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At least 1,117 records · Page 62Linked to original sources
PubMed2004

Shoulder hemiarthroplasty to manage haemophilic arthropathy: two case studies.

Bleeds within the shoulder joint can lead to significant joint destruction and may have associated pain, decreased range of movement (ROM), and impaired function. Conservative management should involve prompt administration of Factor VIII and physiotherapy to address all surrounding structures so as to minimize further damage. If conservative management fails to relieve severe, unremitting shoulder pain in the presence of underlying arthropathy, then arthroplasty may be considered. Outcomes of arthroplasties performed for osteoarthritis and rheumatoid arthritis appear favourable. Few articles, however, have addressed shoulder arthroplasty to manage haemophilic arthropathy, and no reports have documented the rehabilitation process. Three hemiarthroplasties were performed at the Royal Brisbane and Women's Hospital on two men with haemophilia. There were no surgical or postoperative complications. Rehabilitation included intensive physiotherapy. The results in each case revealed a decrease in pain, and an increase in ROM and function postoperatively. These findings suggest that hemiarthroplasty with postoperative physiotherapy may be a feasible option to manage severe, chronic and progressing shoulder pain as a result of haemophilic arthropathy of the shoulder.

Arthroplasty, Replacement↗
PubMedDate not supplied

[Late clinical and roentgenologic results following surgical treatment of chronic shoulder dislocation using Lange's technic].

In German speaking countries the M. Lange procedure is a well known method in the treatment of recurrent shoulder dislocations. In order to study the longterm results 21 shoulder joints of 20 patients were examined clinically and radiologically after an average postoperative period of 13.5 years. According to the subjective judgment of the patients good results were obtained in 19 of the 21 cases. True recurrent dislocation occurred in 5.2%. In 57% of the cases signs of degenerative arthritis of the shoulder joints were found radiologically. Our examination shows that the M. Lange procedure is a reliable method with good longterm results. It should be used in cases of glenoidial dysplasia and in cases of a defect of the anterior glenoid rim.

Adolescent↗
PubMed2006

Surgical treatment for spinal accessory nerve injury.

We report on the surgical results of spinal accessory nerve injuries between 1992-2003. We operated on 10 patients (9 female, and 1 male) who had injuries of the spinal accessory nerve. All injuries were iatrogenic. The mean age of patients was 39.2 years (range, 20-57 years). The average interval between date of injury and surgery was 7 months (range, 4-12 months). All patients had stiffness and pain in the shoulder girdle. The average active abduction of the shoulder joint was 79.5 degrees (range, 60-100 degrees ) before surgery. End-to-end repairs were performed in 7 cases, and graft repairs were indicated in 3 cases. The mean follow-up period was 18.4 months (range, 8-36 months). The average active abduction of the shoulder joint was 171 degrees (range, 140-180 degrees ) at time of final follow-up.

Accessory Nerve↗
PubMed1982

Incidence of shoulder dislocation in Sweden.

Shoulder joint dislocations collected from a randomized population were investigated in Sweden, wherein nearly 50% of people with primary dislocations never visit hospitals nor are treated by a physician. Thus information obtained from surgically treated patients is of limited value because cases requiring operative repair represent only a small and selected percentage of the population. The incidence of shoulder dislocation in people from 18 to 70 years of age was at least 1.7% and was three times more common in males. Spontaneous healing of recurrent dislocations in a period of many years was not uncommon. Shoulder joint dislocation was more common among children than was generally appreciated, with the prognosis usually good. Recurrences of primary dislocations in people 15 to 25 years of age were not as frequent as was expected.

Adolescent↗
PubMed1980

Surgical treatment of the difficult humeral neck fracture: acromial shortening anterolateral approach.

A surgical approach to the shoulder joint for the difficult humeral neck fracture is described with illustration of a case. Resection of a middle portion of the acromial process in addition to the detachment of the anterior origin of the deltoid using an anterolateral approach is presented. This provides an unrestricted exposure to the shoulder joint and eliminates the possible complications arising from acromionectomy.

Acromion↗
PubMedDate not supplied

[The diagnostic value of double contrast CT in shoulder dislocation].

The article reports of the indication, technique and results of the shoulder joint double-contrast-computertomography. It discuss its diagnostic value in comparison to other examining methods. As alternative preoperative diagnostic procedures only arthroscopy, arthrography and MRI can be considered. Also discussed are the therapeutic consequences resulting from the nature of the pathological lesions (rupture of the limbus glenoidalis, Hill-Sachs-defect, reversed Hill-Sachs-defect). Especially for the first traumatic dislocations of the shoulder joint, we consider this investigational method an eminent enlargement of the diagnostic spectrum. Therefore, we are generous with its indication, attempting to prevent reluxations by primary diagnostic and therapeutic procedure.

