Correlação entre resistência de preensão manual e resistência muscular escapular em indivíduos assintomáticos / Correlation between hand grip endurance and scapular muscle endurance in asymptomatic individuals

INTRODUÇÃO: A atividade de preensão é uma ação diária essencial em casa e no local de trabalho, onde muitas vezes é necessário levantar e segurar cargas com uma preensão relativamente estática usando contração isométrica. A força e resistência muscular no aspecto proximal das extremidades superiores influenciam na função da mão, e indivíduos com força e resistência reduzidas são mais propensos a desenvolver distúrbios musculoesqueléticos relacionados ao trabalho. Uma boa resistência de preensão pode ser influenciada pela estabilização fornecida pelos músculos do ombro. Este estudo tem como objetivo determinar a extensão da correlação entre resistência de preensão manual e resistência muscular da escápula em jovens assintomáticos. MÉTODO: O tamanho da amostra para este estudo foi n = 62, com base em estudos anteriores. Indivíduos saudáveis, com idade entre 18 e 25 anos, de ambos os sexos, foram incluídos. Uma avaliação objetiva da resistência da preensão foi realizada usando um dinamômetro manual hidráulico, e a resistência escapular foi avaliada usando o teste muscular escapular. RESULTADOS: A análise de dados foi realizada usando o SPSS versão 20. Houve correlações positivas significativas entre as medidas de resistência escapular e a resistência de preensão palmar para ambos os lados (teste de correlação de Pearson, r = 0,612 (p < 0,001) e r = 0,524 (p < 0,001), respectivamente, para resistência de preensão da mão não dominante e dominante). CONSIDERAÇÕES FINAIS: Os achados preliminares deste estudo sustentam que a resistência do músculo escapular exibe uma relação com a resistência da preensão palmar, sugerindo que o treinamento de resistência escapular pode ser um complemento eficaz no processo de reabilitação das funções da extremidade superior.

INTRODUCTION: Gripping activity is an essential daily activity at home and at the workplace, where lifting and holding loads with a relatively static grip using isometric contraction is often required. Muscle strength and endurance in the proximal aspect of the upper extremities influence hand function, and individuals with reduced strength and endurance are more prone to developing work-related musculoskeletal disorders. Good grip endurance might be influenced by the stabilization provided by shoulder muscles. This study aims to determine the correlation between hand grip endurance and scapula muscle endurance among young asymptomatic individuals. METHOD: The sample size for this study is n = 62, based on previous studies. Healthy individuals of both genders, aged between 18 and 25 years, were included. An objective assessment of grip endurance was performed using a hydraulic hand dynamometer, while scapular endurance was evaluated using the scapular muscle test. RESULTS: Data analysis was performed using SPSS version 20. There were significant positive correlations between scapular endurance measures and the hand grip endurance on both sides (Pearson correlation test, r = 0.612 (p < 0.001) and r = 0.524 (p < 0.001), respectively, for non-dominant and dominant hand grip endurance). FINAL CONSIDERATIONS: The preliminary findings of this study support the notion that scapular muscle endurance is related to hand grip endurance, suggesting that scapular endurance training may be an effective adjunct in the rehabilitation process for upper extremity functions.

Effect of lag screw and support plate through axillary approach for the treatment of Ideberg typeⅡscapular pelvis fracture / 中国骨伤

OBJECTIVE@#To analyze the effect of lag screw and support plate through axillary approach for the treatment of Ideberg typeⅡscapular pelvis fracture.@*METHODS@#From January 2016 to June 2021, 26 patients with Ideberg typeⅡglenoid fractures were treated with trans-axillary lag screw combined with supporting plate, including 15 males and 11 females. The age ranged from 21 to 75 years, with an average of (43.12±6.56) years old. The Constant-Murley Shoulder joint Scale and University of California at Los Angeles (UCLA) score were used to evaluate the function and clinical efficacy of shoulder joint.@*RESULTS@#All patients were followed up, and the duration ranged from 19 to 42 months, with an average of (30.6±10.5) months. One year after surgery, the Constant-Murley score increased from preoperative 34.9±2.5(ranged, from 28 to 47) to 87.2±6.8(ranged, from 70 to 95). The UCLA score improved from preoperative 17.9±1.7(9 to 25) to 33.1±2.3(29 to 35). Seventeen patients got an excellent result, with 7 good, and 2 fair. None of the patients had infection, screw, and plate loosening, fracture, and other complications after surgery. Two patients had different degrees of Chronic pain in the shoulder during the follow-up period.@*CONCLUSION@#The treatment of Ideberg typeⅡscapular glenoid fractures through axillary approach with lag screws and supporting steel plates has the advantages of convenient exposure, direct visual restoration of the normal anatomical shape of the scapular glenoid, selection of suitable positions for screw and steel plate placement, achieving better treatment results, and fewer complications. It is an effective and reliable surgical method.

