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S P Paul
Objective There remains confusion between Langer's lines and wrinkle lines with respect to the optimal orientation of elliptical excisions on the trunk. This study sought to determine the directions of wound closure that would result in least wound tension after skin lesion excisions. Materials and methods Some 1181 consecutive skin lesion excisions were investigated (age range 13-95 years, median 64 years) using a tensiometer to determine directions of least wound tension. These lines were mapped. Skin tension measurements were taken during the procedure and analysed...
March 15, 2018: Annals of the Royal College of Surgeons of England
Molly K Lewis, Omar Ramos-Williams, Hasan M Syed, Theodore K Gregorius
CASE: A 9-year-old boy sustained intrasubstance tears of the rotator cuff and periscapular muscles due to a fall, resulting in scapular winging and severely decreased shoulder range of motion. Treatment consisted of a modified thoracolumbosacral orthosis (TLSO) with a shoulder immobilizer attachment (to reduce the scapula to the thoracic wall and hold the arm in 10° of abduction). The brace was worn for 8 weeks. The patient recovered full, pain-free shoulder function and range of motion, and returned to high-level athletics...
March 14, 2018: JBJS Case Connector
Jieun Cho, Kyeongbong Lee, Minkyu Kim, Joohee Hahn, Wanhee Lee
This study aimed to investigate the effect of double oscillation exercise combined with elastic band exercise on the strength and thickness ratio of the scapular stabilizing muscles in healthy young individuals. A total of 30 subjects (17 male, 13 female) were randomly assigned to an elastic band exercise group (EBG) (n = 15) or an elastic band plus double oscillation exercise group (EB-DOG) (n = 15). A total of 28 subjects completed the experiment and evaluation. Patients in the EBG performed the elastic band exercise for shoulder flexion, extension, abduction, adduction, horizontal abduction/adduction, and internal/external rotation for 30 minutes/session, five times/week, for four weeks...
March 2018: Journal of Sports Science & Medicine
Kutsi Tuncer, Berhan Pirimoglu, Hayri Ogul
No abstract text is available yet for this article.
March 7, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Anna Fabis-Strobin, Miroslaw Topol, Jaroslaw Fabis, Kryspin Niedzielski, Michal Podgorski, Lukasz Strobin, Michal Polguj
INTRODUCTION: Although the pathomechanism of isolated infraspinatus atrophy (ISA) in throwing sports is known to be traction, it is unclear why only some players are affected. One likely explanation is that the infraspinatus pulling force exerted by its contracture generate the compressive resultant component force (Fn) compressing the lateral trunk of the suprascapular nerve (LTSN) against the edge of scapular spine. This paper makes two key assumptions (1) the course of LTSN in relation to the scapular spine, defined as the suprascapular-scapular spine angle (SSSA) is the key individual anatomical feature influencing the Fn magnitude, and thus potentially ISA development (2) SSSA is correlated with scapular notch type...
March 9, 2018: Surgical and Radiologic Anatomy: SRA
Morgan Schellenberg, Kenji Inaba, James M Bardes, Nicholas Orozco, Jessica Chen, Caroline Park, Tarina Kang, Demetrios Demetriades
BACKGROUND: Portable chest x-ray (CXR) and extended FAST (EFAST) screen patients for thoracic injury in the trauma bay. It is unclear if one test alone is sufficient, if both are required, or if the two investigations are complementary. Study objectives were to define the combined diagnostic yield of EFAST and CXR among stable blunt thoracic trauma patients and to determine if a normal EFAST and CXR might obviate the need for CT scan of the chest. METHODS: All blunt trauma patients ≥15 years presenting to LAC+USC Medical Center in 2016 were screened...
March 8, 2018: Journal of Trauma and Acute Care Surgery
T Patzer
BACKGROUND: In a progredient rotator cuff tear with tendon retraction, fatty infiltration and atrophy of rotator cuff muscles the humerus cannot be centered and stabilized sufficiently in the glenohumeral joint. This leads to rotator cuff defect arthropathy as an eccentric osteoarthritis with acetabularization and wear of the acromion, as well as of the glenoid. INDICATION: A painful pseudoparalysis of the shoulder indicates the implantation of a reversed total shoulder arthroplasty (rTSA) to reduce pain and restore active motion...