Adult↗
PubMed1992

Assessing the effects of a health promotion programme for elderly people.

Physical exercise is an increasingly popular health promotion activity for elderly people, although evidence of its effectiveness is limited. We aimed to evaluate the impact of the exercise component of the Look After Yourself (LAY) package promoted by the Health Education Authority in two groups of elderly people attending the 10 weekly sessions which make up the LAY course. Classes 1 and 2 comprised 13 and 18 subjects, aged from 65 to 89 years, and from 58 to 87 years respectively. Class 1 subjects were white with the exception of one Jamaican man, and Class 2 subjects were all Afro-Caribbean. Subjects had measurements of shoulder joint flexibility, grip strength, blood pressure, weight and a self-perceived health questionnaire, the Nottingham Health Profile (NHP) completed at baseline, 10 weeks and at six months. Class 1 showed reductions in grip strength and a deterioration in pain and mobility dimensions of the NHP, whereas Class 2 showed large improvements in shoulder joint flexibility and a small and non-significant trend towards improved self-perceived health. Class 2 subjects felt that they had benefited, and just over half had continued with an exercise programme. These findings suggest that the effect of mild exercise on objective indicators and self-perceived health may depend on the context in which it is done, the type of exercise promoted, and that continued exercise is aided by the provision of further group classes. There is a need for evaluation of the impact of different types of exercise programmes, covering a wider range of indicators of fitness, in larger groups of elderly people.

Aged↗
PubMed1998

[A clinical study of dialysis-related osteoarthropathy in long-term hemodialysis patients].

Amyloid osteoarthropathy has been seen frequently in long-term hemodialysis (HD) patients, in which the bone X-ray examination reveals characteristic cystic radiolucency (CRL) of the carpal bone, shoulder joint, hip joint and knee joint, and destructive spondylarthropathy (DSA) of cervical vertebrae. To clarify the clinico-pathological significance of CRL and DSA in HD-related amyloidosis, we investigated the grade and frequency of CRL or DSA and these relationship with age, HD duration, primary diseases, osteoarticular symptoms and blood analysis in 817 HD patients (492 male and 325 female, age: 52.6 + 15.5 years, dialysis duration: 6.8 + 5.4 years). The number of cases with osteoarticular symptoms increased with the prolongation of HD duration. CRL and DSA were observed even in patients without osteoarticular symptoms: 26.7% for carpal bone, 26.2% for shoulder joint, 17.3% for hip joint and 22.2% for DSA. The grade and frequency of CRL and DSA also increased in accordance with age and HD duration. In patients with CRL of the carpal bone, shoulder CRL was noticed in 39.7%, hip CRL in 25.8%, and DSA in 14.3% of cases, respectively, and these frequencies increased with the prolongation of HD duration. In the carpal CRL negative group, shoulder CRL was noticed in 14.6%, hip CRL in 7.5%, and DSA in 6.0%, respectively. Although there was no relationship between CRL or DSA and serum beta 2-MG level in any of the cases, the serum beta 2-MG level was lower in patients with HD showing shoulder CRL (+2) and DSA (+) for more than 16 years. No significant relationship was noticed between CRL or DSA and serum C-PTH and aluminum level. These results suggested that aging was related to CRL or DSA formation in dialysis-related amyloidosis. The findings also suggested that systemic bone X-ray examination should be considered in patients with carpal bone CRL, high-age patients and long-term HD patients even without osteoarticular symptoms.

Adult↗
PubMed2002

[Efficiency of rehabilitation methods in the treatment of arm lymphedema after breast cancer surgery].

In this article we analyze influence of rehabilitation methods in treatment of arm lymphedema. In Kaunas oncological hospital were examined 60 women after surgery for breast cancer. The work objective was to evaluate efficiency of rehabilitation methods in treatment of arm lymphedema and in evaluate movement amplitude of shoulder joint. Two groups of women depending on rehabilitation start were evaluated. The same methods of rehabilitation were applied to both groups: physical therapy, electrostimulation, massage, lymphodrainage with apparate. Our study indicated that women, who were treated at early period of rehabilitation (3 months), showed statistically significantly (p < 0.01) better results in increase of movement amplitude of shoulder joint. However, results of treatment of arm lymphedema, comparing with women who started rehabilitation after 12 months, were equally successful--results were not statistically significantly better (p > 0.05).