Treatment of Ideberg type Ⅱ scapular glenoid fracture with compression screw combined with Buttress plate through direct axillary approach / 中国修复重建外科杂志

OBJECTIVE@#To investigate the effectiveness of compression screw combined with Buttress plate through direct axillary approach for Ideberg typeⅡ scapular glenoid fractures.@*METHODS@#A retrospective analysis was conducted on 11 patients with Ideberg type Ⅱ scapular glenoid fractures treated with compression screws combined with Buttress plate fixation through the direct axillary approach between January 2014 and June 2022. There were 7 males and 4 females, aged from 34 to 75 years, with an average of 56.0 years. The causes of injury included 4 cases of falling from height injury, 4 cases of heavy object injury, and 3 cases of traffic accident injury. The time from injury to operation was 2-5 days, with an average of 3.8 days. The operation time, intraoperative blood loss, hospital stay, complications, and fracture healing time were recorded. The Constant-Murley score, American Society of Shoulder and Elbow Surgeons (ASES) score, and shoulder joint flexion, abduction, external rotation (neutral position), and internal rotation (neutral position) range of motion were used to evaluate shoulder joint pain and function.@*RESULTS@#The operation time was 45-105 minutes, with an average of 79.0 minutes; the intraoperative blood loss was 80-200 mL, with an average of 99.2 mL; the hospital stay was 3-8 days, with an average of 5.8 days. One patient had poor wound healing after operation, and the wound healed after strengthening dressing change; the rest wounds had primary healing, and no axillary nerve paralysis occurred. Except for 1 patient lost follow-up, the remaining 10 patients were followed up 10-54 months, with an average of 26.4 months. The postoperative X-ray film examination showed that the fractures healed well within 8-15 weeks, with an average of 11.0 weeks. There was no complication such as fracture displacement, internal fixator failure or fracture during follow-up. At last follow-up, the patient's shoulder joint flexion, abduction, external rotation (neutral position), and internal rotation (neutral position) range of motion, Constant-Murley score, and ASES score significantly improved when compared with those before operation ( P<0.05).@*CONCLUSION@#Compression screw combined with Buttress plate through direct axillary approach is an effective way to treat Ideberg typeⅡ scapular glenoid fracture, with advantages of small trauma, concealed incision, and good effectiveness.

Four weeks of exercise regimen for sedentary workers with rounded shoulder posture: a randomized controlled study

ABSTRACT BACKGROUND: Rounded shoulder (RS) posture causes neck and shoulder pathologies. Mechanical correction taping (MCT) is often incorporated into postural corrective therapies; however, its effects on muscle stiffness are unclear. OBJECTIVE: We investigated the effect of MCT with different tape fabrics, along with exercise, on upper trapezius and pectoralis minor muscle stiffness and the posture of sedentary workers. DESIGN AND SETTING: A randomized controlled study was performed at Aydın Adnan Menderes University, Aydın, Turkey. METHODS: The study included 39 workers with RS posture. Two intervention groups (performance tape: PT and classic tape: CT) were taped twice a week and administered a home exercise program for 4 weeks. The control (C) group performed only home exercises. RS was measured using an acromion-testing table (AT), stiffness using shear wave elastography ultrasound, and shoulder angle (SA) using a smartphone application at baseline and 4 weeks. Time and group interactions were determined using 3 × 2 mixed analysis of variance. RESULTS: Intragroup analyses revealed a significant main effect of time on AT distance (η2 = 0.445) and SA (η2 = 0.325) in the PT and C groups (P < 0.05) and left upper trapezius stiffness (η2 = 0.287) in the CT and C groups (P < 0.05). In the post hoc analyses, no difference was noted between the groups from baseline to 4 weeks (P > 0.05). CONCLUSION: Scapular MCT added to postural exercises did not show any difference between the intervention groups and controls in terms of muscle stiffness and posture in sedentary workers.

