29502697/editorial-commentary-lateral-acromioplasty-is-clinically-safe-and-has-the-potential-to-reduce-the-risk-for-rotator-cuff-re-tears
#5
EDITORIAL
J Christoph Katthagen, Peter J Millett
The critical shoulder angle and lateral acromioplasty are areas of controversy that are being studied in association with rotator cuff tears both as potential pathogenic variables and as surgically modifiable variables that could improve clinical outcomes. Current clinical evidence regarding the effectiveness and potential benefit of lateral acromioplasty support the hypothesis that modification of the bony anatomy may influence the integrity of the rotator cuff.
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29494713/total-shoulder-arthroplasty-using-a-bone-sparing-precision-multiplanar-humeral-prosthesis
#6
Steven S Goldberg, Eric S Baranek
Proper reconstruction of proximal humeral anatomy is of primary importance to maximize patient outcomes after total shoulder arthroplasty. This article describes a new arthroplasty technique, where a fixed multiplanar bone resection is made and a novel implant, which is designed to precisely match the bone resection, is inserted.
February 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29494712/humeral-bone-loss-in-revision-shoulder-arthroplasty
#7
Paul B McLendon, Jacob L Cox, Mark A Frankle
Revision shoulder arthroplasty is becoming more prevalent as the rate of primary shoulder arthroplasty in the US continues to increase. The management of proximal humeral bone loss in the revision setting presents a difficult problem without a clear solution. Different preoperative diagnoses often lead to distinctly different patterns of bone loss. Successful management of these cases requires a clear understanding of the normal anatomy of the proximal humerus, as well as structural limitations imposed by significant bone loss and the effect this loss has on component fixation...
February 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29473831/understanding-the-importance-of-the-teres-minor-for-shoulder-function-functional-anatomy-and-pathology
#8
Matthew D Williams, Thomas Bradley Edwards, Gilles Walch
Although the teres minor is often overlooked in a normal shoulder, it becomes a key component in maintaining shoulder function when other rotator cuff tendons fail. The teres minor maintains a balanced glenohumeral joint and changes from an insignificant to the most significant external rotator in the presence of major rotator cuff pathology. The presence or absence of the teres minor provides prognostic information on the outcomes of reverse total shoulder arthroplasty and tendon transfers. Clinical tests include the Patte test, the Neer dropping sign, the external rotation lag sign, and the Hertel drop sign...
March 1, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29460541/radiosurgery-assisted-gingival-displacement-a-proof-of-concept-technique-to-enhance-the-efficiency-of-intraoral-digital-impression
#9
L Arcuri, M Contaldo, R Santoro, A Pozzi, C Lorenzi, C Arcuri, A Barlattani, L Tettamanti, L Ottria
Nowadays, an increasing number of dentists are using intraoral scanners (IOS) in their daily practice as an alternative to conventional impression taking. One of the main concerns is related to the capability of scanning the subgingival anatomy of the die, usually very challenging due to the limited operative field and the presence of oral fluids. The radiosurgery assisted gingival displacement technique (RAGD) may enhance the intraoral optical scanning of the finish line and neighbor tooth anatomy. The contour of the interim prosthesis is used to drive the tip of radiosurgery electrode along the tooth surface and open selectively the gingival crevice with a prosthetically-driven and minimally invasive approach...
January 2018: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29453500/isolated-greater-tuberosity-fractures-of-the-proximal-humerus-anatomy-injury-patterns-multimodality-imaging-and-approach-to-management
#10
Eric A White, Matthew R Skalski, Dakshesh B Patel, Jordan S Gross, Anderanik Tomasian, Nathanael Heckmann, George R Matcuk
The greater tuberosity is an important anatomic structure and its integrity is important for shoulder abduction and external rotation. Isolated fractures of the greater tuberosity are often subtle and may not be detected on initial radiographs. Clinically, these patients display symptoms which mimic a full thickness rotator cuff tear. It is important to differentiate these two entities, as their treatment is different (typically nonsurgical management for minimally displaced fractures versus rotator cuff repair for acute full thickness rotator cuff tears)...
