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At least 847 records · Page 47Linked to original sources
PubMed1996

[Bilateral luxatio erecta of the shoulder joint--a rare injury. Management and therapy in polytrauma patients].

The case of a 36-year-old male patient is reported who fell from 20 m, sustaining injuries to the abdomen and pelvis and fractures of both arms and the left leg as well as erect dislocation of both shoulders (luxatio erecta humeri). The injury on the right was subcoracoid, that on the left subglenoid-a compound dislocation of the humerus head through the axilla. Based on this case and the pertinent literature, the pathophysiology, diagnosis and treatment of this rare injury are discussed. After immediate closed reduction, soft tissue damage, fractures or neurovascular lesions should be operated on as soon as possible.

Adult↗
PubMed1996

[MR arthrography of the shoulder joint in a postoperative patient sample].

Indications of MR arthrography were analyzed in this prospective study. The aim was to evaluate possible advantages over conventional MRI, establish diagnostic criteria and to analyze its meaning further for the therapeutic management of postoperative patients. MR arthrography was performed in eight patients who had undergone surgical repair of rotator cuff lesions (modified Neer acromioplasty) and in six patients who had undergone arthroscopic therapy of recurrent unidirectional dislocation of the shoulder by combined arthroscopic intra- and extracapsular repair. MR investigations were performed before and after application of a contrast solution (2 mmol Gd-DTPA). All patients suffered from chronic postoperative pain. In patients with rotator cuff lesions, a partial tear could be verified in one patient and excluded in all others. In patients after arthroscopic therapy by combined intra- and extracapsular repair, a radiologically patulous-appearing capsule correlated with clinically recurrent dislocations. In all other patients diagnostic criteria, such as distribution of the intra-articular contrast solution, proliferation of scar tissue, nodular appearance of the glenohumeral ligaments and capsule thickness, correlated with a regular postoperative status. MR arthrography of the shoulder represents a promising method in the evaluation of the postoperative shoulder. It might further improve the evaluation of reactive capsule alterations, scar tissue proliferation, and the labroligamentous complex, as well as the ability to differentiate partial and complete rerupture from degenerative changes of the rotator cuff.

Adult↗
PubMed1986

[Rotator cuff ruptures of the shoulder joint. Sonography--arthrography].

47 patients suspected of rupture of the rotator cuff were sonographed and arthrographed. Rupture of the rotator cuff was diagnosed in 12 cases, both diagnostic methods yielding the same result. In 29 patients sonography and arthrography did not reveal any abnormal findings. Six ruptures evident in sonography were not confirmed by arthrography and were considered false positive. Direct pointers towards rupture of the cuff would be: echoless defects, cuff cannot be visualised fully or in part, irregularities of movement during dynamic examination. Echoless "cystic" areas in the periarticular soft parts must be considered an indirect pointer. Echorich focal findings in the echopoor cuff represent a differential diagnostic problem and we cannot give a final assessment as yet. Shoulder sonography is justified as a screening method in suspicion of rotator cuff rupture before initiating arthrography. If sonography reveals no abnormal findings, shoulder arthrography need not be performed.

Arthrography↗
PubMedDate not supplied

[Intermediate-term follow-up of surgically managed tendinosis calcarea (calcifying subacromion syndrome--SAS) of the shoulder joint].

PURPOSE: Investigation of clinical und ultrasonographical results after operatively treated calcifying tendinitis. METHODS: 131 patients with calcifying tendinitis were treated by surgical decompression and, if necessary and possible, calcific deposit removal. 93% of these patients were clinically and ultrasonographically examined after an average time of 4 years and 5 months. RESULTS: Pain rating on a visual analogue scale 0-no pain to 10-maximum pain was 8.7 before surgery and 1.4 at follow-up. 88% of the patients rated the operation excellent or good. The Constant Score results corresponded to the average results of a normal population (100.3). At the time of examination in 16.4% of the cases new calcific deposits could be discovered. CONCLUSION: According to the clinical results operative treatment shows good and excellent results in a high degree even after unsuccessful non-operative therapy.