Comparison of the upper extremity physical performance tests between asymptomatic adults with and without scapular dyskinesis

Abstract Introduction Physical performance tests (PPTs) are screening tools widely available, easy to apply, and that can be performed in different environments and contexts. Scapular dyskinesis can be related to changes in glenohumeral angulation, acromioclavicular joint strain, subacromial space dimension, shoulder muscle strength/activation and humeral position/motion. Few studies were developed to understand the influence of aspects such as strength, stability mobility, and scapular dyskinesis on the scores of the upper extremity PPTs. Objective To compare the performance in the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), Seated Medicine Ball Throw Test (SMBT) and Upper Quarter Y Balance Test (UQYBT) between asymptomatic adults with and without scapular dyskinesis. Methods Cross-sectional study with 20 asymptomatic individuals: 10 with scapular dyskinesis and 10 without scapular dyskinesis. The average number of touches, number of touches normalized by height, and power score in the CKCUEST, distance covered by the ball in the SMBT, reach in the medial, inferolateral, and superolateral directions, total excursion and composite score of the UQYBT were compared between both groups. Results No significant differences were found for all variables (p > 0.05). Small to moderate effect sizes were found for the scores of the CKCUEST (d = 0.16-0.78), a small effect size was found for the distance in the SBMT (d = 0.12), and small to moderate effect sizes were found for the scores of the UQYBT (d = 0.02-0.43). The scapular dyskinesis group presented better performance in all tests. Conclusion The presence of scapular dyskinesis in asymptomatic individuals is not a factor related to worse scores in upper extremity physical performance tests.

Resumo Introdução Os testes de desempenho físico (PPTs) são instrumentos de triagem amplamente disponíveis, de fácil aplicação e que podem ser realizados em diferentes ambientes e contextos. A discinesia escapular pode estar relacionada a alterações na angulação glenoumeral, tensão na articulação acromioclavicular, dimensão do espaço subacromial, força/ativação muscular do ombro e posição/movimento umeral. Poucos estudos foram desenvolvidos para entender a influência de aspectos como força, estabilidade, mobilidade e discinese escapular nos escores dos PPTs de membros superiores. Objetivo Comparar o desempenho no Teste de Estabilidade de Extremidade Superior de Cadeia Cinética Fechada (CKCUEST), Teste de Arremesso de Medicine Ball Sentada (SMBT) e Teste de Equilíbrio em Y do Quarto Superior (UQYBT) entre adultos assintomáticos com e sem discinesia escapular. Métodos Estudo transversal com amostra de 20 indivíduos assintomáticos: 10 com discinesia escapular e 10 sem discinesia escapular. Comparou-se o número médio de toques, número de toques normalizados pela altura e pontuação de potência no CKCUEST, distância percorrida pela bola no SMBT, alcance nas direções medial, inferolateral e superolateral, excursão total e escore composto do UQYBT entre ambos os grupos. Resultados Não foram encontradas diferenças significativas para todas as variáveis (p > 0,05). Tamanho de efeito pequeno a moderado foi encontrado para os escores do CKCUEST (d = 0,16-0,78), tamanho de efeito pequeno foi encontrado para a distância no SBMT (d = 0,12) e tamanho de efeito pequeno a moderado foi encontrado para as pontuações do UQYBT (d = 0,02-0,43). O grupo com discinesia escapular apresentou melhor desempenho em todos os testes. Conclusão A pre-sença de discinesia escapular em indivíduos assintomáticos não é um fator relacionado a piores escores em testes de desempenho físico de membros superiores.

Circumflex scapular perforator propeller flap for reconstruction of axillary scar contractures / 中华显微外科杂志

Objective:To estimate the preliminary result of circumflex scapular perforator propeller flap in reconstruction of axillary scar contractures.Methods:From January 2016 to June 2021, circumflex scapular perforator propeller flaps were used in 7 cases for reconstruction of soft tissue defect after axillary scar contractures. Patients were 5 males and 2 females. Age ranged from 23 to 38 years old, mean age of 27.7 years old. According to Kurtzman and Stern classification of axillary scar contractures, there were 1 case with type 1a, 1 with type 1b, 2 with type 2, and 3 with type 3. The preoperative range of motion of the shoulder joint were 40°-85°, with an average of 63.7°. All the patients were underwent scar release and circumflex scapular perforator propeller flap transfer. All flaps were transferred as the manner of perforator propeller flap. All the donor sites were closed directly. The defects after releasing ranged from 5.0 cm×7.0 cm to 11.0 cm×9.0 cm, and the flaps ranged from 16.0 cm×7.0 cm to 24.0 cm×9.0 cm. Flap survival, complications of donor site and recipient site were recorded after surgery. The range of motion of the shoulder joint, donor and recipient sites were reviewed in outpatient clinic.Results:All flaps survived uneventfully after surgery, besides 1 case complicated with distal venous congestion. The follow-up time ranged from 6 to 23 months, with an average of 12 months. The texture and contour of the flaps were good in all. At last follow-up, the range of motion of the shoulder joints were 90°-120°, with an average of 107°. Mild scar hyperplasia occurred in 2 cases.Conclusion:The circumflex scapular perforator propeller flap is an effective protocol in reconstruction of axillary scar contractures.