Arm↗
PubMed1996

[Prognosis of shoulder calcifications after irrigation treatment and roentgen findings. A prospective study and literature review].

In 106 shoulder joints of 94 patients suffering from calcifying shoulder (calcifying tendinitis), needling and lavage were performed. Patients were prospectively investigated before and after treatment to examine if location, size, number and density of calcium deposits would predict outcome after the above-mentioned lavage. Excellent and good results were seen for subacromial calcifications and those situated near the tuberculum majus. Density and number of calcifications were without discriminating value, whereas large calcium deposits (> 1,5 cm) and fairly small calcifications (< 1,0 cm) responded very well to conservative treatment as described above.

Adult↗
PubMed1996

Malignant humeral bone tumors in children: excision and reconstruction with the use of rotated clavicle.

The application of intensive multimodality therapy has made possible salvage surgery in bone tumors. Reconstruction of the removed part of bone is the great problem, especially in fast-growing children. In three patients (two osteosarcomas and one Ewing's sarcoma), the tumor was confined to the proximal half part of humerus, without invasion of shoulder joint. After induction chemotherapy, reduction of tumor size was observed both clinically and radiologically. During the operation, wide resection of the tumor together with a 12- to 14-cm-long fragment of humerus, was performed. Afterward, the clavicle was rotated in the place of the removed bone, with preservation of the coracoacromial ligament. The humeral stump and clavicle were fixed with the use of metal plate. Adjuvant chemotherapy was used a few days following surgery. After 3 months, the osteosynthesis had healed. The movements in shoulder joint are limited, but functions of elbow joint remained normal. All children are alive and disease free. Reconstruction of humerus with clavicle rotation is possible when the proximal bone loss is not longer than 10-14 cm. This method seems to be an alternative to allogeneic grafts and endoprostheses.

Adolescent↗
PubMed1998

Angular kinematic patterns of limbs in elite and riding horses at trot.

Normal speed videography was used to determine the angular parameters of 28 Spanish Thoroughbreds at trot. Horses were divided into 3 groups: Group UT, comprising 9 animals (provided by the VII National Stud, Cordoba, Spain) which had undergone no specific training programme and which were hand led at the trot; Group T, formed by 19 horses considered to be highly bred and trained, and which were also hand led; and Group RT, comprising the same horses as the latter group but this time trotted by a rider. Each animal was filmed 6 times from the right-hand side, using a Hi8 (25 Hz) video camera. Angular parameters for fore- and hindlimb joints were measured in each stride from computer-grabbed frames and entered into a spreadsheet for calculation; parameters included maximum and minimum angles, range of motion, and angles at landing, lift off and maximum hoof height; the times at which maximum angle, minimum angle, lift off and maximum hoof height occurred were calculated as percentages of total stride duration. Stride velocity (mean [s.d.]) was 4.01 (0.62), 3.60 (0.34) and 3.07 (0.36) m/s for Groups UT, T and RT, respectively. Data were then compared between Groups UT-T and Groups T-RT. Compared with Group UT, horses from Group T featured a shorter stance percentage (P<0.001) in both fore- and hindlimbs. The range of motion in forelimbs was smaller (P<0.05), due to lower retraction (P<0.001); moreover, maximum retraction appeared earlier (P<0.05). Greater scapular inclination was in evidence (P<0.05) and the shoulder joint extended further (P<0.05). Fore- and hind fetlock joints revealed a relatively shorter hyperextension period during the stance phase (P<0.01). Compared with Group T, horses from Group RT had a longer stance percentage, with belated maximum retraction of the fore- and hindlimbs. The range of movement in scapular inclination was greater (P<0.05), due to a smaller minimum angle (P<0.01), and the shoulder joint flexed more (P<0.05). The elbow joint extended more and for longer during the stance phase. Initial extension of the hip joint (P<0.05) and tarsus (P<0.001) lasted longer. The carpal and fore and hind fetlock joints recorded relatively longer hyperextension times, in addition to greater hyperextension during the stance phase. The results from the present study suggest that rider-effect must be taken in consideration when well gaited horses are selected for dressage purposes.

Animals↗
PubMed2000

[Significance of endoscopic axillary dissection in invasive breast carcinoma after introduction of the "sentinel lymph node" method].