Acromion↗
PubMed2002

[Trial manufacture of subsidiary tool and use of technique for shoulder joint of "Scapula Y"].

The technique of "Scapula Y " is effective for capturing forward/backward dislocation of the humeral head and variation in surgical spine fracture. It is also indispensable for describing images of ossification at the tendon plate of the lower lobe of the acrominon and impingement syndrome. However, owing to large individual variations in body shape and position and shape of the scapula, the conventional method does not lend itself to stable reproduction of position or provide adequate diagnostic information. We measured the central angle of entry from scapula m24 pairs of dried bone (Indian) into the spine of the scapula from horizontal and forehead planes to determine the range of variation together with the clinical data referred to in the next paragraph. We then manufactured a trial subsidiary tool to set the angle of the central entering beam base on the acrominon to the spine of the scapula using data on measured angle from 50 clinical radiographs. We identified improvement in radiography of the scapula by using the subsidiary tool designed and manufactured on the basis of the above measured data.

Anthropometry↗
PubMed1990

[Temporary extra-articular Bosworth' fixation in complete shoulder joint separation. Follow-up results of 41 surgically treated patients].

41 patients were reviewed who suffered from complete separation of the acromioclavicular joint which was operated on with an extraarticular clavicular coracoid fixation by means of a Bosworth screw. In 82% of the cases a subjective and functionally good to excellent result was found. Only one patient complained about difficulties in managing daily life. One patient showed a subluxation of the acromioclavicular joint in X-ray with 10kp extension, all other patients demonstrated stabile relations of the ligaments. The coraco-clavicular calcifications of the ligaments increased with the number of months after operation without a negative influence on functions. An operation without much irritation and in a short period of time, the early beginning of functional therapy and the impressive results of the review show that the technique after Bosworth appears superior to other comparable procedures.

Acromioclavicular Joint↗
PubMed1991

[Results after surgical stabilization of the ruptured shoulder joint. Combination procedure versus Bosworth screw].

From 1979 to 1989, 46 patients were operated on for luxation of the acromioclavicular joint (Tossy III) in the department of trauma surgery of the Krankenhaus der Barmherzigen Brüder, Eisenstadt. During the first few years, a combination of traction strapping and Boswoth screws was applied (22 patients) Owing to the high incidence of joint trauma and resulting functional deficit, this procedure was abandoned in favour of fixation with the Bosworth screw alone, combined with transosseous refixation of the joint capsule. The incidence of postoperative complications was approximately equal for both procedures (a total of 3 infections which healed completely, 7 secondary dislocations on removal of the screws, 5 cases of broken or migratory screws). Radiological and clinical follow-up examinations were performed on 36 out of 46 patients up to 93 months postoperatively. In 14 cases, the radiological examination revealed moderate to pronounced signs of arthrosis; the combined procedure was followed by a significantly higher rate of arthrosis. A significant correlation was also found between residual displacement and the occurrence of arthrosis. In cases where only Bosworth screws were used, more joint diastases occurred. In the opinion of the authors, unsatisfactory results are likely to be due to faulty operational technique rather than to the method itself. In general, better reductional results were achieved with the combined method. With reference to the restoration of joint function, however, significantly better results were achieved with exclusively extra-articular stabilization.

Acromioclavicular Joint↗
PubMed1988

[Use of arthrosonography in the diagnosis of Tossy injuries of the shoulder joint].

In a pilot study specificity and sensibility of ultrasonics on Tossy III lesions were tested, and that in 20 cases of guaranteed intact acromioclavicular joints and 22 cases of radiologically diagnosed Tossy III lesions with a following operative control. Additionally in these 22 cases the contralateral acromioclavicular joints were also examined by ultrasonics. All examinations were registered on video tape. With it in a single blind test the exact diagnosis was made in all cases. The diagnosis was based on ultrasonic findings as visible instability, unevenness of the joint line, haematoma formation with ligament stumps. Compared to radiologic diagnostics ultrasonics do not demand cooperative patients or special postures for the examination. A proved accuracy in the diagnosis and the capability of further extension of this technique are of clinical importance. A differentiation of various grades of Tossy lesions is possible.

Acromioclavicular Joint↗