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At least 883 records · Page 49Linked to original sources
PubMed1992

[Shoulder dislocation and periarthrosis humeroscapularis].

1232 injuries involving shoulder luxations in 1984 were investigated on the basis of the insurance dossier. 1/3 of the injured persons have sequelae: 10.5% habitual tendency to luxation, 9% peritendinitis, 2% omarthritis and 2% a shoulder instability. 1/5 in each case still experience pain and restricted movement. The 108 cases where peritendinitis has occurred following shoulder luxations are shown divided up according to various symptoms. Peritendinitis ankylosis or frozen shoulder represents the major share in almost half of the cases. Various characteristics, complications and risk factors for the possibility of contracting peritendinitis following shoulder luxation are being worked out. In conclusion, the insurance-relevant parameters for peritendinitis after shoulder luxation are shown: in cases with peritendinitis, integrity compensation was awarded 12 times more frequently than in cases without peritendinitis; in the case of shoulder luxation with peritendinitis, the entire insurance benefits were 10 times higher than in cases without peritendinitis.

Adult↗
PubMed2005

Limitations of isokinetic testing to determine shoulder strength after rotator cuff repair.

Some investigators have reported incomplete data when using isokinetic testing as a means of analyzing shoulder strength after rotator cuff repair. An explanation provided has been that the subjects could not reach the speed at which the machine was set. The purpose of this study was to determine if strength data could be generated for all motions being tested by using not only the one or two speeds employed by others, but three speeds across the spectrum of those available. Inclusion criteria were a minimum of two years since surgery with a normal contralateral shoulder. All eligible subjects had isokinetic testing of the non-operated shoulder followed by the operated shoulder, in flexion, abduction and external rotation, tested at 60 degrees, 120 degrees and 180 degrees per second. Fourteen patients were eligible and tested. Isokinetic data showed deficiencies in strength in the operated shoulder compared to the opposite side for abduction, external rotation and flexion of 14%, 27% and 20% respectively. In 10/123 (8%) of the tests, the patients could not reach the preset velocity to yield valid data. One patient could not place and maintain the operated arm in the test position of 90 degrees of shoulder abduction. There was a significant deficiency in abduction at only one of three speeds. This study confirms that isokinetic testing is a powerful tool that lends itself well to producing objective data on shoulder strength after rotator cuff repair, but it also has the limitation that some patients cannot reach the preset velocity for some motions, or place and maintain the operated arm in the test position for the movements being tested. Therefore, to optimize the chances of obtaining isokinetic data for all movements after rotator cuff repair, we suggest using speeds for all motions and consideration of scapular, frontal and sagittal planes for testing.

Adult↗
PubMed2005

The epidemiology of shoulder dislocation in a state-hospital: a review of 106 cases.

This retrospective study was conducted in a state hospital set-up and aimed at identifying the magnitude of shoulder dislocations and their demographic data, characteristics of the injury, mechanism and predisposing factors, and the instituted treatment. Patients with radiographic evidence of shoulder dislocation admitted to the hospital from January 1999 to December 2002 were included. Data were recorded from the case notes. There were 105 shoulder dislocations with male predomination in 77% cases and age ranged between 11 and 90 years (average 30.9 years). The right shoulder was affected in 68% of the cases. The contributing events were fall in 37% of cases, road traffic accident 23%, sports 17% and pathological conditions 13%. Anterior dislocation occurred in 96.2% of the cases. Posterior and inferior dislocations encountered in two patients for each type. Twelve dislocations were associated fracture of the greater tuberosity, two each with humeral neck fracture and cerebral injuries. First time dislocation occurred in 73.6% of the cases. The recurrences ranged between 2 to 6 times (average 3.4 times). Closed manipulative reduction and strapping was the definitive treatment in 92.4% of the cases and the remaining needed surgical reconstruction. Four patients had open reduction and internal fixation of the associated fractures while another four had arthroscopic Bankart's repair. In conclusion, shoulder dislocation represents the most common shoulder problems. It afflicted young adults of reproductive age (21-40 years) and participation in sports was a risk factor in men. Women over 40 years and fall were at risk to develop shoulder dislocation.

