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At least 433 records · Page 24Linked to original sources
PubMed1998

[Posterior shoulder joint instability. Classification, pathomechanism,diagnosis, conservative and surgical management].

The posterior instability of the shoulder is a more difficult diagnostic and therapeutic challenge than the anterior instability. There are many etiologies and causes of posterior instability. Most studies in the literature are retrospective and yield a great variation in therapeutic recommendations. Generally it has to be separated in traumatic and atraumatic instabilities. Most of the traumatic dislocations are impaction fractures of the humeral head against the dorsal glenoid. Therapy is depending on the size of the humeral defect, the duration of dislocation and the functional demand of the patient. Therapeutic possibilities are closed reduction and fixation with a cast, open reduction and the transfer of the lower tubercule (McLaughlin's procedure), lifting of the defect and supporting with cancellous bone, subcapital rotational osteotomy or arthroplasty. The therapy of choice for atraumatic instability is a individualized rehabilitation program with strengthening and balancing of rotator cuff muscles and scapular stabilizers. Psychologic abnormalities and emotional problems have to be recognized prior to any operative procedure. These patients are no operative candidates. Operative treatment of choice is the posterior capsular shift addressing the causative redundancy or laxity of the postero-inferior capsule. Posterior bony procedures as glenoid osteotomy or bone block transfers are indicated, if the pathologic geometry of the glenoid is primarily responsible for posterior instability. It is strongly recommended to combine them with a capsular shift to address the secondary capsular redundancy.

Decision Making↗
PubMed1979

The treatment of arthritis of the shoulder joint by double osteotomy.

This paper presents the new operations of double osteotomy of the shoulder for the treatment of painful arthritis. The procedure consists of osteotomy without displacement of the necks of both the scapula and the humerus. Sixteen patients who have had this operation have been followed for one to nine years (average 2 years 11 months). The results show good or excellent pain relief in 13 patients and a substantial increase in active abduction in 13 patients. Complications were few and none were serious. A possible reason for the reduction of pain is suggested and the advantages of this operation over arthrodesis and total shoulder replacement are discussed.

Adult↗
PubMed1983

Influence of adjuvant irradiation on shoulder joint function after mastectomy for breast carcinoma.

The influence of postoperative radiation therapy on ipsilateral shoulder function following mastectomy was evaluated from a series of 52 women with primarily operable carcinoma of the breast. Mastectomy and partial axillary dissection were carried out in all patients. In addition, 29 of the patients received postoperative irradiation with 36.6 Gy applied mid-axillarily in 12 fractions with irradiation twice a week. A significant impairment of the active shoulder mobility was found in the irradiated group (p less than 0.01). The passive mobility did not differ significantly between the two groups. The impairment of active shoulder mobility is suggested to be caused by radiation induced subcutaneous fibrosis.

Adult↗