Foramen escapular osificado en una muestra poblacional colombo-chilena / Ossified scapular foramen in a Colombian-Chilean population sample

RESUMEN: Ocasionalmente la incisura escapular puede ser reemplazada por un foramen óseo producto de la osificación del ligamento transverso superior de la escápula. Esta formación ósea se considera un factor precipitante de la compresión del nervio supraescapular. Ciento noventa y cinco escápulas de individuos adultos pertenecientes a osteotecas de universidades de Colombia (114 escápulas) y de Chile (81 escápulas), fueron estudiadas macroscópicamente para determinar la presencia de un foramen escapular óseo. Ambas escápulas de un mismo individuo colombiano (1,75 % del total) presentaban el foramen escapular y una escápula izquierda (1,23 %) presentaba esta formación en un individuo chileno. La prevalencia de la osificación del ligamento transverso superior de la escápula es muy variable en los distintos estudios y tiende a situarse inferior al 10 %, sin embargo, puede constituirse en un factor de riesgo debido al atrapamiento o compresión del nervio supraescapular, hecho conocido como neuropatía supraescapular.

SUMMARY: Occasionally the scapular notch can be replaced by a bony foramen product of the ossification of the superior transverse scapular ligament. This bone formation is considered a precipitating factor for compression of the suprascapular nerve. One hundred and ninety-five adult scapulae from Colombian (114 scapulae) and Chilean (81 scapulae) university osteotheques were studied macroscopically to determine the presence of a bony scapular foramen. Both scapulae of the same Colombian individual (1.75% of the total) presented the scapular foramen and one left scapula (1.23%) presented this formation in a Chilean individual. The prevalence of ossification of the superior transverse scapular ligament is highly variable in the different studies and tends to be less than 10%; however, it can become a risk factor due to entrapment or compression of the suprascapular nerve, a fact known as suprascapular neuropathy.

Effect of kinesio tape on scapular kinematics in subjects with scapular dyskinesis

Scapular dyskinesis is an abnormality in scapula static or dynamic position. There are several techniques for scapular dyskinesis conservative treatment, including Kinesio Tape application, which is used to promote and support scapula joint alignment, decrease pain and improve local muscle control. The study aim to investigate the effect of kinesio tape on scapular kinematics in subjects with scapular dyskinesis. Fourteen subjects with scapular dyskinesis performed flexion and scaption movements in two conditions: (1) without load and (2) holding a dumbbell. A scapular tape was applied over the lower trapezius (Y shaped) muscle with a 20% tension. Kinematic data were captured with 10 infrared cameras and analyzed based on Euler angles, peak values of upward rotation, internal rotation, and posterior tilt angles. To compare the situations with and without kinesio tape the repeated measures two-way ANOVAs (α = 0.05) was performed using SPSS software. Scapular tape increase upward rotation and posterior tilt during flexion of the shoulder. No interaction (Load x KT) was found during flexion, suggesting that KT effect in the peak values is the same, regardless the load condition. Scapular tape decreases internal rotation during scaption and a significant interaction was found between load x KT, suggesting the effect of using KT could depend the load u sed during this movement. The results suggest that kinesio tape may can be use as assistant to increase upward rotation, posterior tilt and decrease internal rotation in scapular dyskinesis subjects. (AU)

Treatment of scapular glenoid fractures via the modified Judet approach / 中华创伤骨科杂志

