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Shoulder anatomy and pain

L Tarallo, R Mugnai, M Rocchi, C Rovesta, F Catani
BACKGROUND: Distal humeral malunions are uncommon injuries, often associated with limited elbow motion, pain, instability, weakness, and sometimes ulnar neuritis. The complex anatomy of the elbow joint makes this condition one of the most complex elbow injuries to treat. MATERIALS AND METHODS: Four patients were treated by the same surgeon between 2011 and 2013 using a double-locking precontoured plating system for malunited intra-articular or extra-articular fractures of the distal end of the humerus...
December 2016: Musculoskeletal Surgery
Achilleas Boutsiadis, Laurent Baverel, Hubert Lenoir, Philippe Delsol, Johannes Barth
Chronic acromioclavicular (AC) instability is a rare posttraumatic shoulder condition that can lead to undesirable symptoms like persistent pain, muscle fatigue, loss of strength, or even scapular dyskinesis. It is well known that in these cases the superior functional results depend on the restoration of the anatomy and stability of the AC joint in both vertical and horizontal planes. Considering the ligaments degeneration and atrophy in chronic AC joint dislocations, we present an arthroscopic-assisted reconstruction of both the coracoclavicular and AC ligaments using autograft augmentation...
December 2016: Techniques in Hand & Upper Extremity Surgery
Matthew H Lee, Scott E Sheehan, John F Orwin, Kenneth S Lee
Shoulder pain is one of the most common musculoskeletal conditions encountered in primary care and specialty orthopedic clinic settings. Although magnetic resonance (MR) imaging is typically the modality of choice for evaluating the soft-tissue structures of the shoulder, ultrasonography (US) is becoming an important complementary imaging tool in the evaluation of superficial soft-tissue structures such as the rotator cuff, subacromial-subdeltoid bursa, and biceps tendon. The advantages of US driving its recent increased use include low cost, accessibility, and capability for real-time high-resolution imaging that enables dynamic assessment and needle guidance...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Simon Lee, Asheesh Bedi
Acromioclavicular joint separations are a common cause of shoulder pain in the young athletic population. In high-grade injuries, acromioclavicular joint reconstruction procedures may be indicated for functional improvement. There is currently no gold standard for the surgical management of these injuries. Multiple reconstructive options exist, including coracoclavicular screws, hook plates, endobutton coracoclavicular fixations, and anatomic ligament reconstructions with tendon grafts. This article aims to review pertinent acromioclavicular joint anatomy and biomechanics, radiographic evaluation, classification system, as well as reconstruction options, outcomes, and complications...
December 2016: Current Reviews in Musculoskeletal Medicine
Saad M AlQahtani, Ryan T Bicknell
Lesions of the proximal long head of the biceps tendon (LHB) have been considered as a major cause of shoulder pain and dysfunction. The role of the LHB in causing pain has been a source of controversy for many years, and extensive literature is available discussing anatomy, function, pathology, and most importantly appropriate treatment. Despite this, there is a lack of consensus in the literature regarding the management of biceps-related pathology. Biceps tenotomy and tenodesis are common surgical treatment options when dealing with LHB-related pathology...
December 2016: Current Reviews in Musculoskeletal Medicine
Keyvan Eghbal, Fariborz Ghaffarpasand
BACKGROUND: Several injuries in the cervical region as complications of acupuncture have been previously reported in the literature, including cord and medulla oblongata injuries, subdural empyema, and cervical hematoma. Spinal cord subdural hematoma is a rare condition mainly associated with coagulopathy, trauma, and iatrogenic procedures. We herein report an acute cervical subdural hematoma after cervical acupuncture for neck and shoulder pain. CASE DESCRIPTION: A 74-year-old woman presented with progressive quadriparesis and sensory deficit after receiving acupuncture in the neck and shoulder...
November 2016: World Neurosurgery
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
Sushant Swaroop Das, Anita Mahajan, Neelam Vasudeva
INTRODUCTION: Anthropologists have used Coracoclavicular Joint (CCJ), a non-metric anatomical variant in population, as a marker for population migration from prehistoric times to present. AIM: The aim of this osteological study was to determine the incidence and morphometry of articular facet of CCJ on conoid tubercle of clavicle in Indian population, as Indian studies are scanty and incomplete. MATERIALS AND METHODS: The study was done on 144 adult human clavicles (76 right and 68 left; 93 males and 51 females) collected from osteology museum in Department of Anatomy, Maulana Azad Medical College, New Delhi, India...