Adolescent↗
PubMed2006

Resection arthroplasty of the infected shoulder: a salvage procedure for the elderly patient.

Infection of the shoulder joint is a challenging problem for the orthopaedic surgeon. Several treatment options have been proposed. Here, we evaluate the results achieved following resection arthroplasty of the shoulder in seven patients. We performed resection arthroplasty in seven cases to treat a chronic uncontrollable infection of the shoulder. Three patients had an infected shoulder arthroplasty, one had an infected non-united arthrodesis, one was treated for an infected osteosynthesis, one had an infected rotator cuff repair and one patient had a septic arthritis of the shoulder joint. All patients were reviewed after a mean of 252 days. The functional outcome was evaluated using the Constant and DASH score. C-Reactive Protein levels were determined to evaluate the presence of residual infection. Except for one doubtful result, all our patients remained free of infection and there was excellent pain relief after the resection. Nevertheless, the functional outcome was poor: the mean Constant score was 25.7 and the mean DASH score was 69.3. Resection arthroplasty of the shoulder is a valuable treatment option for infection of the shoulder, especially in older patients with a poor mental and physical condition who suffer intolerable pain.

Adult↗
PubMed2006

[The impacts of various types of neck dissection on postoperative shoulder function for patients with oral squamous cell carcinoma].

OBJECTIVE: To compare the impact of various types of neck dissection on postoperative shoulder function. METHODS: The shoulder functions of 66 patients with oral squamous cell carcinoma (OSCC) and cN0 necks who underwent various types of neck dissection were evaluated by Constant's shoulder function test and neck dissection impairment index at least 12 months after surgery. RESULTS: The patients with accessory spinal nerve reserved had better shoulder function than those with accessory spinal nerve resected. In the group with accessory spinal nerve reserved, the patients receiving selective neck dissection (SND) showed better shoulder function than those with modified radical neck dissection (MRND). The shoulder dysfunction and pain arising from SND were minor in patients with selective neck dissection. CONCLUSIONS: The shoulder function after SND was superior to those after RND and MRND.

Adult↗
PubMed2006

Shoulder dysfunction assessment: self-report and impaired scapular movements.

BACKGROUND AND PURPOSE: Shoulder dysfunction is common in various patient populations. This investigation was performed to assess shoulder dysfunction with self-report and performance-based functional measures. SUBJECTS: Fifty men (25 with shoulder dysfunction and 25 without shoulder dysfunction) participated in this study. METHODS: Self-report functional disabilities were assessed with the Flexilevel Scale of Shoulder Function (FLEX-SF), and electromagnetic tracking sensors were used to monitor 3-dimensional scapular movements during 4 functional tasks. RESULTS: Relative to the control group, the group with shoulder dysfunction showed significant alterations in scapular movements (averages of 6.9 degrees less posterior tipping, 5.7 degrees less upward rotation, and 2.3 cm more elevation). Scapular kinematics correlated significantly (r) with the Self-report FLEX-SF measure during functional tasks (posterior tipping = .454 to .712, upward rotation = .296 and .317, and elevation = -.310). DISCUSSION AND CONCLUSION: Functional disabilities were identified with self-report and performance-based functional measures. The inadequate scapular posterior tipping and scapular upward rotation as well as the excessive elevation may have implications in planning intervention strategies for people with shoulder dysfunction.

Activities of Daily Living↗
PubMed1991

Electromyographic analysis of muscle action about the shoulder.

