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PubMed1989

Glenohumeral movements of the involuntary inferior and multidirectional instability.

The glenohumeral movements of the involuntary inferior and multidirectional instability were studied by means of cineradiography. Using the devised two parameters, i.e., the shoulder center edge and glenoid angles, the author compared the glenohumeral movements of the normal shoulder with the involuntary inferior and multidirectional instability of the shoulder. The glenohumeral movements of the involuntary inferior and multidirectional instability showed not only an excessive excursion and sliding motion but also a deterioration of the scapular abduction and external rotation, with the arm progressively abducted. These phenomena were especially remarkable at the maximum elevation of the arm. The roentgenogram of the overhead view of the shoulder joint indicates whether or not there is an involuntary inferior and multidirectional instability, and whether or not these parameters can be useful for diagnosis of shoulder lesions.

Adolescent↗
PubMed1986

The microangiographic pattern of the glenoid labrum of the dog.

Microangiographic investigation of the glenoid labrum of the dog shows a rich vascular supply to the labrum except for its free edge. The vessels originate predominantly from the shoulder joint capsule and periosteum of the scapula neck. Several anastomoses to the glenoid vessels were demonstrated. This rich vascularization provides a good environment for surgical repair of traumatically detached parts of the labrum.

Angiography↗
PubMed1979

Injury to the suprascapular nerve associated with anterior dislocation of the shoulder: case report and review of the literature.

A young man with persistent pain beginning 2 days following reduction of an anterior subcoracoid dislocation was found to have a suprascapular nerve injury. The patient described was felt to have a neurapraxia of the suprascapular nerve. Possible causes of post-reduction subluxation are interposition of the shoulder joint capsule or biceps tendon, or rupture of the rotator cuff. EMG in 3 weeks, followup examinations, and active assisted motion 4 to 6 weeks postinjury are recommended.

Adult↗
PubMed2004

Destructive arthritis in a patient with Haim-munk syndrome.

Haim-Munk and Papillon-Lefèvre are 2 closely related syndromes, inherited in an autosomal recessive pattern, manifested by palmoplantar keratoderma and early, destructive periodontitis. Recently, mutations in the cathepsin C gene have been recognized in both syndromes. We describe a patient with Haim-Munk syndrome (palmar plantar keratosis and periodontitis) and destructive arthritis of the wrists and shoulder joints, an association that has not been previously described.

Adult↗
PubMed1997

A biomechanical study of fast throwing movements of the shoulder in baseball pitching.

OBJECTIVE: To define the biomechanic function of the shoulder in fast throwing movements in baseball pitching. METHODS: Using NAC high-speed video and PIAS LA-555 computer system, overhand pitching movements carried out by 12 healthy Japanese professional baseball pitchers were analyzed in three dimensions. The pitching motion was displayed as stick to sick figures dynamically. RESULTS: Pitching motion was a combination of translational and rotational movements. Acceleration and deceleration, being two typical motion patterns, worked sequentially through the anatomic link system from the pivot leg to the pitching hand. During the acceleration phase, the shoulder joint acted as a junction point and a fulcrum, supporting the rotational acceleration motion, shoulder forward flexion and elbow extension. According to the changing glenohumeral angles of the pitching shoulder, shearing force turned into tension force which worked on the anterior shoulder structures and then shifted to the posterior part of the joint. CONCLUSIONS: In fast throwing motion, the shoulder functions as an important fulcrum to support the pitching arm during the acceleration phase. Avoiding excessive stress and shearing force on the joint components and enhancing coordination of muscle action are important to a successful throwing motion and the prevention of shoulder injury.

Athletic Injuries↗
PubMed1985

[A new sign for the establishment of gunshot in suicide?].

Two cases involving deadly bullet shots to the head are reported (entry wounds at the right temple, shots fired at absolutely close range, 7.65 or 9 mm caliber). In both cases bleeding was determined in the fissure of the right shoulder joint. This bleeding can be explained by hyperextension and extreme position of the joint at the time of the gun firing. Should further cases of bleeding be confirmed during additional autopsies, then this bleeding could be an indication of death "by one's own hand."

Aged↗
PubMed1993

Absolute angle measurement using the earth-field-referenced hall effect sensors.

A miniaturized absolute angle sensor utilizing Hall generators referenced to the Earth's ambient magnetic field has been developed. The sensor has three-dimensional angular sensitivity which allows the output to be self-normalized resulting in high immunity to both B-field and temperature induced errors. The individual Hall generator elements were operated with a final sensitivity of 4.07 V G-1. The Earth's field, magnitude 0.486 G with a surface declination angle of 58.2 degrees (San Diego, California), was used as the excitation/reference field. Bandwidth limiting, low-noise design, and active/passive thermal compensation techniques were employed resulting in a sensor bandwidth of DC to 100 Hz with a maximum signal-to-noise ratio of 44.5 dB. The maximum angular resolution of the sensor was measured to be +/- 0.27 degrees. Temperature induced error was measured to be less than 2% from 25 degrees C to 40 degrees C. The measurement of shoulder joint rotation was used as the test case application for the sensor with excellent agreement between theoretical and experimental performance.

