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"Shoulder anatomy"

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
Ryan Woods, Steve J Wisniewski, Daniel R Lueders, Thomas P Pittelkow, Dirk R Larson, Jonathan T Finnoff
BACKGROUND: Accurate diagnosis of musculoskeletal disorders relies heavily on the physical examination, including accurate palpation of musculoskeletal structures. The literature suggests that there has been a deterioration of physical examination skills among medical students and residents, in part due to increased reliance on advanced imaging. It has been shown that knowledge of musculoskeletal anatomy and physical examination skills improve with the use of ultrasound; however, the literature is limited...
December 7, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
Luís Faria, Bárbara Campos, Renato Natal Jorge
PURPOSE: The shoulder girdle is a complex system, comprised by a kinematic chain and stabilizers. Due to the delicate equilibrium and synchronism between mobility and stability, high external loads may compromise its physiology, increasing the risk of injuries. Thus, this study intends to fully characterize the effects of a rugby tackle on the shoulder's anatomy and physiology. METHODS: For the experimental procedures, a matrix of pressure sensors was used, based on the Teckscan® pressure in-soles, force plates, an isokinetic dynamometer and sEMG (surface electromyography)...
2017: Acta of Bioengineering and Biomechanics
Santos Moros Marco, José Luis Ávila Lafuente, Miguel Angel Ruiz Ibán, Jorge Diaz Heredia
BACKGROUND: The glenohumeral joint is a ball-and-socket joint that is inherently unstable and thus, susceptible to dislocation. The traditional and most common anatomic finding is the Bankart lesion (anterior-inferior capsule labral complex avulsion), but there is a wide variety of anatomic alterations that can cause shoulder instability or may be present as a concomitant injury or in combination, including bone loss (glenoid or humeral head), complex capsule-labral tears, rotator cuff tears, Kim´s lesions (injuries to the posterior-inferior labrum) and rotator interval pathology...
2017: Open Orthopaedics Journal
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
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
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
Ryan A Mlynarek, Simon Lee, Asheesh Bedi
The overhead pitching motion is a coordinated sequence of movements that subjects the shoulder to extreme forces. The ultimate goal of this complex, dynamic activity is to generate high ball velocity and accuracy. In doing so, repetitive throwing can cause adaptive and pathologic changes in the thrower's shoulder. This article reviews the relevant shoulder anatomy, the kinetic chain, and throwing mechanics, as well as common shoulder injuries and surgical options for the treating orthopedic surgeon.
February 2017: Hand Clinics
Chad M Fortun, Ivan Wong, Joseph P Burns
Failed arthroscopic soft-tissue stabilization and anterior glenoid bone loss have been shown to have high failure rates after standard arthroscopic stabilization techniques. For patients with recurrent glenohumeral instability, the Bristow-Latarjet procedure is currently the standard of care. It is predominantly performed through an open deltopectoral approach but has recently been described arthroscopically. Although providing excellent clinical outcomes, the Bristow-Latarjet procedure violates the subscapularis muscle, has a steep learning curve with a high complication rate, and permanently changes the anterior shoulder anatomy, making any future revision surgery more challenging...
August 2016: Arthroscopy Techniques
Adam M Pourcho, Sean W Colio, Mederic M Hall
Chronic and acute shoulder pain and dysfunction are common complaints among patients. Shoulder pain may be the result of abnormality involving the rotator cuff, subacromial-subdeltoid bursa, biceps tendon, glenoid labrum, glenohumeral joint, acromioclavicular joint, sternoclavicular joint, or glenohumeral joint capsule. Ultrasound-guided (USG) procedures of the shoulder are well established for interventional management. Ultrasound provides the advantages of excellent soft tissue resolution, injection accuracy, low cost, accessibility, portability, lack of ionizing radiation, and the ability to perform real-time image-guided procedures...
August 2016: Physical Medicine and Rehabilitation Clinics of North America
Anthony G Ho, Ashok L Gowda, J Michael Wiater
Management of the unstable shoulder after a failed stabilization procedure can be difficult and challenging. Detailed understanding of the native shoulder anatomy, including its static and dynamic restraints, is necessary for determining the patient's primary pathology. In addition, evaluation of the patient's history, physical exam, and imaging is important for identifying the cause for failure after the initial procedure. Common mistakes include under-appreciation of bony defects, failure to recognize capsular laxity, technical errors, and missed associated pathology...
September 2016: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
Larry D Field, Richard K N Ryu, Jeffrey S Abrams, Matthew Provencher
Arthroscopic shoulder stabilization offers several potential advantages compared with open surgery, including the opportunity to more accurately evaluate the glenohumeral joint at the time of diagnostic assessment; comprehensively address multiple pathologic lesions that may be identified; and avoid potential complications unique to open stabilization, such as postoperative subscapularis failure. A thorough understanding of normal shoulder anatomy and biomechanics, along with the pathoanatomy responsible for anterior, posterior, and multidirectional shoulder instability patterns, is very important in the management of patients who have shoulder instability...