The application of dynamic integrated EMG and motion analysis to the shoulder has improved the understanding of dynamic shoulder biomechanics during athletic activities and rehabilitation protocols. These studies exemplify a symbiotic merger of basic science research and clinical application. EMG and motion analysis has produced specific objective quantifiable data concerning the muscles in and about the shoulder during normal planar motion, athletic motions, and rehabilitation exercises. This expanded understanding of intricate muscular interrelationships during athletic activities and rehabilitative exercises has not only complemented clinical awareness of subtle shoulder anomalies but helped to develop logical preventative exercises, surgical procedures, and rehabilitation protocols, all of which are based on sound scientific principles. Comprehension of the normal intermuscular interdependence during the previously mentioned activities has led us to investigate common athletic shoulder disorders. It is hoped that application of the normal EMG and motion analysis to the pathologic state will enable us to suggest new ideas concerning the pathomechanics of these disorders, as well as propose future treatment and rehabilitation of these maladies. The specific emphasis in this article has been the role of integrated EMG and motion analysis in the evaluation of athletic activities and rehabilitation exercises. It is hoped that knowledge of these investigations will increase the clinician's basic understanding of the biomechanics of the shoulder and aid in his or her clinical evaluation, treatment, and subsequent rehabilitation of the shoulder.

Athletic Injuries↗
PubMed1991

[On the etiology of the loose shoulder--biochemical studies on collagen from joint capsules].

In order to investigate the etiology of loose shoulder, biochemical characteristics of collagens from four major joint capsules of extremities and from joint capsules of loose shoulder have been investigated. Joint capsules of normal shoulder were found to synthesize less collagen fibers comparing to those of other major joints. Furthermore formation of inter-molecular cross-links of collagen from shoulder joint capsule was relatively lower than that of collagens from other major joints. Noteworthy was the fact that collagen fibers from joint capsules of loose shoulder were more soluble and contain less amount of the reducible cross-links than those from joint capsules of the normal shoulder. These data suggest that collagen synthesis and formation of collagen fibers vary with the differences in joint structures, functions and movements. It may also be implied that the joint capsules of loose shoulder produce immature collagen fibers which may reflect the clinical feature of the disease.

Adolescent↗
PubMed1991

Shoulder dystocia.

Shoulder entrapment during delivery is a true obstetric emergency that can result in significant maternal and infant trauma. Fetal macrosomia, maternal obesity, maternal diabetes and prolonged second stage of labor are associated risk factors. Infant complications of shoulder dystocia include traumatic brachial plexus injury, humeral fracture, clavicular fracture and severe birth asphyxia. With fetal shoulder entrapment, the mother may have significant hemorrhage, fourth-degree perineal lacerations and endometritis. Maneuvers to release the shoulder include closed-fist suprapubic pressure, downward pressure on the posterior shoulder, rotation of the anterior shoulder to the oblique position, rotation of the posterior shoulder beneath the pubic symphysis, release of the posterior arm and anterior rotation of the fetal body.

Delivery, Obstetric↗
PubMed1991

Shoulder limitation in juvenile rheumatoid arthritis.

One hundred consecutive children with juvenile rheumatoid arthritis (JRA) were evaluated for shoulder dysfunction. Shoulder arthritis was virtually absent in all 45 children with pauciarticular onset JRA. Twenty of 40 children (50%) with polyarticular JRA and 12 of 15 (80%) with systemic onset JRA had shoulder involvement characterized by pain or restricted passive range of motion (PROM). Ninety-five percent of those with shoulder arthritis had bilateral involvement. Children with systemic onset were likely to have shoulder disease within 2.5 years of onset and to have more severely limited PROM. Children with polyarticular onset developed shoulder arthritis any time during the course of their disease. With either type of onset, internal rotation was the most commonly and severely limited motion, followed by abduction. Clinicians treating children with JRA should carefully monitor pain and examine both rotational and planar components of shoulder motion.

Adolescent↗
PubMed1991

Shoulder subluxation in hemiplegia: effects of three different supports.

Shoulder subluxation in hemiplegia is a difficult problem to manage and it may be associated with pain and other complications. Measurements taken from x-rays have been used to obtain objective measures of shoulder subluxation, but have not been used to compare the effects of different shoulder supports. This study used x-ray measurements to evaluate different shoulder supports for subluxation in hemiplegia and to see if there was a significant difference between the Harris hemisling and the Bobath sling. The Harris hemisling gave good vertical correction of subluxation and compared closely to the uninvolved shoulder. The Bobath sling did not correct the subluxation as well, and the mean difference between the two slings was significant. The arm trough or lap board was less effective and tended to overcorrect. The Harris hemisling and arm trough or lap board had horizontal measurements similar to the uninvolved shoulders. The Bobath sling, however, distracted the glenohumeral joint horizontally and was more variable. The mean horizontal difference between the Harris hemisling and the Bobath sling was significant. These results support the effectiveness and specificity of shoulder support to decrease subluxation after hemiplegia.

