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Shoulder anatomy

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https://www.readbyqxmd.com/read/28644936/the-deltoid-lift-a-comparison-study-of-exposure-area-in-proximal-humeral-approaches
#1
Michael Ting, Nicholas Kusnezov, John Dunn, Alok K Dwivedi, Miguel A Pirela-Cruz
BACKGROUND: Adequate exposure of the proximal humerus is necessary to address atypical or complex proximal humerus fractures and orthopedic tumors. Surgical management may be difficult through existing approaches due to their limited nature and the delicate neurovascular anatomy of the shoulder. The deltoid lift, a previously described extensile approach, can be incorporated into the surgeon's armamentarium as an alternative exposure to the proximal humerus. The objective of this study was to quantify and compare the humeral exposure achieved through the deltoid lift with the standard direct lateral deltoid-splitting, anterolateral acromial, and deltopectoral approaches in terms of surface area and exposure of key anatomic landmarks...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28641735/anatomical-and-biomechanical-framework-for-shoulder-arthroplasty-rehabilitation
#2
Aviva L Wolff, Lee Rosenzweig
This article provides an anatomical and biomechanical framework for the postoperative management and progression of treatment for shoulder arthroplasty. The clinical relevance of normal shoulder anatomy, biomechanics, and pathomechanics related to this surgery is emphasized to provide the reader with an understanding of the rationale for treatment. We review the rehabilitation implications of surgical indications and technique for both traditional total shoulder arthroplasty and reverse total shoulder arthroplasty procedures with an emphasis on biomechanical considerations...
April 2017: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/28641732/rehabilitation-of-symptomatic-atraumatic-degenerative-rotator-cuff-tears-a-clinical-commentary-on-assessment-and-management
#3
Sarah Bleichert, Genevieve Renaud, Joy MacDermid, Lyn Watson, Ken Faber, Ross Lenssen, Marie Saulnier, Paul Phillips, Tyler Evans, Jackie Sadi
STUDY DESIGN: Clinical Commentary. INTRODUCTION: Atraumatic rotator cuff (RC) disease, is one of the most common cause of shoulder pain, which encompasses a continuum from tendinopathy to full thickness cuff tears. Extrinsic, intrinsic and environmental factors have been implicated in the pathophysiology of this disorder, affecting the clinical presentation of symptoms including pain and irritability. Successful rehabilitation of symptomatic atraumatic degenerative rotator cuff (SADRC) tears must address the underlying mechanisms causing dysfunction and correct modifiable factors...
April 2017: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/28624856/the-glenocapsular-ligament-and-the-posterosuperior-part-of-the-joint-capsule-of-the-shoulder-are-well-vascularized
#4
Elle Põldoja, Madis Rahu, Kristo Kask, Jüri-Toomas Kartus, Imke Weyers, Ivo Kolts
PURPOSE: A detailed structural anatomy of the posterosuperior shoulder capsule and "glenocapsular ligament" is still rather unknown. The purpose of this study was meticulously to investigate and describe the structure and blood supply of the glenocapsular ligament on the posterosuperior shoulder joint capsule. METHOD: Sixteen fixed and twelve fresh cadaveric shoulder specimens with a mean age of 73.4 (±6.4) years were analysed. Dissection without arterial injection was performed on the 16 fixed specimens-using an alcohol-formalin-glycerol solution...
June 17, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28508008/the-coracoacromial-ligament-anatomy-function-and-clinical-significance
#5
Adam Rothenberg, Gregory Gasbarro, Jesse Chlebeck, Albert Lin
The coracoacromial ligament (CAL) was first described as a pain generator by Dr Charles Neer in the early 1970s. Since that time, considerable controversy regarding CAL management during acromioplasty has persisted. This review aims to better understand the role of the CAL in shoulder physiology and pathology. Sixty-six articles from 1958 to 2016 were identified using an electronic search of PubMed, Cochrane Library, AccessMedicine, and MD Consult for case series as well as cohort and prospective studies. The authors used "coracoacromial ligament" and "coracoacromial veil" as medical subject headings (MeSH)...
April 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28506491/mapping-of-glenoid-bone-loss-in-recurrent-anterior-shoulder-instability-is-there-a-particular-deficit-pattern
#6
Benjamin Bockmann, Arne Johannes Venjakob, Frank Reichwein, Marthe Hagenacker, Wolfgang Nebelung
BACKGROUND: Glenoid bone loss in recurrent anterior shoulder instability is a challenging problem for shoulder surgeons, and knowledge about the anatomy of glenoid deficits is scarce. In this study, we tried to evaluate the pattern of this pathology. METHODS: Our analysis included 44 shoulders from 44 patients with recurrent anterior shoulder instability accompanied by a clinically relevant glenoid bone loss. The defect size, the localization of the inferior defect edge, and the defect angle were measured, and osseous landmarks were identified...