2016: Instructional Course Lectures
Chan Hong Park, Sang Ho Lee
BACKGROUND: Cervical epidural steroid injection (CESI), given in conjunction with local anesthetics, is a common remedy for cervical radicular pain and is generally performed under c-arm fluoroscopic guidance, computed tomography (CT), or ultrasound. Interlaminar procedures, such as CESI, typically rely on anteroposterior and lateral (APL) views during needle placement. However, lateral views may be obscured by body habitus in certain individuals. Swimmer's view or contralateral oblique (CLO) view may be used to avoid this...
September 2016: Pain Practice: the Official Journal of World Institute of Pain
Bakir Kadum, Hamid Hassany, Mats Wadsten, Arkan Sayed-Noor, Göran Sjödén
PURPOSE: The aim of this study was to investigate the ability of a stemless shoulder prosthesis to restore shoulder anatomy in relation to premorbid anatomy. METHODS: This prospective study was performed between May 2007 and December 2013. The inclusion criteria were patients with primary osteoarthritis (OA) who had undergone stemless total anatomic shoulder arthroplasty. Radiographic measurements were done on anteroposterior X-ray views of the glenohumeral joint...
April 2016: International Orthopaedics
Benjamin Bockmann, Sonja Soschynski, Philipp Lechler, Steffen Ruchholtz, Florian Debus, Tim Schwarting, Michael Frink
PURPOSE: Profound knowledge of variations in shoulder anatomy is gaining relevance in daily clinical work. In our study, we examine age-dependent variations of glenohumeral parameters in healthy individuals. METHODS: In this analysis, 774 severely injured patients who received a whole-body computed tomography (CT) scan were included. Patients with shoulder fractures were excluded. The resulting scans were split into two groups: patients younger than 25 (group 1) and older than 60 years (group 2)...
January 2016: International Orthopaedics
Jorge H Villafañe, Kristin Valdes, Fabio Anselmi, Caterina Pirali, Stefano Negrini
STUDY DESIGN: A cohort study. INTRODUCTION: The causes of the pain can be difficult for clinicians to diagnose due to the complexity of the shoulder anatomy and the wide spectrum of shoulder conditions. PURPOSE OF THE STUDY: The aim of this study was to investigate the clinical usefulness of provocative diagnostic tests, in patients with partial-thickness tears of the supraspinatus (SST) tendon. METHODS: The partial-thickness tears SST tendon group consisted of 50 patients and 50 subjects with shoulder pain...
July 2015: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
Soterios Gyftopoulos, Eric J Strauss
OBJECTIVE: The objectives of the article are to improve the radiologist's understanding of shoulder arthroscopy and see how it correlates with MRI. We review the basic principles of arthroscopy followed by a comparison of its strengths and weaknesses relative to MRI. This discussion is supplemented by a series of cases that show the relationship between arthroscopy and MRI in terms of the visualization of normal and abnormal anatomy in the diagnosis of common shoulder abnormalities. CONCLUSION: By understanding what our orthopedic colleagues are seeing (and not seeing) during arthroscopic shoulder surgery, we can better understand the strengths and weaknesses of MRI, which provides us the opportunity to improve our imaging interpretations and produce valuable management-guiding diagnostic reports...
June 2015: AJR. American Journal of Roentgenology
Thomas Youm, Richelle Takemoto, Brian Kyu-Hong Park
The shoulder joint has the greatest range of motion of any joint in the body. However, it relies on soft-tissue restraints, including the capsule, ligaments, and musculature, for stability. Therefore, this joint is at the highest risk for dislocation. Thorough knowledge of the shoulder's anatomy as well as classification of dislocations, anesthetic techniques, and reduction maneuvers is crucial for early management of acute shoulder dislocation. Given the lack of comparative studies on various reduction techniques, the choice of technique is based on physician preference...
December 2014: Journal of the American Academy of Orthopaedic Surgeons
Randy Mascarenhas, Jamie Rusen, Bryan M Saltzman, Jeff Leiter, Jaskarndip Chahal, Anthony A Romeo, Peter MacDonald
Recurrent shoulder instability and resultant glenoid and humeral head bone loss are not infrequently encountered in the population today, specifically in young, athletic patients. This review on the management of bone loss in recurrent glenohumeral instability discusses the relevant shoulder anatomy that provides stability to the shoulder joint, relevant history and physical examination findings pertinent to recurrent shoulder instability, and the proper radiological imaging choices in its workup. Operative treatments that can be used to treat both glenoid and humeral head bone loss are outlined...
2014: Advances in Orthopedics
Todd C Moen, Glen H Rudolph, Kyle Caswell, Christopher Espinoza, Wayne Z Burkhead, Sumant G Krishnan
Over the past 20 to 30 years, arthroscopic shoulder techniques have become increasingly popular. Although these techniques have several advantages over open surgery, surgical complications are no less prevalent or devastating than those associated with open techniques. Some of the complications associated with arthroscopic shoulder surgery include recurrent instability, soft-tissue injury, and neurapraxia. These complications can be minimized with thoughtful consideration of the surgical indications, careful patient selection and positioning, and a thorough knowledge of the shoulder anatomy...
July 2014: Journal of the American Academy of Orthopaedic Surgeons
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