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At least 145 records · Page 8Linked to original sources
PubMed1987

Skiing-related injuries to the shoulder.

An analysis of 135 consecutive shoulder injuries seen in one clinic during a single ski season revealed anterior dislocation to be the most common ailment, constituting 52% of the total. Rotator cuff tears accounted for 20% of the total, followed by acromioclavicular (AC) separations (18%) and a miscellaneous group of contusions and isolated fractures comprising the other 10%. All of the shoulder dislocations were anterior, most were primary (81%) and men (83%) were involved more frequently. Twenty-four percent of the dislocations were thought to be equipment related. At follow-up examination three to four years after injury, a significant number (41%) were still symptomatic either from a recurrence (18%) or pain and weakness (23%). Patients with rotator cuff tears tended to be about ten years older than the average skier. Their injuries were usually a result of a fall on ipsilateral arm and were not equipment related. Of the 13 patients responding after a three-year follow-up period, most (10/13) were asymptomatic. There were 24 AC separations. All resulted from a direct fall on the shoulder. Sixty percent were first degree, 22% were second degree, and 18% were third degree. About one-third of the respondents with first and second degree injuries were still having significant pain at three-year follow-up examination. The most frequent isolated fracture was a minimally displaced fracture of the greater tuberosity (only three cases in 135 injuries), but this same fracture occurred in 10% of the shoulder dislocations.

Acromioclavicular Joint↗
PubMed1988

[Computerized tomography imaging of shoulder joint injuries].

In addition to conventional radiography using standard and special projections, CT offers valuable information in selected cases. Native CT allows detection of minimal bony lesions, which may cause severe pain that is resistant to therapy. Small amounts of joint effusion as well as the Hill-Sachs impression fracture of the humeral head can be detected with a high degree of accuracy. Following intra-articular injection of contrast medium, CT-arthrography enables visualization of capsular and ligamentous injuries of the shoulder joint. Lesions of the glenoid labrum following shoulder dislocation can be detected and classified by this method.

Arthrography↗
PubMed1991

Shoulder dystocia recognition: differences in neonatal risks for injury.

Shoulder dystocia (SD) is an event whose current diagnostic approach is based on subjective criteria alone. Since the risk for immediate neonatal morbidity is critically linked to recognition and appropriate management of this obstetric emergency, we hypothesized that infants having injuries consistent with SD are frequently delivered without the intrapartum identification of this condition. A retrospective analysis of 26,033 vaginal births from January 1979 to April 1987 identified 162 maternal cases in which SD was diagnosed during delivery (incidence, 0.62%). Within this subset of patients, 24 neonates (15%) were identified as having either brachial plexus or fractured clavicle injuries associated with delivery. An additional 60 neonates were identified as having similar injuries immediately following delivery but without obstetric recognition of SD. Therefore 71% of all the injured infants were the product of deliveries without SD recognition. A comparison was made of maternal and neonatal variables for three groups (SD, uninjured; SD, injured; unrecognized SD, injured). The SD, injured group distinguishes itself from the other two groups by significant differences in the degree to which variables previously associated with SD are present. Conversely, both other groups are similar in all parameters except for accepted SD maneuvers utilized. These results support our hypothesis that SD is underreported in the obstetric literature and that unrecognized SD is associated with an increased risk of neonatal injury. Efforts to define objectively the threshold forces associated with neonatal injury and to develop SD teaching models should improve this clinical dilemma.

Adult↗
PubMed2003

Tears in the subscapularis tendon: descriptive analysis and results of surgical repair.

Although not well known, lesions of the subscapularis tendon are more common than usually reported. We conducted a descriptive study of 22 patients (23 shoulders), who underwent surgical repair of subscapularis tendon tears. Mean follow-up was 73 months. The findings were compared to the results of a prospective study published by one of us (R.H.C.), who reviewed 97 other patients (105 shoulders) with a mean follow-up of 13.4 years after surgical repair of a rotator cuff tear. This comparison allowed us to identify the specific features of rotator cuff tears involving the subscapularis tendon. Subscapularis tears were more likely to be related to a shoulder injury and caused more severe functional impairment, as compared to lesions of the other tendons. Time to surgical treatment was shorter when the subscapularis was torn. Subscapularis tears required adaptation of the surgical approach and postoperative protection of external rotation for 4-6 weeks. Outcomes were less satisfactory when the subscapularis tendon was torn. However, the outcomes in both studies were correlated to tear size. The outcomes were often favorable after isolated subscapularis tendon tears and less so when other tendons were involved.

Adult↗
PubMed1995

Posture in patients with shoulder overuse injuries and healthy individuals.