May 11, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28500457/an-alternative-technique-for-greater-tuberosity-fractures-use-of-the-mesh-plate
#7
Yelena Bogdan, Elizabeth B Gausden, Robert Zbeda, David L Helfet, Dean G Lorich, David S Wellman
INTRODUCTION: Isolated greater tuberosity (GT) fractures (AO 11-A1) tend to occur in the younger patient population and are poorly managed by most precontoured proximal humerus locking plates. The goal of this study was to identify and assess an alternative treatment strategy for greater tuberosity fractures. MATERIALS AND METHODS: A retrospective review of all cases of isolated greater tuberosity fractures treated with a 2.4/2.7 mesh plate (Synthes) between 2010 and 2015 was conducted...
May 12, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28488127/imaging-of-the-coracoglenoid-ligament-a-third-ligament-in-the-rotator-interval-of-the-shoulder
#8
Marcello Zappia, Alessandro Castagna, Antonio Barile, Vito Chianca, Luca Brunese, Nicole Pouliart
OBJECTIVE: The coracoglenoid ligament (CGL) forms part of the anterosuperior capsuloligamentous complex of the shoulder. Although it has received attention in the anatomical literature, it has not been investigated on imaging. The purpose of this study is to determine the percentage value and the interobserver agreement of identification and classification of the CGL on MR and MR arthrography (MRA) imaging. MATERIALS AND METHODS: Retrospectively, 280 MR and 150 MRA examinations were evaluated for detection of the CGL by two musculoskeletal radiologists...
August 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28484716/anatomic-variation-in-morphometry-of-human-coracoid-process-among-asian-population
#9
Manal Fathi, Pike-See Cheah, Umar Ahmad, M Nizlan Nasir, Aye Aye San, Ezamin Abdul Rahim, Paisal Hussin, Rozi Mahmud, Fauziah Othman
Ethnic origin plays an important role in bone morphometry. Studies examining the influence of coracoid process have focused primarily on adults and have not included people from diverse Asian ethnic backgrounds. Our goal was to explore ethnic differences in morphometry of coracoid among Asian population. We performed morphometric measurements of coracoid process on cadaveric shoulders and shoulder CT scans from 118 specimens. The cadaveric sample included Indian (46%), Chinese (27%), and Myanmarese (27%) subjects, while the CT scans sample included Chinese (67%) and Malay (33%) subjects...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28459709/the-humeral-implant-in-shoulder-arthroplasty
#10
Jay D Keener, Peter Nissen Chalmers, Ken Yamaguchi
Humeral hemiarthroplasty, anatomic total shoulder arthroplasty, and reverse total shoulder arthroplasty all rely on a prosthetic articular surface fixed to the proximal humerus. Humeral implant designs have changed considerably as a result of improved understanding of proximal humeral anatomy and prosthetic biomechanics. Fixed, monoblock implants have been superseded by modular implants with variable inclination, offset, version, and stem length. Press-fit designs now commonly have surface coatings that allow bony ingrowth...
June 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28437496/novel-solution-for-massive-glenoid-defects-in-shoulder-arthroplasty-a-patient-specific-glenoid-vault-reconstruction-system
#11
David M Dines, Lawrence Gulotta, Edward V Craig, Joshua S Dines
Complex glenoid deformities present the most difficult challenges in shoulder arthroplasty. These deformities may be caused by severe degenerative or congenital deformity, posttraumatic anatomy, tumor, or, in most cases, bone loss after glenoid failure in anatomical total shoulder arthroplasty. Methods of treating severe bone loss have included inlay and onlay bone-graft options with augmented fixation and, in severe cases, salvage hemiarthroplasty with limited goal expectations. Unfortunately, none of these methods has provided consistently satisfactory reproducible results...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28427870/all-endoscopic-brachial-plexus-complete-neurolysis-for-idiopathic-neurogenic-thoracic-outlet-syndrome-a-prospective-case-series
#12
Thibault Lafosse, Malo Le Hanneur, Laurent Lafosse
PURPOSE: To describe an all-endoscopic technique for infra- and supraclavicular brachial plexus (BP) neurolysis and to assess its functional outcomes for patients suffering from nonspecific neurogenic thoracic outlet syndrome (NTOS). METHODS: Between January 2010 and January 2013, 36 patients presenting an idiopathic nonspecific NTOS benefited from an endoscopic decompression in our institution. The inclusion criteria were a typical clinical NTOS and failure of a 6-month well-conducted nonsurgical treatment...
April 17, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28417038/anomalous-innervation-of-the-median-nerve-in-the-arm-in-the-absence-of-the-musculocutaneous-nerve
#13
Khursheed Raza, Seema Singh, Neerja Rani, Raghav Mishra, Kamakshi Mehta, Saroj Kaler
The brachial plexus innervates the upper extremities. While variations in the formation of the brachial plexus and its terminal branches are quite common, it is uncommon for the median nerve to innervate the muscles of the arm. During the dissection of an elderly male cadaver at the Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India, in 2016, the coracobrachialis muscle was found to be supplied by a direct branch from the lateral root of the median nerve and the musculocutaneous nerve was absent...
