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At least 217 records · Page 12Linked to original sources
PubMed1985

[Differential arthrographic diagnosis of the painful shoulder joint].

60 arthrograms of the shoulder were explored under morphologic and pathologic-anatomic aspects. Differentiation was made between acute and chronic pain. The possible findings in leaking of the contrast material out of the joint capsule are shown and discussed. Signs are quoted of degeneration of soft tissue and bone. The findings in patients with rheumatoid arthritis and a history of shoulder dislocation are summarised. Distension of the joint capsule without shoulder dislocation is described. Filling of the periarticular lymphatics is mentioned in different cases.

Adolescent↗
PubMed1989

[Etiopathogenetic factors of congenital habitual shoulder joint dislocation].

Six of 56 patients (10.7 per cent) surgically treated for anterior habitual and recurrent dislocation of the shoulder joint exhibited congenital habitual dislocation. Surgery revealed agenesis of the anterior and upper parts of the capsular wall. The lower part of the capsular wall was used for reconstruction.

Adolescent↗
PubMedDate not supplied

[Arthroscopic therapy of the unstable shoulder joint--acceptance and critical considerations].

PURPOSE: The purpose of this study was to document and to present the acceptance of arthroscopically performed stabilising procedures of the glenohumeral joint. METHOD: In a nationwide survey of instructors of the association of arthroscopy, members of the arthroscopy group of the german orthopedic society, and orthopedic and trauma surgeons with special interest in joint surgery we evaluated the current treatment modalities for patients with unstable shoulder joints. RESULTS: After an average of 2.09 +/- 1.0 shoulder redislocations surgery is recommended. The Bankart-operation (63.4%) is the favourite procedure for open surgery. In a descended order the Weber rotation-osteotomie, the Putti-Platt operation, the Max-Lange procedure, and in a minimal amount of the cases the Bristow-procedure are performed. Looking at the arthroscopic procedures, the distribution is much more equal. The Caspari technique is used by 27.6% and the Morgan technique by 25.1%. Bone anchors are used by 20.4% and the Suretac is used by 18.9% of the surgeons. The anchor knot technique (8%) is only rarely performed. In case of an elongated capsule the majority of the surgeons would not perform arthroscopic surgery. 42.4% of the surgeons judge the arthroscopic technique less secure. However, 38.9% do not see any difference to open procedures. CONCLUSION: Taking the available information, arthroscopic stabilising procedures seems to have slightly inferior results compared to standard open surgery. The Bankart procedure with or without a capsular shift is still the golden standard.

Arthroscopy↗
PubMed2004

Determining the relationship of the axillary nerve to the shoulder joint capsule from an arthroscopic perspective.

BACKGROUND: The axillary nerve is out of the field of view during shoulder arthroscopy, but certain procedures require manipulation of capsular tissue that can threaten the function or integrity of the nerve. We studied fresh cadavers to identify the course of the axillary nerve in relation to the glenoid rim from an intra-articular perspective and to determine how close the nerve travels in relation to the glenoid rim and the inferior glenohumeral ligament. METHODS: We dissected nine whole-body fresh-tissue shoulder joints and exposed the axillary nerve through a window in the inferior glenohumeral ligament. Then we cut coronal sections through the glenoid fossa of ten unembalmed, frozen shoulder specimens after the axillary nerve had been stained with Evans blue dye. All specimens were studied with the joint secured in the lateral decubitus position used for shoulder arthroscopy. RESULTS: Microsurgical dissection through the inferior glenohumeral ligament from within the joint capsule revealed the axillary nerve as it traversed the quadrangular space. In each dissection, the teres minor branch was the closest to the glenoid rim. The coronal sectioning of the unembalmed shoulder specimens demonstrated that the closest point between the axillary nerve and the glenoid rim was at the 6 o'clock position on the inferior glenoid rim. At this position, the average distance between the axillary nerve and the glenoid rim was 12.4 mm. The axillary nerve lay, throughout its course, at an average of 2.5 mm from the inferior glenohumeral ligament. CONCLUSIONS: We used two novel approaches to map the axillary nerve from an intra-articular perspective. Our analysis of the position of the nerve with use of these methods provides the shoulder arthroscopist with essential information regarding the location, route, and morphology of the nerve as it passes inferior to the glenoid rim and shoulder capsule.

Aged↗
PubMed1983

Recurrent anterior dislocation of the shoulder joint a modification of Bankart's capsuloplexy. Notes on the surgical technique.

Twenty-one cases of recurrent anterior dislocation of the shoulder joint were operated on by a modification of Bankart's technique between 1975 and 1981. The modification consists in the introduction of two screws with their respective washers in order to fix the lateral flap of the capsule to the neck of the glenoid cavity, after which the medial flap is turned back and secured by a reefing suture. This device overcomes the difficulty encountered with the insertion of the joint capsule in Bankart's original method.

