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Biomedical subjects

C S Neer

Publications and source records attributed to C S Neer.

At least 37 records · Page 2Linked to original sources
PubMed1982

Revision of humeral head and total shoulder arthroplasties.

A prospective study was undertaken of 40 revisions of humeral head and total shoulder arthroplasties performed during the past nine years. The average follow-up period was 42 months. Surgical revision consisted of conversion to unconstrained total shoulders in 34 shoulders, fixed-fulcrum total shoulder in one shoulder, and "cleanout" of the implant and cement in five shoulders, of which three were later fused. The indications for fusion were (1) infection, and (2) extensive loss of shoulder muscles, including both the deltoid and rotator cuff. Neither loss of bone nor rotator cuff defects were considered contraindications to unconstrained total shoulder arthroplasty; however, the results of this study emphasize the need for a good initial humeral head arthroplasty, insofar as the function of revisions is often impaired by muscle damage, bone loss, and scar.

Adolescent↗
PubMed1981

On the disadvantages of radical acromionectomy.

We studied thirty consecutive patients who previously had a radical acromionectomy performed elsewhere. All had poor results from the procedure. Twenty-seven had persistent pain, all had marked weakness of the shoulder, and none could raise the arm above the horizontal. Eight had had serious wound complications. All objected to the appearance of the shoulder. We concluded that radical acromionectomy weakened the deltoid both by removing its lever arm and by encouraging retraction of the deltoid muscle became adherent to either the rotator cuff or the humerus, or both, and soon became fibrotic and permanently shortened. This combination of factors makes a successful reconstruction of the deltoid mechanism especially difficult.

Acromion↗
PubMed1980

Inferior capsular shift for involuntary inferior and multidirectional instability of the shoulder. A preliminary report.

In thirty-six patients (forty shoulders) with involuntary inferior and multidirectional subluxation and dislocation, there had been failure of standard operations or uncertainty regarding diagnosis or treatment. Clinical evaluation of these patients stressed meticulous psychiatric appraisal, conservative treatment, and repeated examination of the shoulder. All patients were treated by an inferior capsular shift, a procedure in which a flap of the capsule reinforced by overlying tendon is shifted to reduce capsular and ligamentous redundancy on all three sides. This technique offers the advantage of correcting multidirectional instability through one incision without damage to the articular surface. One shoulder began subluxating again within seven months after operation, but there have been no other unsatisfactory results to date. Seventeen shoulders were followed for more than two years.

Adolescent↗
PubMed1975

Glenohumeral joint replacement and postoperative rehabilitation.

Prosthetic replacement of the humeral head in patients with severe fractures that detach or crush the articular surface and in patients with glenohumeral arthritis has been done at the Columbia-Presbyterian Medical Center since 1953. Recently, a revised prosthesis for the articular surface of the head of the humerus has been used in combination with a polyethylene glenoid component. This method of total shoulder replacement has been used in patients with rheumatoid arthritis and in other conditions where the glenoid fossa is abnormal. Postoperative physical therapy management is especially important in this unique joint and is explained in detail.

Arthroplasty↗
PubMed1975

Recurrent dislocation of the elbow.

Recurrent dislocation of the elbow resulted from laxity of the lateral capsule and collateral ligament in four patients. An intra-articular lesion was usually also present. Elbow arthrotomy for removal of loose bodies and repair of the lateral capsuloligamentous structures are thought to offer an excellent prognosis for satisfactory relief from symptoms of recurrent dislocation. More complicated techniques, such as bone blocks or tendon transfers, are believed to be less effective and unnecessary.

Adolescent↗