April 2016: Journal of Clinical and Diagnostic Research: JCDR
Adam J Lorenzetti, Geoffrey P Stone, Peter Simon, Mark A Frankle
The evolution of reverse shoulder arthroplasty has provided surgeons with new solutions for many complex shoulder problems. A primary goal of orthopaedics is the restoration or re-creation of functional anatomy to reduce pain and improve function, which can be accomplished by either repairing injured structures or replacing them as anatomically as possible. If reconstructible tissue is lacking or not available, which is seen in patients who have complex shoulder conditions such as an irreparable rotator cuff-deficient shoulder, cuff tear arthropathy, or severe glenoid bone loss, substantial problems may arise...
2016: Instructional Course Lectures
Christian K Spies, Peter Hahn, Lars P Müller, Steffen Löw, Richard M Sellei, Johannes Oppermann
INTRODUCTION: To evaluate the efficacy of open partial aponeurectomy for recurrent Dupuytren's contracture. METHODS: Eighteen patients with recurrent Dupuytren's contracture of 22 fingers were retrospectively assessed with a mean follow-up time of 94 months (range: 70-114 months). Examination parameters included the determination of range of motion (ROM), grip strength, pain and subjective outcome (disabilities of the arm, shoulder and hand (DASH) questionnaire)...
June 2016: Archives of Orthopaedic and Trauma Surgery
Jonathan D Barlow, Joseph Abboud
Young patients with glenohumeral arthritis are an ongoing treatment challenge. They typically have high demands of their shoulders, require long-term durability due to their young age, and often have altered local anatomy, through their disease process (instability arthropathy, juvenile rheumatoid arthritis, etc.) or from previous surgery (capsulorraphy arthropathy, chondrolysis, etc.). Workup to evaluate underlying causes of early arthritis, and to exclude infectious causes are necessary. When nonoperative management fails, arthroscopic debridement, hemiarthroplasty (isolated, with glenoid reaming, or with biological interposition), and total shoulder arthroplasty are treatment options available to the treating surgeon...
January 2016: International Journal of Shoulder Surgery
J Jurča, M Němejc, V Havlas
PURPOSE OF THE STUDY: The aim of the study was to compare results of the Burton-Pellegrini trapeziectomy with ligamentoplasty using the flexor carpi radialis tendon with those of trapeziometacarpal joint replacement in the treatment of advanced rhizarthrosis. MATERIAL AND METHODS: A group of 17 patients, 15 men and two women, underwent trapeziectomy with ligamentoplaty; in 12 of them, the dominant hand was involved. The trapeziometacarpal joint prosthesis Beznoska was implanted in 11 patients (10 men and one woman) with seven dominant and four non-dominant hands...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Hervé Thomazeau, Thomas Raoul, Anthony Hervé, Frédéric Basselot, Harold Common, Mickaël Ropars
HYPOTHESIS: The objective of this study was to improve our understanding of the pathogenesis and symptoms of ganglion cysts (GCs) in the spinoglenoid notch. Two hypotheses were tested: (1) the labral tears responsible for these cysts are mainly degenerative and nontraumatic, (2) spinoglenoid cysts are early magnetic resonance image (MRI) markers of eccentric posterior glenoid wear. MATERIALS AND METHODS: This was a descriptive diagnostic study. Patients were included when a spinoglenoid cyst was discovered after complaints of pain in the posterosuperior aspect of the shoulder...
July 2016: Journal of Shoulder and Elbow Surgery
Matthew M Crowe, Bassem T Elhassan
The importance of coordinated, normal scapulothoracic motion in facilitating full, pain-free motion of the shoulder complex has been increasingly studied over the past decade, leading to renewed interest in scapular-based reconstructions to improve shoulder girdle motion through the use of muscle advancements and tendon transfers. This article will review recent advances regarding scapulothoracic motion and the muscular stabilizers of the scapula, focusing on clinical diagnosis and anatomy as it pertains to scapular dyskinesis and common periscapular tendon transfers...