Objective:To analyze the treatment of scapular glenoid fractures via the modified Judet approach.Methods:A retrospective study was conducted of the 25 patients who had been treated for scapular glenoid fractures via the modified Judet approach and completely followed up at Department of Orthopaedic Trauma, Beijing Jishuitan Hospital from January 2014 to January 2020. They were 19 males and 6 females with an average age of 46 years (from 29 to 66 years). According to the Goss-Ideberg classification, 8 cases were diagnosed as type Ⅱ, 2 cases as type Ⅳ, 10 cases as type Ⅴ and 5 cases as type Ⅵ. 3D reconstruction of the CT scans by software Mimics 16.0 was made to confirm the diagnoses and classifications of the fractures. Articular step-off and displacement of the scapular glenoid were calculated and recorded. The functional outcomes were evaluated by Constant-Murley scoring system at 6 months postoperatively.Results:Preoperatively, the mean articular step-off was 5.8 mm (from 1.2 to 6.3 mm) and the mean displacement 7.7 mm (from 2.1 to 12.9 mm). All fractures obtained bony union within postoperative 6 months. The mean follow-up period was 58.8 months (from 7 to 92 months). The forward flexion was 158.6° (from 125° to 180°) and the external rotation 39.0° (from 30° to 45°) at 6 months postoperatively. The mean Constant-Murley score was 92.6 (from 75 to 100) at 6 months post-operatively; 19 cases were excellent (76%), 5 were good (20%) and one was fair (4%), giving an excellent to good rate of 96% (24/25).Conclusion:For scapular glenoid fractures of Goss-Ideberg types Ⅱ/Ⅳ/Ⅴ/Ⅵ, surgery via the modified Judet approach may promise satisfactory reduction and fixation and fine clinical outcomes.

Advance in Scapular Dyskinesis and Its Rehabilitation Management (review) / 中国康复理论与实践

Conclusion:The clinical assessment and classification of scapular dyskinesis had been summarized. Scapular dyskinesis is mainly secondary to rotator cuff injury, subacromial impingement syndrome, glenohumeral instability, injury of acromioclavicular joint, throwing shoulder and adhesive capsulitis, etc. Scapular exercise may be a supplement to routine rehabilitation management. Objective:To review the pathogeny, clinical assessment and classification, and rehabilitation management of scapular dyskinesis. Results and Methods:The literatures in recent ten years were reviewed and summarized.

Morphological classification and clinical significance of inferior angle of scapula based on CT three-dimensional reconstruction / 解剖学报

Objective To research the morphological classification of inferior angle of scapula based on CT 3D reconstruction and its clinical significance. Methods A total of 290 scapular bones data were collected from People's Hospital of Lu Xian County and measured based on CT 3D reconstruction. The scapular bones images were reconstructed by CT 3D technique. Reference points; g was the inferior scapular angle, n was the inferior glenotubular nodule, m was the intersection of the scapular ganglion and the medial edge of the scapula, k was the upper scapular angle, r was the notch of the scapular glenoid, h was the intersection of point g to mr. The parameters of inferior angles of 290 scapular bones, including the thickness of point g (the thickest part of inferior angle of the scapula), the length of the line gn, line gm, and line gh, and the angle of ∠ ngm, ∠ gmk (the projection of the scapular coronal plane), and ∠ gmk' (the projection of the scapular sagittal plane) were observed and measured by CT 3D technique. Results Under the CT three-dimensional reconstruction, the inferior angle of scapula was classified into three types; accessory angle-type ( 175, 60. 34%), U-type ( 81, 27. 93%) and V-type (34, 11. 73%). In addition, there was a significant difference between the auxiliary angle type and the V type on the thickest part of the g point and gn (P<0.05); U-type and V-type with paragonai gm-significant difference (P<0.05); There was a significant difference between the auxiliary angle type and the U shape on gh (P<0.05); there was a significant difference between the auxiliary angle type and the U shape on ∠ gmk' (P<0.05). There was a significant difference in the inferior angle of the bilateral scapula on mngm (P<0.05). Conclusion Based on the result of CT three-dimensional reconstruction, the inferior angle of scapulae have three anatomical types, with the accessory angle-type as the main type, and the morphology and classification of it are of certain clinical implication.