February 16, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29444578/-anatomy-of-fractures-of-the-inferior-scapular-angle
#11
J Bartoníček, M Tuček, J Malík
INTRODUCTION: The aim of this study is to describe the anatomy of fractures of the inferior angle and the adjacent part of the scapular body, based on 3D CT reconstructions. METHOD: In a series of 375 scapular fractures, we identified a total of 20 fractures of the inferior angle of the scapular body (13 men, 7 women), with a mean patient age of 50 years (range 3373). In all fractures, 3D CT reconstructions were obtained, allowing an objective evaluation of the fracture pattern with a focus on the size and shape of the inferior angle fragment, propagation of the fracture line to the lateral and medial borders of the infraspinous part of the scapular body, fragment displacement and any additional fracture of the ipsilateral scapula and the shoulder girdle...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/29427059/arthroplanner-a-surgical-planning-solution-for-acromioplasty
#12
Caecilia Charbonnier, Sylvain Chagué, Bart Kevelham, Delphine Preissmann, Frank C Kolo, Olivier Rime, Alexandre Lädermann
PURPOSE: We present a computer-assisted planning solution "ArthroPlanner" for acromioplasty based on 3D anatomical models, computed tomography and joint kinematic simulations. METHODS: In addition to a standard static clinical evaluation (anamnesis, radiological examination), the software provides a dynamic assessment of the shoulder joint by computing in real time the joint kinematics from a database of activities of daily living. During motion, the precise bone resection (location and amount) is computed based on detected subacromial impingements, providing surgeons with precise information about the surgical procedure...
February 9, 2018: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/29417986/three-dimensional-anatomy-of-the-anthropoid-bony-pelvis
#13
Carol V Ward, Scott D Maddux, Emily R Middleton
OBJECTIVES: Pelvic form is hypothesized to reflect locomotor adaptation in anthropoids. Most observed variation is found in the ilium, which traditionally is thought to reflect thoracic and shoulder morphology. This article examines the articulated bony pelvis of anthropoids in three dimensions (3D) to test hypothesized variation in pelvic anatomy related to overall torso form. MATERIALS AND METHODS: Sixty landmarks were collected on articulated pelves from 240 anthropoid individuals...
February 8, 2018: American Journal of Physical Anthropology
https://www.readbyqxmd.com/read/29399735/rotator-cuff-repair-post-operative-rehabilitation-concepts
#14
REVIEW
Terrance A Sgroi, Michelle Cilenti
PURPOSE OF REVIEW: With improvements in surgical techniques and increased knowledge of rotator cuff healing, there was a need to identify a safe progression after rotator cuff repair. The rehabilitation specialist plays an integral role in the care of these patients, and by implementing an evidence and criteria-based model, patients may be able to return to their prior levels of function sooner with fewer complications. RECENT FINDINGS: Timing of progression for rotator cuff patients should align not only with healing but also potential strain on the involved tissue...
February 5, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29395551/quantitative-assessment-of-the-coracoacromial-and-the-coracoclavicular-ligaments-with-3-dimensional-mapping-of-the-coracoid-process-anatomy-a-cadaveric-study-of-surgically-relevant-structures
#15
Jorge Chahla, Daniel Cole Marchetti, Gilbert Moatshe, Márcio B Ferrari, George Sanchez, Alex W Brady, Jonas Pogorzelski, George F Lebus, Peter J Millett, Robert F LaPrade, Matthew T Provencher
PURPOSE: To perform a quantitative anatomic evaluation of the (1) coracoid process, specifically the attachment sites of the conjoint tendon, the pectoralis minor, the coracoacromial ligament (CAL), and the coracoclavicular (CC) ligaments in relation to pertinent osseous and soft tissue landmarks; (2) CC ligaments' attachments on the clavicle; and (3) CAL attachment on the acromion in relation to surgically relevant anatomic landmarks to assist in planning of the Latarjet procedure, acromioclavicular (AC) joint reconstructions, and CAL resection distances avoiding iatrogenic injury to surrounding structures...