Biophysics↗
PubMed1975

A simplified injection technique for shoulder arthrography.

An easy and reliable technique to inject the shoulder joint for arthrography is described. The technique utilizes a straight anteroposterior position of the patient and a directly vertical placement of the needle with the aid of fluoroscopy.

Contrast Media↗
PubMed1990

Muscle activity and coordination in the normal shoulder. An electromyographic study.

Muscle activity and coordination in ten shoulders were studied in five healthy subjects using electromyography (EMG) recorded during standardized loaded movements, i.e., flexion, extension, abduction, external rotation, and internal rotation at 0 degrees, 45 degrees, and 90 degrees of abduction. Bipolar surface and intramuscular fine-wire electrodes were used, and the EMG signal was low-pass filtered, full-wave rectified, and time-averaged. Activity from the subscapularis, supraspinatus, infraspinatus, pectoralis major (sternoclavicular part), the anterior, middle, and posterior parts of the deltoid, and the latissimus dorsi was recorded in parallel. In order to allow a comparison of the activity in a subject's different muscles and the activity in specific muscles between different individuals, the EMG was normalized. Muscle activity occurred simultaneously in muscles producing the movement and in antagonistic muscles. Coordination due to muscle contractions plays a significant role in stabilizing the shoulder joint. The infraspinatus, subscapularis, and latissimus dorsi acted as stabilizers during flexion; the subscapularis acted as a stabilizer during external rotation and with the supraspinatus during extension.

Adult↗
PubMed1980

Total shoulder replacement with a constrained prosthesis.

Forty-three shoulder-joint replacements were performed in forty-two patients using a constrained joint. Twelve material failures were experienced in the first series of twenty-two shoulders and only two in the second, modified series (twenty-one shoulders). Loosening of the glenoid components was not encountered, although radiolucent lines have been observed about some of the components. A basic feature of the design was to allow dislocation of the metal head from its cup when excessive motion of the components is attempted by the patient and a specific torque is exceeded. A method of insertion and design considerations allowed us to achieve strong attachment between the metal glenoid and the scapula.

Adult↗
PubMed2005

MRI of rotator cuff muscle atrophy in relation to glenohumeral joint incongruence in brachial plexus birth injury.

PURPOSE: To evaluate rotator cuff muscles and the glenohumeral (GH) joint in brachial plexus birth injury (BPBI) using MRI and to determine whether any correlation exists between muscular abnormality and the development of glenoid dysplasia and GH joint incongruity. MATERIALS AND METHODS: Thirty-nine consecutive BPBI patients with internal rotation contracture or absent active external rotation of the shoulder joint were examined clinically and imaged with MRI. In the physical examination, passive external rotation was measured to evaluate internal rotation contracture. Both shoulders were imaged and the glenoscapular angle, percentage of humeral head anterior to the middle of the glenoid fossa (PHHA) and the greatest thickness of the subscapular, infraspinous and supraspinous muscles were measured. The muscle ratio between the affected side and the normal side was calculated to exclude age variation in the assessment of muscle atrophy. RESULTS: All muscles of the rotator cuff were atrophic, with the subscapular and infraspinous muscles being most severely affected. A correlation was found between the percentage of humeral head anterior to the middle of the glenoid fossa (PHHA) and the extent of subscapular muscle atrophy (r(s)=0.45, P=0.01), as well as between its ratio (r(s)=0.5, P P=0.01). Severity of rotator cuff muscle atrophy correlated with increased glenoid retroversion and the degree of internal rotation contracture. CONCLUSIONS: Glenoid retroversion and subluxation of the humeral head are common in patients with BPBI. All rotator cuff muscles are atrophic, especially the subscapular muscle. Muscle atrophy due to neurogenic damage apparently results in an imbalance of the shoulder muscles and progressive retroversion and subluxation of the GH joint, which in turn lead to internal rotation contracture and deformation of the joint.

Adolescent↗
PubMed1991

Rotator cuff lesions. Acute and chronic.

The complex anatomy of the shoulder often impedes the orthopedic surgeon's evaluation and understanding of injuries to the shoulder joint, particularly the rotator cuff muscle-tendon complex. Arthroscopy, MRI, and digital data analysis are several techniques now at the surgeon's disposal. This article reviews the application of these techniques in the evaluation of rotator cuff injuries.