Assessment of posture is an integral component of patient evaluation with shoulder overuse injuries. However, the professional literature contains relatively few studies that have assessed the relationship between posture, function, and injury. The purpose of this study was to determine the relationship and differences in postural variables within and between subjects with overuse injuries to the shoulder of healthy subjects. Thirty patient subjects and 30 healthy subjects matched for age and gender were recruited. Scapular protraction and rotation, forward head position, midthoracic curvature, and passive humeral elevation in the plane of the scapula were measured randomly in standing. All measurement techniques were standardized and validated. Intrarater and interrater reliability for all clinical measures were established before data collection. Forward head position was significantly greater (p < .001) in the patient group than the healthy group; humeral elevation was significantly greater (p < .001) in the healthy group than in the patient group and in the uninvolved shoulders (p < .01) than the involved shoulders within the patient group. Scapular protraction, rotation, midthoracic curvature, and scapular symmetry were not significantly different between groups. Scapula protraction and rotation were significantly related (p < .05) in the patient group. No other postural variables were related. Conclusions regarding the influence of posture to shoulder injury are inconclusive based on several confounding variables that may have affected the outcome.

Adolescent↗
PubMedDate not supplied

Incidence and causes of shoulder girdle injuries in an urban population.

In a prospective population-based study of all shoulder injuries seen at Malmö General Hospital during 1987, the incidence and causes of major injuries involving fractures of the clavicle, scapula, or proximal humerus and glenohumeral or acromioclavicular dislocations were investigated in children, adults, and the elderly. Seventy-five shoulder injuries occurred in children. Sixty-five of them were fractures of the clavicle. In this age group no sex-related differences were seen in incidence, and 37 of 73 injuries were related to sports or playing. One hundred eighty-one injuries occurred in adults. Sixty fractures of the proximal humerus, 67 fractures of the clavicle, and 31 primary glenohumeral dislocations were seen. The injuries in this group were significantly more frequent in men, with most of them caused by traffic and sport injuries. Two hundred forty-eight injuries occurred in elderly people. Two hundred one were fractures of the proximal humerus. The incidence was significantly higher in women; 147 of 247 injuries were caused by an indoor fall. The variations among age groups are probably attributable to age-related differences in activity, mobility, and fragility.

Acromioclavicular Joint↗
PubMed1991

[Role of arthroscopy in complex sports injuries].

Shoulder lesions caused by accident are often of complex nature. In most cases, different structures are involved, which cannot be distinguished and individualized clinically with certainty. Arthroscopy permits far more differentiated diagnosis with systematic revision of traumatized structures. Besides the possibility of comprehensive repair (e.g. in part arthroscopic, in part open), the faster rehabilitation attained by minimal exposures is also of importance.

Arthroscopy↗
PubMed1997

Common injuries in volleyball. Mechanisms of injury, prevention and rehabilitation.

Volleyball has become an extremely popular participation sport worldwide. Fortunately, the incidence of serious injury is relatively low. The sport-specific activity most commonly associated with injury is blocking. Ankle sprains are the most common acute injury. Recurrent sprains may be less likely to occur if an ankle orthosis is worn. Patellar tendinitis represents the most common overuse injury, although shoulder tendinitis secondary to the overhead activities of spiking and serving is also commonly seen. An unusual shoulder injury involving the distal branch of the suprascapular nerve which innervates the infraspinatus muscle has been increasingly described in volleyball players in recent years. Hand injuries, usually occurring while blocking, are the next most common group of injuries. Fortunately, severe knee ligament injuries are rare in volleyball. However, anterior crutiate ligament injury is more likely to occur in female players. Many of these injuries may be preventable with close attention to technique in sport-specific skills and some fairly simple preventive interventions.

Ankle Injuries↗
PubMed1987

Arthrography in evaluation of birth injuries of the shoulder.

Birth injuries of the shoulder and proximal humerus of infants can be difficult to evaluate on plain radiographs because of lack of ossification in the proximal humeral epiphysis. We here describe arthrography of the infant shoulder and advocate it as a useful diagnostic procedure in the evaluation of humeral fractures and brachial palsies. Two infants with birth injuries of the shoulder are described. The value of dynamic fluoroscopic evaluation of the injured joint in conjunction with arthrography is illustrated in evaluation of a brachial plexus palsy.

Arthrography↗
PubMed1996

Injuries in elite volleyball.

