Biomedical subjects

O Gagey

Publications and source records attributed to O Gagey.

41 records · Page 3Linked to original sources

PubMed1984

[Recent fractures of the scapula. Apropos of 43 cases].

The authors have studied a series of 43 fractures of the scapula. They confirm the results are generally good. However, 12 displaced fractures of the neck of the scapula have been seen. All were treated conservatively with only one good result, the other results being fair or poor. These results are explained by the fact that displaced fractures of the neck disorganize the coraco-acromial arch. This type of fracture should be surgically treated as an articular fracture by open reduction and plate fixation. Fractures of the glenoid should also be treated surgically.

Adolescent↗

PubMedDate not supplied

The subscapular and subcoracoid bursae: descriptive and functional anatomy.

The subscapularis and subcoracoid bursae, as well as the subscapularis muscle, were studied in 42 fresh cadaveric shoulders. Fibrous bands were found in the medial part of the muscle; they were intercalated with the distal tendon-like bands. The superior distal fibrous band was always found to be thicker than the others. Strong fibrous attachments of the subscapularis muscle were found along the lateral border of the scapula as well as along the medial third of the bony crests in the subscapular fossa. Between the crests, the muscle bundles were directly attached to the bone. In the lateral part of the scapula, the subscapularis muscle had only weak connective links with the bone. The subscapularis bursa was found in all cases as a pouch strongly attached to the scapular neck and the adjacent part of the joint capsule. The top of the bursa was linked to the coracoid process by a fibrous attachment called the suspensory ligament. The subcoracoid bursa had only weak connective links with the coracoid process. In 28% of cases, the subscapularis and subcoracoid bursae merged into a unique wide bursa. The subscapular bursa had two types of links with the muscle: (1). weak connective links with the superficial muscle bundles and (2). at least 2 fibrous arcs joining the lateral tendon-like bands, the bursa, and bony crests of the subscapularis fossa. These arcs allow the bursa to follow the course of the muscle exactly. During movements of the glenohumeral joint, the subscapularis muscle sustains huge changes of orientation, particularly the upper part of the muscle that coils around the coracoid process. The strong superior fibrous band enables the muscle to maintain contact with the coracoid process. It is the function of the subscapularis and subcoracoid bursae to manage the friction of the superficial fibers against the scapular neck, the humeral head, and the coracoid process.

Aged↗

PubMedDate not supplied

Rotator interval lesions and their relation to coracoid impingement syndrome.

In the last 10 years we have found impingement of the coracoid process on the rotator interval in 12 patients (14 shoulders). Seven of these patients were women and 5 were men; the average patient age was 48.5 years. One patient had a calcified coracohumeral ligament, another patient had an anterior tear of a repaired deltoid flap, and a third had an aberrant pectoralis minor tendon inserted into the rotator interval. Eleven patients had a weak rotator interval, and in 4 cases the rotator interval had a small tear. We closed the rotator interval in all 12 patients. We also performed a coracoidoplasty in 5 of the patients. The condition of all shoulders improved clinically after operation; the average follow-up was 4.2 years. Three patients (4 shoulders) still had moderate pain, and 7 patients (9 shoulders) lacked strength. Internal rotation was the only shoulder movement that remained limited. Although impingement seemed obvious during surgery, experimental studies have reported contradictory findings.

Acromion↗

PubMedDate not supplied

Posterolateral approach of the shoulder: assessment of 50 cases.

A new posterior approach of the shoulder for hemiarthroplasty or total arthroplasty has been used 53 times over a 6-year period. The posterior part of the deltoid is detached subperiosteally from the spine and the posterior aspect of the acromion. Distally, the incision is made between the posterior and middle parts of the muscle. The subacromial bursa is opened to reveal the plane of the external rotator muscles. The articular approach is performed by means of an osteotomy of the external rotator muscles' insertion. This approach provides a wide exposure of the joint. The socket can be seen almost head-on, which eases glenoid preparation during arthroplasty. Transosseous reinsertion of the osteotomy fragments seems stronger that tendinous suture. One early case of failure of external rotator muscle repair was recorded. Atrophy of the posterior deltoid was found in 2 cases.

Arthroplasty, Replacement↗

PubMedDate not supplied

MR evaluation of factors predicting the development of rotator cuff tears.

PURPOSE: The purpose of this work was to assess the incidence of various factors predicting impingement in the shoulder. METHOD: MR examination was used to assess various anatomic parameters in 46 patients with clinical abnormalities of the shoulder and 40 asymptomatic volunteers. All patients had undergone surgery, showing no rotator cuff tear. RESULTS: A few of the parameters evaluated were significantly different in the two groups: The acromion was more frequently curved or hook-shaped in patients than in volunteers. The acromiohumeral distances differed (4.87 mm in patients and 6.05 mm in volunteers); so did the coracohumeral distances (7.9 mm in patients and 8.9 mm in volunteers). The shape of the acromioclavicular joint and the anterior covering of the humerus, defined on the coronal view, also differed (1.07 mm in patients and 1.49 mm in volunteers). Only the shapes of the acromioclavicular joint and of the acromion were linked with age. CONCLUSION: All these factors reflected a decrease in the acromiohumeral space, except for the anterior covering of the acromial arch, which could be due to anterior instability.

Acromioclavicular Joint↗