Adult↗
PubMed2006

Shoulder joint kinetics and pathology in manual wheelchair users.

BACKGROUND: Manual wheelchair users rely heavily on their upper limbs for independent mobility which likely leads to a high prevalence of shoulder pain and injury. The goal of this study was to examine the relationship between shoulder forces and moments experienced during wheelchair propulsion and shoulder pathology. METHODS: Kinetic and kinematic data was recorded from 33 subjects with paraplegia as they propelled their wheelchairs at two speeds (0.9 and 1.8 m/s). Shoulder joint forces and moments were calculated using inverse dynamic methods and shoulder pathology was evaluated using a physical exam and magnetic resonance imaging scan. FINDINGS: Subjects who experienced higher posterior force (Odds Ratio (OR)=1.29, P=0.03), lateral force (OR=1.35, P=0.047), or extension moment (OR=1.35, P=0.09) during propulsion were more likely to exhibit coracoacromial ligament edema. Individuals who displayed larger lateral forces (OR=4.35, P=0.045) or abduction moments (OR=1.58, P=0.06) were more likely to have coracoacromial ligament thickening. Higher superior forces (OR=1.05, P=0.09) and internal rotation moments (OR=1.61 P=0.02) at the shoulder were associated with increased signs of shoulder pathology during the physical exam. INTERPRETATION: Specific joint forces and moments were related to measures of shoulder pathology. This may indicate a need to reduce the overall force required to propel a wheelchair in order to preserve upper limb integrity. Potential interventions include changes to wheelchair setup, propulsion training, or alternative means of mobility.

Adult↗
PubMed1991

[Radiologic and sonographic screening study of shoulder joints of patients with rheumatoid arthritis].

In the course of a prospective study at our department the shoulder joints of 50 RA-patients were examined. Two criteria have been applied: only righthanded patients have been examined in order to ascertain any prevalence of changes in the dominant extremity, and only patients who were primarily admitted to our department because of complaints other than those of the shoulder. Examination consisted of anamnesis, clinical tests, radiography and sonography. Reports in the literature concerning involvement of 60%. This percentage was confirmed in our clinical and radiological examinations. If, however, sonography is used, it increases to 96%. Lesions of the rotator cuff can be demonstrated, beginning on the synovial side above bone erosions, without any clinical signs or radiographic changes. Radiographic changes have been rated according to Larsen stages 0-5. Upward migration of the humeral head already before massive bone destruction of the shoulder seems to confirm an early involvement of the rotator cuff. Involvement of the acromioclavicular joint begins with Larsen stage 2 and often includes a distension of the joint cavity. The dominant extremity was not found to be affected predominantly. The therapeutic consequences resulting from this examination are discussed.

Adult↗
PubMed1997

Periarticular fiber system of the shoulder joint.

The structure and attachment of the glenoid labrum were examined from the functional point of view in 42 shoulder-joint cavities using a combination of macroscopic and microscopic techniques. The labrum continues the long tendon of the biceps as far as the ventral glenoid notch and is supplemented by a connecting band between the superior and inferior glenohumeral ligaments. In the upper quadrants, the periarticular fibers are broadly attached to the neck of the scapula and separated by a gap from the articular cartilage. In the lower quadrants, they are attached to both the neck of the scapula and the joint surface. The periarticular structures consist of bundles of parallel collagen fibers that run round the entire circumference of the cavity. The labrum, glenohumeral ligaments, and inserting tendons form a basket of fibers around the neck of the scapula, which constitutes a functional unit: the periarticular fiber system (PAFS). This acts as a tension-brace for the joint cavity and takes part in the local transmission of pressure through the cavity. Detachment of the labrum, or the labral-biceps anchor, should only be diagnosed when it can be shown that the tissue between the PAFS and the upper part of the neck of the scapula has been torn, and that the extent of the gap formation reaches laterally and caudally beyond the peripheral edge of the cartilage.

Adolescent↗
PubMed1988

[Possibilities of magnetic resonance tomography in diagnostic imaging of the shoulder joint].

By virtue of its multiplanar representation, magnetic resonance imaging (MRI) allows clear visualization of the complex anatomical relationships of the shoulder joint. In addition to axial planes, slices perpendicular and parallel to the glenoid cavity are used to good advantage. In tears of the rotator cuff an increase in signal intensity within the cuff is recognized in T2- and proton-density-weighted images. Lesions of the glenoid labrum following luxations of the glenohumeral joint can be detected and classified using MRI. The diagnostic value of MRI as compared with other imaging modalities will have to be evaluated in larger series with operative verification.

Arthrography↗