During the 1993-1994 volleyball season, injuries to players in the two Danish elite divisions were registered by means of a questionnaire survey. Eighty per cent of the players returned the questionnaire. A total of 70 female players reported 79 injuries and 67 male players reported 98 injuries, representing an overall incidence of 3.8 injuries per player per 1000 volleyball hours played. The injury incidence was the same for female and male players. Most injuries occurred in spiking (32%) and in blocking (28%). The injuries were predominantly either acute injuries to fingers (21%) and ankles (18%) or overuse injuries to shoulders (15%) and knees (16%). Shoulder injuries seemed to be a more serious problem in females. During the past 10 years the rate of overuse injuries has increased from 16% to 47% in male elite volleyball, corresponding to a significant increase in the incidence of these injuries from 0.5 to 1.8 injuries per player per 1000 played hours (P < 0.001). A possible explanation for this could be a 50% increase in training activity during this period.

Adolescent↗
PubMed1993

Classification and treatment of shoulder dysfunction in the overhead athlete.

There are two distinct pathological categories of shoulder injury. In the older population, shoulder injury is generally a result of the degenerative aging process. In the younger population, it is commonly a result of the repetitiousness of an overhead sport. In the latter group, instability is typically the core problem, leading to the continuum of subluxation, impingement, and rotator cuff tear. A classification scheme, proposing four definitive types of shoulder injury, assists in directing an effective management program. Once diagnosed (the first step of treatment) a conservative rehabilitation program that emphasizes strengthening of the glenohumeral protectors, scapulohumeral pivotors, humeral positioners, and power drivers is advised. The surgery of choice, for the small minority who fail to respond to the rehabilitation program, is the anterior capsulolabral reconstruction. A sports medicine team working together with the athlete is instrumental in his/her return to sport.

Adolescent↗
PubMedDate not supplied

Injury incidence and prevalence among elite weight and power lifters.

The purpose of this study was to investigate the incidence and prevalence of injuries among elite weight lifters and power lifters, with a special focus on shoulder injuries and possible injury-provoking exercises. In 1995, a questionnaire was administered to 110 male and female elite lifters to evaluate injuries and training characteristics. A follow-up of the athletes from 1995 was conducted in 2000, and a new 2000 elite group was also queried. In 1995 and again in 2000, the athletes sustained, on average, 2.6 injuries per 1000 hours of activity. Most common in 1995 were low back injuries, with an injury rate of 0.43 per 1000 hours, and shoulder injuries, with a rate of 0.42 per 1000 hours. Shoulder injuries dominated in 2000, with an injury rate of 0.51 per 1000 hours of activity. There was a difference in injury pattern between weight lifters, who mostly sustained low back and knee injuries, and power lifters, in whom shoulder injuries were most common. No correlation was found between shoulder injuries and any specific exercise. Although the total injury rate was the same during the two periods of study, the rate of shoulder injuries had increased.

Adult↗
PubMed1996

[Biomechanics of the shoulder and therapeutic applications].

The influence of biomechanics in surgery of the locomotor apparatus has been constantly increasing over the last few decades. The purpose of this study was to determine wether biomechanical studies can significantly influence therapy and treatment of shoulder injuries, especially shoulder instability. The investigation was performed on 23 fresh human specimens with intact capsular ligaments of the glenohumeral joint. A Bankart lesion from 3 o'clock to 6 o'clock was repaired, and a Bankart repair and anterior inferior capsular shift, as described by Neer, were performed. The measurement was done on six clinically relevant positions of instability: superior, anterior, anterior-inferior, inferior, posterior-inferior, posterior. Measurement was done using a specially developed strain-gauge system. It was demonstrated that both instability and too much stability of the shoulder joint lead to a significant change in shoulder biomechanics. The anatomical O-position of the glenohumeral joint in 110 degrees of abduction is a position of about 60 degrees of external rotation compared to the O-position for clinical measurement. From the therapy point of view, one has to ask for anatomical reconstruction instead of tight repair in soft-tissue repair in the glenohumeral joint. Immediate post-operative rehabilitation in a 60 degrees range of motion is possible.

Adult↗
PubMed1997

Common carotid artery and tracheal injury from shoulder strap seat belt.

Carotid artery injuries from seat belt shoulder straps have been reported involving primarily the internal carotid artery. This paper describes a case of common carotid artery disruption and tracheal transection after a shoulder strap seat belt injury. A successful method for management of this rare injury is presented. Repair involved autogenous arterial replacement in a contaminated field using an interposition graft of superficial femoral artery.

Accidents, Traffic↗
PubMed2003

Shoulder disorders in the skeletally immature throwing athlete.

Shoulder injuries are common in young throwing athletes. Most injuries are overuse types related to excessive pitch counts, premature use of breaking pitches, and improper pitching mechanics. These etiologic factors should be recognized early and treated. Prevention of injuries should play a major role in decreasing shoulder injury.

Adolescent↗