Aged↗
PubMed1990

[Evaluation of shoulder function after removal of the latissimus dorsi muscle for surgical flap].

The latissimus dorsi muscle is frequently used in reconstructive surgery. The present study was undertaken to determine the post-operative function of the shoulder girdle with respect to dominance in 26 patients following latissimus dorsi flap transplantation mainly for soft tissue coverage in the lower leg. The patients were interviewed and examined, with special attention being paid to shoulder mobility, dexterity and muscular strength. On interview, a considerable majority felt that very good results had been achieved. Raising the latissimus dorsi flap did however influence shoulder retroversion, particularly when surgery was performed on the non-dominant side. The influence of dominance was further noted as regards inward rotation of the shoulder and the ability to lead the hand backward over the shoulder. Dexterity was determined by a modified tapping test in the sagittal plane. Other than a minor correlation with age, post-operative function depended on whether the latissimus dorsi flap had been raised from the dominant or non-dominant shoulder. No effect of operation or dominance was observed in terms of isometric muscular strength, measured with an electronic device (Hottinger-Baldwin-Messtechnik). We believe that the function of the latissimus dorsi muscle can be compensated for by synergistic muscles. Yet, in rehabilitation, particular attention must be paid to the function of the non-dominant shoulder since it is used less in daily activity.

Adolescent↗
PubMed1990

Painful shoulder in the hemiplegic and unilateral neglect.

Shoulder pain is a frequent and debilitating problem in hemiplegic patients, and its etiology remains poorly understood. The role played by hemineglect in the appearance of shoulder pain was studied. During two years, 94 hemiplegic subjects were involved in a rehabilitation program after cerebrovascular accidents. Their average age was 68 years; 45 (47.9%) subjects had shoulder pain, and 24 subjects (22.5%) had hemineglect. The subjects with shoulder pain were compared to those without pain (the control group) with respect to gender, age, diabetes, heart failure, cardiac ischemia, scapulohumeral arthritis, and calcified tendinitis of the rotator cuff. We were unable to demonstrate a relationship between hemineglect and shoulder pain in the hemiplegic (X2 (1) = 2.03, p = .15), although pain was significantly more frequent in subjects with right hemispheric cerebrovascular accident (X2 (1) = 5.0, p less than .025). The subjects with shoulder pain had significantly more spasticity of the affected limb (X2 (1) = 26.3, p less than .01), less sensitivity to pinprick of the upper paralyzed extremity (X2 (1) = 10.8, p less than .01), and a more severe subluxation of the affected shoulder (t(51) = 14.0, p less than .01).

Aged↗
PubMed1990

Cervical spine and shoulder pain.

The complex problem of combined neck and shoulder pain was investigated in 26 operations in 13 patients who had a shoulder procedure (subacromial decompressions or rotator cuff repairs) and an anterior cervical spine fusion. This select group of complex patients illustrates the diagnostic studies required to determine whether the pain comes primarily from the cervical spine, shoulder, or both. Good pain relief was accomplished after 24 of the 26 surgical procedures (average follow-up, 4.3 years). In the 13 patients, eight presented with nearly equal neck and shoulder pain as the chief complaint, whereas in the remaining five patients, the initial complaint was predominantly neck pain with only minor shoulder involvement. The shoulder pain became more significant after the anterior cervical fusion in these five patients. This study emphasizes the need for a careful evaluation of patients with combined neck-shoulder pain syndrome in a systematic approach allowing appropriate treatment.

Adult↗
PubMed1988

Surgical treatment of osteoarthritis of the shoulder.