UNLABELLED: Axillary clearance provides prognostic information, determines adjuvant therapy and reduces axillary recurrences. However significant morbidity may follow axillary dissection. Patients with small tumors (pT1a-c) may benefit from new less invasive (endoscopic lymph node dissection) or more selective (sentinel lymph node biopsy) axillary procedures which recently have been introduced. In this prospective study the axilloscopic approach was evaluated. PATIENTS AND METHODS: 55 clinically node negative patients (mean age: 60 years [30-86]) had endoscopic axillary surgery by one single surgeon (1.1996-6.1998). After axillary liposuction individual lymph nodes (level I + II) were identified and removed under direct vision by means of a laparoscope (successful procedure in 95%; n = 52). Patients were followed every four months according to a institution based follow up protocol. Results of 51 patients (1 refused) were analyzed after a median follow up of 22 (7-37) months by self-evaluation questionnaire, interview and clinical examination (including: range of motion of the shoulder joint, circumferences of the upper extremities). RESULTS: An average of 13.3 (5-25) lymph nodes was endoscopically removed. Patients (n = 16; 31%) had involved nodes with a mean of 3.1 nodes positive per individuum. Seromas necessitated needle aspiration in 8 patients (15%). There were no hematomas and one low grade infection (2%). After a median follow up period of 22 (7-37) months no axillary relapse but one trocar site implantation metastasis (1/55, 2%) was detected and resected. No lymph edema was observed. Early range of motion of the shoulder joint was excellent. CONCLUSION: This technique allows the removal of an adequate number of lymph nodes for staging as well as for regional control. The morbidity is low and the medium-term follow-up results are promising. The atraumatic and very well tolerated endoscopic axillary dissection is being replaced by the selective sentinel lymph node procedure.

Adult↗
PubMed1983

The influence of protein nutrition in early life on growth and development of the pig. 2. Effects on the cellularity of muscle and subcutaneous adipose tissue.

The effects of feeding either high-protein (HP) or low-protein (LP) diets between 1.8 and 15 kg live weight (LW) and a low-energy (LE) or high-energy (HE) intake subsequently on the cellularity of muscle and adipose tissue in pigs growing to 75 kg LW were investigated. The effects of the nutritional treatments on muscle tissue were assessed from the weight and DNA content of the m. adductor. For adipose tissue the total DNA content and fat cell size of the subcutaneous adipose tissue contained in the left shoulder joint were determined. Feeding the LP diets in early life reduced the weight and DNA content of the m. adductor (P less than 0.01) and increased fat cell size (P less than 0.01) at 15 kg LW. Subsequent to 15 kg there was an almost linear increase in muscle DNA with increasing LW, and the difference between pigs from the initial protein treatments progressively diminished and was no longer apparent at 60 kg LW. At 30 kg LW, pigs given the LP diets before 15 kg LW contained less DNA in the subcutaneous adipose tissue from the shoulder joint (P less than 0.01) and had larger fat cells (P less than 0.05) than pigs given the HP diets initially. However, adipose DNA and fat cell size increased with increasing LW and the differences resulting from the initial protein treatments progressively diminished. On the LE and HE treatments subsequent to 15 kg these differences were no longer evident at 45 and 60 kg respectively. Pigs given the HE intake subsequent to 15 kg, contained less DNA in muscle tissue (P less than 0.05) at 60 and 75 kg LW and had larger fat cells (P less than 0.05) at 45, 60 and 75 kg LW, than pigs on the LE treatment.

Adipose Tissue↗
PubMedDate not supplied

Arm movement and EMG mean power frequency in the trapezius muscle: a comparison between surface and intramuscular recording techniques.

In a previous study it has been shown that there is a systematic variation of the EMG mean power frequency recorded under dynamic conditions with surface electrodes from non-fatigued trapezius muscle. The variation was most pronounced in relation to shoulder joint angle. The aim of the present study was to find out whether this variation was caused by geometric factors such as electrode displacement, or by neuromuscular factors within the muscle. A comparison has been made between surface and intramuscular recordings. EMG was recorded with standard surface electrodes and with a monopolar "hooked wire" intramuscular electrode. The recordings were analyzed for calculation of mean power frequency (MPF) and root mean squared (RMS) signal level. For MPF we found a low, but statistically significant correlation (r = 0.30) between surface and intramuscular recordings. For RMS the corresponding correlation was high (r = 0.92). Analysis of variance showed a high proportion of explained variance related to the shoulder joint angle for surface recordings, but not for intramuscular recordings. The results were confirmed in the regression analysis. The results indicate that the observed variation is largely caused by geometric displacement of the surface electrodes and not by intrinsic neuro-muscular factors.

Adult↗
PubMed2000

Spatial generalization from learning dynamics of reaching movements.