March 7, 2018: Der Orthopäde
Carlos Cobo-Vázquez, Gemma De Blas, Pablo García-Canas, María Del Carmen Gasco-García
Cardiopulmonary resuscitation requires the provider to adopt positions that could be dangerous for his or her spine, specifically affecting the muscles and ligaments in the lumbar zone and the scapular spinal muscles. Increased fatigue caused by muscular activity during the resuscitation could produce a loss of quality and efficacy, resulting in compromising resuscitation. The aim of this study was to evaluate the maximum time a rescuer can perform uninterrupted chest compressions correctly without muscle fatigue...
2018: Anesthesia Progress
Abdelfettah Zidane, Adil Arsalane, Mohammed Lahkim, Issam Lalya, Abderrahim Ktaibi, Ismail Essadi
BACKGROUND: Radiotherapy associated with chemotherapy is a well-established treatment modality for locally advanced non-small cell lung cancers. Radiation-induced second malignancies, particularly radiation-induced sarcomas, are rare. Some authors reported a recent increase in the incidence of this rare complication, especially because of the improved prognosis and survival of patients after radiotherapy. Pathogenic mechanisms of radiation-induced sarcomas are poorly understood. However, diagnosis criteria are well established...
March 5, 2018: Journal of Medical Case Reports
Elisa Doria Pires, Paula Rezende Camargo
BACKGROUND: This study measured strength of the trunk and hip, and compared Y Balance Test and Upper Quarter Y Balance Test in individuals without and with scapular dyskinesis. Strength and endurance of the scapulothoracic muscles were also assessed. METHODS: Forty-four individuals without shoulder pain were divided in 2 groups: without scapular dyskinesis (age 26.00, SD 4.10 years) and scapular dyskinesis (age 23.68, SD 4.20 years). Scapular dyskinesis was assessed by clinical observation of the scapular motion during arm elevation, and was classified as present or absent...
February 27, 2018: Clinical Biomechanics
Patricia Dayrell Neiva, Letícia Paiva Franco, Renata Noce Kirkwood, Helena Gonçalves Becker
The clinical decision for surgical treatment of children diagnosed with mouth breathing depends on the percentage of mechanical obstruction correlated with exacerbation of upper respiratory tract infections and systemic changes. The benefits of adenotonsillectomy include changes in the nasopharyngeal space, the mandibular plane and myofunctional alterations. Post-adenotonsilectomy postural benefits have not yet been described. OBJECTIVES: To investigate the kinematics of the shoulder girdle, cervical and thoracic spine in children with mouth breathing before and after adenotonsillectomy...
April 2018: International Journal of Pediatric Otorhinolaryngology
Jessy Lauer, João Paulo Vilas-Boas, Annie Hélène Rouard
BACKGROUND: The mechanical demands of underwater shoulder exercises have only been assessed indirectly via electromyographical measurements. Yet, this is insufficient to understand all the clinical implications. The purpose of this study was to evaluate musculoskeletal system loading during slow (30°/s) scapular plane arm elevation and lowering performed in two media (air vs water) and body positions (sitting vs supine). METHODS: Eighteen participants' upper bodies were scanned and virtually animated within unsteady numerical fluid flow simulations to compute hydrodynamic forces...
February 27, 2018: Clinical Biomechanics
Y Nilipour, S Nafissi, A E Tjust, G Ravenscroft, H Hossein-Nejad, R Taylor, V Varasteh, F Pedrosa Domellöf, M Zangi, S H Tonekaboni, M Olivé, K Kiiski, L Sagath, Davis, N Laing, H Tajsharghi
BACKGROUND: Nemaline myopathy has been associated with mutations in twelve genes to date. However, for some patients diagnosed with nemaline myopathy, definitive mutations are not identified in the known genes, suggesting there are other genes involved. This study describes compound heterozygosity for rare variants in RYR3 in one such patient. RESULTS: Clinical examination of the patient at 22 years of age revealed a long-narrow face, high arched palate and bilateral facial weakness...