Shoulder dysfunction is unusual in osteoarthritis and usually responds to conservative treatment. The primary indication for surgery is pain unresponsive to medical management. The procedure of choice for degenerative changes in the glenohumeral joint is hemiarthroplasty or total shoulder replacement depending on the condition of the glenoid. Shoulder fusion is rarely necessary for osteoarthritis and is recommended for chronic infection, flail shoulder, and failed total shoulder replacement not amenable to revision. Joint resection is reserved for infected joints with massive bone loss. The results of shoulder arthroplasty are good to excellent in 86 to 94 per cent of all patients. The results of shoulder arthrodesis are less predictable, but are usually satisfactory in approximately 75 per cent of patients with 10-year follow-up. The treatment of AC and SC joint arthritis is conservative with rest, local heat, and medication. Pain unresponsive to this regimen is an indication for resection of the joint. Good results with this procedure directly correlate with pain relief on injection of the joint with local anesthetic.

Humans↗
PubMed1988

Shoulder pain in middle age. A study of prevalence and relation to occupational work load and psychosocial factors.

Studies on 574 subjects demonstrated the prevalence of shoulder pain and its relationship to occupational work load and psychosocial factors. The prevalence of shoulder pain was 14% (13% men, 15% women). Women had more often myalgias with a tenderness on palpation of the shoulder muscles and rhizopathia-brachialgia type of pain, whereas men had mainly intraarticular pain. Three percent had been on sick leave because of shoulder pain in the year preceding the examination and 5% had a reduced range of shoulder joint motion. The subjects with shoulder pain were less satisfied with their jobs and had been less successful in a childhood intelligence test. No difference could be demonstrated between subjects with or without shoulder pain in estimated overall work load, but women with signs of supraspinatus tendinitis more often had jobs with physical demands.

Educational Status↗
PubMed1988

The Dana total shoulder arthroplasty.

Fifty-six Dana unconstrained total shoulder arthroplasties in forty-seven patients were followed for a minimum of two years. The preoperative diagnoses included osteoarthritis, rheumatoid arthritis, traumatic arthritis, avascular necrosis, failed hemiarthroplasty, and failed total shoulder arthroplasty of another design. For all of the patients, the average rating for pain improved from 3 points preoperatively to 8 points postoperatively, and the average rating for function improved from 3 to 7 points. The ranges of abduction and of external rotation improved substantially in the shoulders that were affected by osteoarthritis, rheumatoid arthritis, or osteonecrosis. Ten patients were treated with a hooded glenoid component, designed to improve stability in shoulders in which the rotator cuff is deficient. In these shoulders, both the rating for pain and the rating for function improved, although the range of motion did not. Complications that required revision of the arthroplasty developed in five shoulders in which a regular component had been implanted and in two that had a hooded glenoid component. A radiolucent line developed at the bone-cement interface of the glenoid component in fifty-three shoulders, but only two revisions were done for loosening of the glenoid component.

Adult↗
PubMed1984

Arthrographic findings in hemiplegic shoulders.

To discover the influence of hemiplegia on arthrographic changes in hemiplegic shoulders, we compared arthrographic findings from paralyzed and nonparalyzed shoulders in 77 patients with hemiplegia. The correlation between arthrographic changes in paralyzed shoulders and characteristics of the hemiplegic condition was also investigated. Hemiplegic changes were considered to be responsible for adhesive changes in affected shoulders because those changes were found in paralyzed shoulders at a statistically significant higher rate (54.6%) than in the nonparalyzed side (32.5%). The occurrence rate of contrast leakage from capsule tear on the subscapular bursa and the bicipital tendon sleeve was higher on the nonparalyzed side than on the paralyzed side. It is suggested that capsular contracture due to hemiplegia prohibits capsular tear during arthrographic maneuvers. No significant difference was found in the occurrence of rotator cuff tear between the paralyzed and the nonparalyzed shoulder. Those changes on the paralyzed side were not correlated with any characteristics of hemiplegics except for shoulder pain prior to the onset of hemiplegia.

Adult↗