Arthroscopy↗
PubMed2005

Force estimation processing as a function of the input--output relationship of the corticospinal pathway in humans.

Static changes of the shoulder joint from 30 degrees adduction (ANT) to 30 degrees abduction (POST) in the horizontal plane reduce the gain of the input--output relationship of the corticospinal pathway to the abductor digiti minimi (ADM) muscle [F. Ginanneschi et al. (2005)Exp. Brain Res., 161, 374--382]. The present study examined force estimation under conditions in which the input--output relationship of the corticospinal innervation to ADM was modified by changing shoulder position as above. The input--output relationship was studied using transcranial magnetic stimulation. Estimates of force were assessed using a matching procedure; subjects first matched a target level (10--40% of maximum) on a screen by applying a reference (Ref) isometric contraction of ADM and then they reproduced the same level of force without visual feedback by a test contraction (Test). When Ref and Test contractions were performed at either ANT or POST (i.e. the same input--output), the respective force levels were closely matched. In contrast, when the Test and Ref were performed in POST and ANT, respectively (i.e. different input--output), subjects exerted more force than required. Errors were in the opposite direction when the Test and Ref were in ANT and POST, respectively. The present results suggest that the process of force estimation is based on the effort : tension ratio which is a direct function of the corticomotoneuronal input--output relationship. This notion may contribute to explaining the pathophysiology of central fatigue.

Adult↗
PubMed1986

Pseudarthrosis following proximal humeral fractures: a possible mechanism.

A small series of four patients with pseudarthrosis of the proximal humeral shaft is reported. These patients all had restricted movement of the shoulder joint prior to the trauma, three as a result of rheumatoid arthritis and one due a surgical fusion of the glenohumeral joint. It is suggested that pseudarthrosis is more likely under these circumstances and that pursuit of union of the fracture in such patients may not always be necessary.

Aged↗
PubMed1992

Reconstruction of the bones and joints of the upper extremity by vascularized free fibular graft: report of 46 cases.

The vascularized free fibular graft was applied in reconstructing bone and joint structures of the upper extremity in 46 cases between August, 1977 and December, 1989. Among these, 30 were grafts of the fibular shaft and 16 were grafts of the fibular head. There were 19 bony defects after trauma or osteomyelitis, 18 bony or articular defects after resection of tumors, five congenital deformities or defects, and four replacements for fibrous dysplasia. The longest grafted fibula was 22 cm and the shortest, 5 cm. Thirty-one cases were followed for more than two years, and these were evaluated for functional ability in daily living, roentgenologic appearance, and 99mTc scan during follow-up. The results revealed quite sufficient functional restoration, solid bone healing, and adequate blood supply, in most cases. The vascularized free fibular head graft appears to be an ideal procedure for the reconstruction of defects of the lower end of the radius or the upper humerus, including the humeral head. The stability of the reconstructed wrist or shoulder joint was maintained by suturing the lateral collateral ligament, the palmar collateral ligament around the wrist, or by passing the long head of the biceps brachii through the grafted fibula at the shoulder. Methods for fixation of the fibular shaft to the recipient bone and the selection of vessels for anastomoses, both in the graft and at the recipient site, are discussed. The importance of postoperative functional exercise is emphasized.

Adult↗
PubMed1994

Hemorrhagic rupture of the shoulder.

Two cases of hemarthrosis and rupture of the shoulder joint are described and 6 reported cases are reviewed; 5 of these were associated with a destructive glenohumeral joint arthropathy and rotator cuff dissolution. All have occurred suddenly, without trauma, in elderly persons. Conservative treatment is often successful, but recurrent episodes of rupture may require replacement arthroplasty.

Aged↗
PubMed1983

Tuberculous arthritis of the shoulder: delayed diagnosis aided by arthrography.

Tuberculous arthritis of the shoulder was not diagnosed in an 80-year-old man with Addison's disease until the appearance of a draining abscess in his arm. Initially signs, symptoms, x-rays and laboratory studies were consistent with calcific tendonitis and degenerative arthritis. Then an arthrogram demonstrated a connection between the shoulder joint and the abscess. A high level of suspicion for tuberculous arthritis should be maintained in an elderly patient whose past medical history is suspicious for tuberculosis and whose articular complaints are chronic.

Abscess↗
PubMed1975

[Combined traumatic rupture of the rotator cuff and nerve lesions (author's transl)].

Traumatic damage to the rotator cuff was diagnosed in 13 patients by clinical, electromyographic and arthrographic studies. The main features were failure to rotate, elevate or abduct the affected shoulder joint. Eight patients also had peripheral nerve lesions: axillary nerve lesion was present in five, partial brachial plexus lesion in three.

Adult↗