January 24, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29392730/three-dimensional-mobility-and-muscle-attachments-in-the-pectoral-limb-of-the-triassic-cynodont-massetognathus-pascuali-romer-1967
#16
Phil H Lai, Andrew A Biewener, Stephanie E Pierce
The musculoskeletal configuration of the mammalian pectoral limb has been heralded as a key anatomical feature leading to the adaptive radiation of mammals, but limb function in the non-mammaliaform cynodont outgroup remains unresolved. Conflicting reconstructions of abducted and adducted posture are based on mutually incompatible interpretations of ambiguous osteology. We reconstruct the pectoral limb of the Triassic non-mammaliaform cynodont Massetognathus pascuali in three dimensions, by combining skeletal morphology from micro-computed tomography with muscle anatomy from an extended extant phylogenetic bracket...
March 2018: Journal of Anatomy
https://www.readbyqxmd.com/read/29366667/anatomical-characterization-of-the-brachial-plexus-in-dog-cadavers-and-comparison-of-three-blind-techniques-for-blockade
#17
Alicia Skelding, Alexander Valverde, Melissa Sinclair, Jeffrey Thomason, Noel Moens
OBJECTIVES: To describe the ventral spinal nerve rami contribution to the formation of the brachial plexus (BP), and to compare ease of performing and nerve staining between three blind techniques for BP blockade in dogs. STUDY DESIGN: Prospective, randomized, blind study. ANIMALS: A total of 18 dog cadavers weighing 28.2 ± 9.7 kg (mean ± standard deviation). METHODS: Dogs were randomly assigned to two of three BP treatments: traditional approach (TA), perpendicular approach (PA), and axillary approach (AA)...
March 2018: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29349020/an-arthroscopic-humeral-medializing-repair-of-the-supraspinatus
#18
Amir Ghazanfari, Daniel J H Henderson, Geoffroy Nourissat
Posterosuperior repair of the rotator cuff is one of the most frequently performed surgical procedures in the shoulder. Its aim is to fix the tendon back to the bone to restore anatomy, improve shoulder function, and prevent progression of cuff tear arthropathy and attendant muscle degeneration. Despite technical advances in this procedure, in some cases, the tendon cannot be fixed back to the footprint without excessive tension on the repair. In young patients or in patients with low-grade muscle atrophy and fatty degeneration (Goutallier grade 1 or 2), it is mandatory to attempt fixation of the tendon to restore functional anatomy and prevent further muscle degeneration...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29314501/peripheral-nerve-stimulation-for-chronic-shoulder-pain-a-proof-of-concept-anatomy-study
#19
REVIEW
Michael Gofeld, Anne Agur
OBJECTIVES: Although spinal cord and dorsal root ganglia stimulation may be effective for managing regional pain syndromes, a more targeted approach is perhaps more appealing for discrete anatomical structures. Chronic shoulder pain is a common musculoskeletal problem with significant socioeconomic impact. A peripheral nerve stimulation of the axillary and suprascapular nerves may prove to be effective as a long-term solution for this indication. In anticipation of the future experimental research and clinical utilization, a sound methodology for the lead placement was developed, and its feasibility is tested in a cadaveric study...
April 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29305099/the-posterior-ridge-of-the-greater-tuberosity-of-the-humerus-a-suitable-landmark-for-the-posterior-approach-to-the-shoulder-joint
#20
Karl Grob, Rebecca Helen Monahan, Mirjana Manestar, Luis Filgueira, Vilijam Zdravkovic
BACKGROUND: The purpose of this study was to evaluate the posterior ridge of the greater tuberosity, a palpable prominence during surgery, as a landmark for the posterior approach to the glenohumeral joint. METHODS: Twenty-five human cadaveric shoulders were dissected. In 5 cases, a full-thickness rotator cuff tear was present. The posterior surgical anatomy was defined, and the distance from the ridge to the interval between the infraspinatus (IS) and teres minor (TM) muscle, the distance from the ridge to the inferior border of the glenoid (IBG), and the distance between the IS-TM interval and the IBG were determined...
April 2018: Journal of Shoulder and Elbow Surgery
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