February 2016: Journal of Hand Surgery
Emily J Curry, Elizabeth E Matzkin, Yan Dong, Laurence D Higgins, Jeffrey N Katz, Nitin B Jain
BACKGROUND: Structural characteristics of rotator cuff tears are used in surgical decision making. However, data on the association of tear size with patient-reported pain and function are sparse. PURPOSE: To assess the association of tear size, fatty infiltration, and muscle atrophy with shoulder pain/function in patients with cuff tears undergoing operative and nonoperative treatment. STUDY DESIGN: Cross-sectional study; Level of evidence, 3...
May 2015: Orthopaedic Journal of Sports Medicine
Jonathan J Streit, Yousef Shishani, Reuben Gobezie
Reverse shoulder arthroplasty may be performed using components that medialize or lateralize the center of rotation. The purpose of this prospective study was to directly compare 2 reverse shoulder arthroplasty designs. Two treatment groups and 1 control group were identified. Group I comprised 9 patients using a medialized Grammont-style (GRM) prosthesis with a neck-shaft angle of 155°. Group II comprised 9 patients using a lateralized (LAT) prosthesis with a neck-shaft angle of 135°. Pre- and postoperative assessment of range of motion, American Shoulder and Elbow Surgeons score, and visual analog scale pain score were performed...
December 2015: Orthopedics
Pierre-Henri Flurin, Christopher P Roche, Thomas W Wright, Joseph D Zuckerman
UNLABELLED: Many glenohumeral studies have demonstrated how anatomy varies across the population. Third and fourth generation shoulder prosthesis designs were developed to provide greater modularity and size ranges to better reproduce this anatomy and thus achieve better results in terms of shoulder function. This study quantifies the quality of anatomic reconstruction and compares that to long-term clinical outcomes using one fourth generation platform shoulder system. METHODOLOGY: One hundred and forty primary total shoulder arthroplasties were performed by one experienced single surgeon between 2001 and 2009, using the same fourth generation modular prosthesis...
December 2015: Bulletin of the Hospital for Joint Diseases
R Singh, M Singla, R S Tubbs
BACKGROUND: There is controversy over the nature of tissues covering the bicipital groove protecting the biceps brachii tendon from dislocation/subluxation causing shoulder pain. Recent researches on cadaveric dissection and histological studies have changed the old concept of the transverse humeral ligament covering the bicipital groove to tendinous fibres of the subscapularis or interdigitating fibres of the subscapularis and supraspinatus. The change has not been incorporated into standard text books of anatomy...
2015: Folia Morphologica (Warsz)
Thomas W Wright, Pierre-Henri Flurin, Lynn Crosby, Aimee M Struk, Joseph D Zuckerman
In this article, we present clinical results of primary total shoulder arthroplasty for osteoarthritis using an implant that provides dual eccentricity and variable neck and version angles for reconstruction of proximal humeral anatomy. Two hundred one patients with symptomatic osteoarthritis underwent 218 total shoulder arthroplasties with a fourth-generation anatomical shoulder and a replicator plate at 4 centers between August 1, 2006, and December 31, 2010. Fourth-generation implants allow for varying humeral neck and version angles and have dual eccentricity so as to be consistently able to cover the humeral head cut...
November 2015: American Journal of Orthopedics
P Loriaut, L Casabianca, J Alkhaili, B Dallaudière, E Desportes, R Rousseau, P Massin, P Boyer
INTRODUCTION: Arthroscopic treatment of acute grade 3 and 4 acromioclavicular dislocation is controversial, due to the risk of recurrence and of postoperative reduction defect. The purpose of the present study was to investigate whether the healing of the acromioclavicular (AC) and coracoclavicular (CC) ligaments and the accurate 3D positioning parameters of the AC joint using MRI were correlated with satisfactory functional outcome. MATERIAL: Thirty-nine patients were enrolled from 2009 to 2011 and managed arthroscopically by CC lacing using a double-button device...
December 2015: Orthopaedics & Traumatology, Surgery & Research: OTSR
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