March 2, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
S Navarro-Ledesma, A Luque-Suarez
BACKGROUND: The reduction of the subacromial space has traditionally been linked to rotator cuff pathology. The contribution of this narrowing, both in the development and maintenance of rotator cuff tendinopathy, is still under debate. The objective of the present study was compare the acromiohumeral distance at 0 and 60 degrees of active shoulder abduction in scapular plane, static position, in both symptomatic and contralateral shoulders, between participants with unilateral rotator cuff related shoulder pain, and in asymptomatic participants...
February 23, 2018: Clinical Biomechanics
Mohammad Thawabi, Rajiv Tayal, Zain Khakwani, Michael Sinclair, Marc Cohen, Najam Wasty
OBJECTIVE: To identify a fluoroscopic bony landmark for safe percutaneous axillary artery cannulation. BACKGROUND: No bony landmarks exist to guide safe percutaneous axillary artery cannulation, which is an important alternate access site for catheter-based procedures in selected patients. METHODS: We retrospectively analyzed 51 consecutive percutaneous axillary artery sheath angiograms and attempted to correlate a fixed bony landmark to the proximal end of the third part of the artery...
March 2018: Journal of Invasive Cardiology
Alexandre Lädermann, Patrick J Denard, Pascal Boileau, Alain Farron, Pierric Deransart, Gilles Walch
PURPOSE: The purpose of this study was to analyze the effect of different glenoid configurations on arm position and range of motion (ROM) following reverse shoulder arthroplasty (RSA). The hypothesis was that different glenoid configurations would lead to changes in humeral offset, acromio-humeral distance (AHD), ROM, and rotator cuff muscle length. METHODS: Using a three-dimensional (3D) computer model, implantation of an RSA was simulated with a 145° onlay humeral stem combined with five different glenoid configurations which varied in diameter and centre of rotation...
February 28, 2018: International Orthopaedics
Yueh-Hsia Chen, Wei-An Liang, Chung-Yin Hsu, Siang-Lan Guo, Shwu-Huei Lien, Hsiao-Jung Tseng, Yuan-Hung Chao
Background: Advanced treatment of oral cancer increases survival rates; however, it also increases the risk of developing shoulder dysfunction, dysphagia, oral dysfunction, donor site morbidity and psychological issues. This single-arm preliminary pilot study aims to explore the effects of a six-month early intervention program following reconstructive surgery in oral cancer survivors. Methods: A total of 65 participants were analyzed following reconstructive surgery...
2018: PeerJ
Antonio Cusano, Nicholas Pagani, Xinning Li
Medial scapular winging is often due to dysfunction of the serratus anterior muscle as a result of injury to the long thoracic nerve. Impairment of the serratus anterior muscle may cause uncoordinated scapulohumeral rhythm during shoulder elevation and subsequent subscapular or shoulder pain, subacromial impingement, and glenohumeral joint instability. Although long thoracic nerve injury typically resolves in 12 to 18 months after a physical therapy regimen, surgical intervention is indicated in patients who fail conservative management...
August 2017: Arthroscopy Techniques
Carlos Torrens, Eduard Alentorn-Geli, Felipe Mingo, Carlo Gamba, Fernando Santana
PURPOSE: To investigate the influence of greater tuberosity healing on the functional outcomes of reverse shoulder arthroplasty (RSA) for the treatment of acute complex proximal humeral fractures (PHFs), and to investigate the influence of patient- and surgery-related factors in the healing of the greater tuberosity. METHODS: Retrospective study including 41 consecutive PHFs treated using RSA with minimum 2-year follow-up. In all the cases, tuberosities were reattached with a standardized technique...
January 2018: Journal of Orthopaedic Surgery
Antoine Eskander, Stephen Y Kang, Enver Ozer, Amit Agrawal, Ricardo Carrau, James W Rocco, Theodoros N Teknos, Matthew O Old
BACKGROUND: This pictorial essay demonstrates a modification to the positioning, prepping, and draping technique for the subscapular system of flaps allowing the patient to be placed supine and without the need for a second assistant during the harvest or closure. METHODS AND RESULTS: We performed a literature review focusing on the positioning of the patient during the harvest of the subscapular system of flaps. A supine modification harvest prepping, draping, and position is then described in pictorial essay format...
February 27, 2018: Head & Neck
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