February 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/28400882/suprascapular-nerve-pathology-a-review-of-the-literature
#14
REVIEW
Lazaros Kostretzis, Ioannis Theodoroudis, Achilleas Boutsiadis, Nikolaos Papadakis, Pericles Papadopoulos
BACKGROUND: Suprascapular nerve pathology is a rare diagnosis that is increasingly gaining popularity among the conditions that cause shoulder pain and dysfunction. The suprascapular nerve passes through several osseoligamentous structures and can be compressed in several locations. METHODS: A thorough literature search was performed using online available databases in order to carefully define the pathophysiology and to guide diagnosis and treatment. RESULTS: Suprascapular neuropathy diagnosis is based on a careful history and a thorough clinical and radiological examination...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28400880/arthroscopic-findings-in-anterior-shoulder-instability
#15
REVIEW
Michael Hantes, Vasilios Raoulis
BACKGROUND: In the last years, basic research and arthroscopic surgery, have improved our understanding of shoulder anatomy and pathology. It is a fact that arthroscopic treatment of shoulder instability has evolved considerably over the past decades. The aim of this paper is to present the variety of pathologies that should be identified and treated during shoulder arthroscopy when dealing with anterior shoulder instability cases. METHODS: A review of the current literature regarding arthroscopic shoulder anatomy, anatomic variants, and arthroscopic findings in anterior shoulder instability, is presented...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28400877/latissimus-dorsi-transfer-in-posterior-irreparable-rotator-cuff-tears
#16
REVIEW
Panagiotis P Anastasopoulos, George Alexiadis, Sarantis Spyridonos, Emmanouil Fandridis
BACKGROUND: Massive rotator cuff tears pose a difficult and complex challenge even for the experienced surgeon; inability to repair these tears by conventional means designates them as irreparable, while management becomes quite taxing. Several operative options have been suggested for the management of such lesions with varying degrees of success, while it is imperative to match patient demands and expectations to the predicted outcome. METHODS: Research articles are examined and key concepts are discussed, in order to provide an evidence based review of the available literature...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28364322/arthroscopic-management-of-lesser-tuberosity-osteochondroma-causing-impingement-and-subscapularis-tear-of-the-shoulder
#17
Jung Ryul Kim, Ju Hong Lee, Sung Il Wang
Although the proximal humerus is a common site of osteochondroma, osteochondroma arising from the lesser tuberosity of the proximal humerus is rare. Because of the anatomy of the shoulder, mechanical impingement can occur via direct contact of the protruding lesser tuberosity against the glenoid rim or coracoid. In younger patients, this may cause isolated tearing of the subscapularis. In this study, is presented a rare case of osteochondroma on the lesser tuberosity that caused a subscapularis tear after shoulder impingement in a 34-year-old male...
March 31, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28317555/the-cervical-spine-of-australopithecus-sediba
#18
Marc R Meyer, Scott A Williams, Peter Schmid, Steven E Churchill, Lee R Berger
Cervical vertebrae are rare in the early hominin fossil record, presenting a challenge for understanding the evolution of the neck and head carriage in hominin evolution. Here, we examine the cervical vertebrae of Australopithecus sediba, which unlike other South African taxa is known from associated cervical vertebrae. The A. sediba cervical vertebrae exhibit human-like values for wedging, pedicle cross-sectional areas, and articular facet heights, indicating reduced ventral loading relative to African apes...
March 2017: Journal of Human Evolution
https://www.readbyqxmd.com/read/28298060/a-cadaveric-model-evaluating-the-influence-of-bony-anatomy-and-the-effectiveness-of-partial-scapulectomy-on-decompression-of-the-scapulothoracic-space-in-snapping-scapula-syndrome
#19
Dimitri S Tahal, J Christoph Katthagen, Daniel Cole Marchetti, Jacob D Mikula, Scott R Montgomery, Alex Brady, Grant J Dornan, Peter J Millett
BACKGROUND: Snapping scapula syndrome (SSS) is caused by bony and/or soft tissue impingement in the scapulothoracic articulation. Surgical resection of the superomedial angle (SMA) plus bursectomy can provide relief in most cases; however, the amount needed to achieve adequate scapulothoracic space decompression (SSD) is unknown. PURPOSE: The aim of this study was to evaluate the effectiveness of partial scapulectomy and the influence of bony anatomy on SSD. It was hypothesized that the anterior offset and costomedial angle would correlate with the amount of bony resection needed to achieve adequate SSD...
May 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28274881/arthroscopic-congruent-arc-shoulder-bone-block-for-severe-glenoid-bone-defect-preliminary-report
#20
J Kany, B Codanda, P Croutzet, R Guinand
INTRODUCTION: Glenoid bone defect remains a surgical challenge in managing anterior shoulder instability. The technique first described by Latarjet has become the gold standard, but may fail to restore fully normal anatomy in case of severe "inverted-pear" glenoid bone defect. Likewise, the naturally "banana-shaped" coracoid process fails to match this flat shoulder. The congruent-arc modified Latarjet technique, which consists in pivoting the coracoid process through 90°, optimizes the contact surface, adapting to the glenoid curvature radius and increasing the articular surface of the graft...
May 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
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