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At least 1,675 records · Page 93Linked to original sources
PubMed2006

Posterior subluxation and dislocation of the shoulder in obstetric brachial plexus palsy.

We describe the results of surgical treatment in a prospective study of 183 consecutive cases of subluxation (101) and dislocation (82) of the shoulder secondary to obstetric brachial plexus palsy between 1995 and 2000. Neurological recovery was rated 'good' or 'useful' in all children, whose lesions fell into groups 1, 2 or 3 of the Narakas classification. The mean age at operation was 47 months (3 to 204). The mean follow-up was 40 months (24 to 124). The mean gain in function was 3.6 levels (9.4 to 13) using the Mallet score and 2 (2.1 to 4.1) on the Gilbert score. The mean active global range of shoulder movement was increased by 73 degrees ; the mean range of active lateral rotation by 58 degrees and that of supination of the forearm by 51 degrees . Active medial rotation was decreased by a mean of 10 degrees . There were 20 failures. The functional outcome is related to the severity of the neurological lesion, the duration of the dislocation and onset of deformity.

Bone Remodeling↗
PubMedDate not supplied

Isolated traumatic rupture of the subscapularis tendon.

BACKGROUND: Although rotator cuff tears are well documented in the literature, there have been relatively few reported cases of isolated subscapularis tears. To our knowledge, no case has been reported that describes an isolated subscapularis tear in a woman without anterior shoulder dislocation or bony avulsion. METHODS: This report outlines the case of a healthy 46-year-old woman with no history of shoulder problems who sustained injury to her right shoulder while hanging a light fixture. We highlight several key points to early diagnosis and underscore operative management for a successful outcome. RESULTS AND CONCLUSIONS: Isolated subscapularis tendon ruptures are uncommon in women. Increased vigilance during the history and physical examination is necessary to detect these injuries. Subscapularis tendon ruptures are commonly mistaken for degenerative rotator cuff tears or subacromial impingement syndrome. The lift-off test can isolate a subscapularis injury. Pertinent radiographic and magnetic resonance imaging findings are described.

Female↗
PubMed1994

Osteoarthritis after the Eden-Hybbinette-Lange procedure for anterior dislocation of the shoulder. A 15 year follow up.

We have quantified the rate and severity of osteoarthritis after the Eden-Hybbinette-Lange procedure. With a mean follow up of 15 years, 44/56 (79%) of operated shoulders showed osteoarthritic changes on radiographic review. Of the contralateral non-operated shoulders the rate of osteoarthritis was 8/60 (8%). Only shoulders in the operated group demonstrated severe osteoarthritis. In our hands the rate of osteoarthritis for the Eden-Hybbinette-Lange procedure is higher than for the Eden-Hybbinette procedure or for rival operations for recurrent dislocation. We recommend careful evaluation of the Eden-Hybbinette-Lange procedure. The high rate of late osteoarthritis indicates that other operations with an equally low rate of redislocation may be of greater long term benefit to the patient.

Adolescent↗
PubMed1992

The fate of traumatic anterior dislocation of the shoulder in children.

The cases of twenty-one patients who had open physes and were treated for radiographic evidence of traumatic anterior dislocation of the shoulder at either the Adelaide Childrens Hospital or The Hospital for Sick Children, Toronto, during a fifteen-year period, were reviewed. All twenty-one patients had had one or more recurrent dislocations. Treatment, which included immobilization in a sling and swathe for as long as six weeks, had no effect on the rate of recurrence.

Adolescent↗
PubMed1993

Philosophy of osteosynthesis in shoulder fractures.

A wide range of workable instrumentation is available for the treatment of proximal humeral fractures, whereas osteosynthesis of scapular fractures is commonly achieved by plate/screw fixation. Older persons are confronted with a steadily rising incidence of osteoporotic fractures. Especially for this group of patients, minimally invasive and minimally instrumented surgical procedures, such as K-wiring and bone sutures, seem to have superseded plate fixation. For the treatment of scapular fractures, an important question remains: Which fracture types provide better functional results with open reduction and internal fixation, and which with conservative treatment? Our indications for an operative procedure are limited to the floating shoulder, dislocated scapular neck fracture, and dislocated glenoid fracture.

Fracture Fixation, Internal↗
PubMed1986

Anterior dislocation of the shoulder. Experience with a modified clavicular harness.

There is a high incidence of recurrence after traumatic dislocation of the shoulder. In this study of 417 patients, we found that initial dislocation below the age of 30, dislocation with capsular detachment, dislocation without tuberosity fracture and a short period of fixation after reduction were predisposing factors. We have designed a modified clavicular harness and have used it in the treatment of 41 such high risk patients. We found no recurrences during an observation period of one year.

Adolescent↗
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↗
PubMed1993

Capsular properties of the shoulder.

The purpose of this study was to determine the structural properties of the capsule of the glenohumeral joint. Twelve fresh frozen cadaveric shoulders were studied. Capsular strips were prepared from four different sites (anterior, posterior, superior, and inferior) of the capsule. One end of the capsular sections was left attached to the humerus, and the other excised was fixed in a clamp of an Instron universal testing machine. Maximum load, strength (maximum stress), and modulus of elasticity of these four capsular portions were measured. The most common mode of failure was tear at the midsubstance (68%), followed by tear at the clamp-capsule junction (23%), and detachment from the humerus (9%). The posterior capsule (1.0 +/- 0.4 mm) was thinner than the anterior (1.8 +/- 0.3 mm), superior (1.6 +/- 0.4 mm), and inferior capsule (1.5 +/- 0.3 mm). Among the four portions of the capsule, the posterior capsule showed the greatest strength (216.6 +/- 58.2 kg/cm2) and modulus of elasticity (683.1 +/- 228.8 kg/cm2), whereas the superior capsule showed the least strength (82.4 +/- 33.5 kg/cm2). There were no significant differences in maximum load. The greater strength of the posterior capsule may be one explanation for the low incidence of posterior shoulder dislocation.

Biomechanical Phenomena↗
PubMed1982

Fracture-dislocation of the shoulder in a 32-month-old child.

A case of fracture-separation and dislocation of the proximal humeral epiphysis, a rare injury, is reported. The patient, a 32-month-old girl suspected of being an abused child, was reported to have fallen from her crib 2 days earlier. She had a painful, swollen, slightly ecchymotic left shoulder, which she held in the neutral position and refused to move. Radiographs showed a healing, nondisplaced radial fracture and fracture-separation of the proximal humeral epiphysis, which was dislocated into an anterior subglenoid location. Surgery under general anesthesia showed the humeral head to lie in a subglenoid position and the distal fragment of the separated epiphysis to have penetrated the posterior lateral capsule. The reduction was stabilized with a single, percutaneous, smooth Kirschner wire and shoulder immobilized in a Velpeau cast for 3 weeks. At 2 year follow-up, the patient has painless, full range of motion, the epiphysis is open, and the length of the humerous appears normal.

Child Abuse↗