When subjects practice reaching movements in a force field, they learn a new sensorimotor map that associates desired trajectories to motor commands. The map is formed in the brain with elements that allow for generalization beyond the region of training. We quantified spatial generalization properties of these elements by training in one extreme of the reachable space and testing near another. Training resulted in rotations in the preferred direction (PD) of activation of some arm muscles. We designed force fields that maintained a constant rotation in muscle PDs as the shoulder joint rotated in the horizontal plane. In such fields, training in a small region resulted in generalization to near and far work spaces (80 cm). In one such field, the forces on the hand reversed directions for a given hand velocity with respect to the location of original training. Despite this, there was generalization. However, if the field was such that the change in the muscle PDs reversed as the work spaces changed, then performance was worse than performance of naive subjects. We suggest that the sensorimotor map of arm dynamics is represented in the brain by elements that globally encode the position of the arm but locally encode its velocity. The elements have preferred directions of movement but are modulated globally by the position of the shoulder joint. We suggest that tuning properties of cells in the motor system influence behavior and that this influence is reflected in the way that we learn dynamics of reaching movements.

Adult↗
PubMed2004

[The treatment of deformity of axillary scar contracture after burns].

OBJECTIVE: To explore the best methods to repair the deformity of axillary scar contracture after burns. METHODS: Ninety cases in 78 patients with axillary scar contracture after burns from January 1998 to January 2002 were analyzed. According to the severity of the deformity and its influence on the function of the shoulder joint. 46 cases suffered from mild degree axillary scar contracture, 26 cases with moderate and 18 with severe degree. The deformities of axillary scar contracture were repaired by Z plasty (18 cases), five-flap plasty (14 cases), skin graft (23 cases), Z plasty and skin graft (14 cases), transfer of scapular skin flaps (5 cases), lateral throatic skin flaps (4 cases) and scar flaps (12 cases), respectively. Exopexy, anti-scar drug and functional exercises were applied postoperationally. RESULTS: All the flaps were survived with first intention, except for necrosis of the split skin graft occurring in 4 cases. The function and configuration in all the cases were satisfactory after 6 months to 4 years follow-up. CONCLUSION: Appropriate methods should be chosen to restore the function and configuration of the shoulder joint and improve patients' living condition according to the size, degree of the deformity of axillary scar contracture after burns.

Adolescent↗
PubMed2000

Bicipital tendinitis and tenosynovitis in the dog: a study of 15 cases.

AIM: To describe the clinical, radiographic, and sonographic features of 15 dogs with bicipital tendinitis and tenosynovitis, classify them according to cause, and evaluate the long-term efficacy of treatment. METHODS: Dogs exhibiting forelimb lameness with pain localised to the biceps tendon were included in the study. Sonographic examination of the tendon and tendon sheath, and radiographic examination including positive contrast arthrograms of the shoulder joint were performed, and assessed for features consistent with biceps tendon disease. In some cases, synovial-fluid analysis and surgical investigation were also undertaken. The causes of the conditions were classified as either traumatic, mechanical, neoplastic or inflammatory. Dogs were treated conservatively with rest and anti-inflammatory drugs, or surgically by either transection of the transverse humeral ligament or tenodesis of the biceps tendon. Assessment of the effects of treatment was made by re-examination at six weeks and from information gained by telephone interview with the dog's owner at longer-term follow-up. RESULTS: Bicipital tendinitis and tenosynovitis were common causes of forelimb lameness in active, middle-aged or older, medium to large-breed dogs. The most sensitive physical tests for localising pain to the biceps apparatus were shoulder flexion with the elbow extended, focal digital pressure applied directly to the biceps origin, and the biceps retraction test. Sonographic assessment was found to be more sensitive than shoulder radiography or arthrography for characterising the lesion. Conservative treatment of 11 traumatic cases resulted in good or excellent function at long-term follow-up. One mechanical bicipital tendinitis secondary to mineral deposits within the supraspinatus tendon improved following transection of the transverse humeral ligament and removal of the deposits. One of two cases of inflammatory tendinitis/ tenosynovitis improved following tenodesis. One dog with neoplastic disease did not improve and was euthanased. CONCLUSIONS: The diagnosis of bicipital tendinitis and tenosynovitis requires a careful examination using a combination of physical tests. Of the ancillary tests, sonography was the most reliable, however information gained from all tests was useful in fully evaluating the biceps apparatus and shoulder joint. The classification system employed in this study was helpful in selecting a treatment protocol and determining the likely prognosis.

Journal Article↗