Effect Of Motor Control Retraining Of Scapular Stabilizers Versus Mulligan Mobilisation With Movement In Shoulder Impingement Syndrome

Background: Shoulder Impingement is one of the most common causes of shoulder pain in adults. Scapular muscle imbalances results in impaired scapular orientation with altered scapular kinematics and altered glenohumeral rhythm. Purpose of study: To study the effect of motor control retraining of scapular stabilizers versus mulligan mobilisation with movement in shoulder impingement patients. Methodology: 60 patients with positive Hawkins, kinetic medial rotation and/or Neer impingement test were taken for the study as subjects. They were then divided into two groups of 30 each- Group A and Group B. Both the groups were assessed and reassessed for(i) pain status using VAS (Visual Analogue Scale) both at rest and on internal rotation, (ii)Shoulder Flexion, Extension, Shoulder Abduction, Adduction, Internal and External Rotation Range Of Motion (ROM), (iii)Functional Scale SPADI( Shoulder Pain and Disability Index) pre and post the intervention. Group A received motor control retraining of scapular stabilizers whereas group B received Mulligan’s mobilization with movement for 6 weeks (3 times in a week). Both the groups received conventional physiotherapy. Data analysis was done using Wilcoxon sign ranked test for intragroup comparison and Manwhitney test for intergroup comparison. Results: The results showed statistically significant improvement in shoulder pain, ROM and shoulder function in motor control retraining as compared to mulligan mobilisation with movement. Conclusion: Motor control retraining of scapular stabilizers is more effective treatment technique as compared to mulligan mobilisation with movement in shoulder impingement.

Differences in Scapular Movement and Muscle Activity of the Periscapular Muscle According to the Belt-tying Movement Method / The Japanese Journal of Rehabilitation Medicine

Objective：The belt-tying movement is of two types. One uses an abduction method in which the scapular on the same side as the upper limb to be moved is touched. The other type uses an adduction method in which the scapular on the opposite side is touched. The purpose of this study was to determine the scapular movement and muscle activity of the periscapular muscle in each method.Methods：Ten healthy men performed abduction and adduction belt-tying movements. The scapular upward rotation, anterior tilt, and internal rotation angles were measured using a three-dimensional operation analysis device. The joint angles were compared between the abduction and adduction methods by using a multiple comparison procedure. In addition, the muscle activities of the trapezius upper, middle, lower, and serratus anterior muscles were measured and analyzed using surface electromyography.Results：The abduction method involved an anterior tilt and upward rotation of the scapular muscle. By contrast, the adduction method involved an upper limb descent at the L5/T12 level, a scapular anterior tilt and upward rotation, and a scapular downward rotation at a level higher than L5/T12. The muscle activity of the upper trapezius muscle fiber was always increased between the ptosis and T7 by the abduction method but was attenuated at a higher level than T12 by the abduction method.Conclusion：Rehabilitation therapy that focuses on scapular anterior tilt and downward rotation, and the muscle activity of the upper trapezius muscle fiber is important for acquiring the belt-tying movement ability using the adduction method.

Evaluation of total scapular arthroplasty after total scapulectomy for scapular tumors / 中国修复重建外科杂志

Objective: To evaluate the effectiveness of total scapular arthroplasty after total scapulectomy for scapular tumors. Methods: A clinical data of 17 patients with scapular tumors treated with total scapulectomy and total scapular arthroplasty between January 2010 and December 2017 were retrospectively reviewed. There were 9 males and 8 females with an average age of 34.4 years (range, 13-64 years). Seven patients were diagnosed with chondrosarcoma, 3 with osteosarcoma, 2 with Ewing's sarcoma, 1 with high-grade sarcoma, 1 with polymorphic dedifferentiated sarcoma, 1 with fibrosarcoma, 1 with plasmacytoma, and 1 with bone giant cell tumor. According to the surgical staging system described by Enneking et al, 1 patient was rated as stage 3, 8 as stageⅠB, 8 as stageⅡB. According to the classifications of shoulder girdle resections of Malawer et al, 11 patients were type ⅢB, 5 were type ⅣB, 1 was type ⅥB. The disease duration ranged from 0.5 to 8.0 months (mean, 3.2 months) and tumor size ranged from 11.0 cm×7.5 cm×6.0 cm to 18.5 cm×18.0 cm×12.5 cm. The 1993 Musculoskeletal Tumor Society (MSTS) upper limb function scoring system and shoulder mobility were used to evaluate postoperative shoulder joint function. Tumor recurrence and metastases were monitored by radiograph. Results: Poor superficial incision healing occurred in 1 patient, the rest incisions achieved healing by first intention. All patients were followed up 20-72 months (mean, 45.4 months). Two of the 17 patients died of multiple organ dysfunction syndrome caused by tumor metastases; 3 patients suffered from pulmonary metastases and were alive with disease. No local recurrence occurred in all patients. The overall survival rate was 88.2% (15/17) and the disease-free survival rate was 70.6% (12/17). Rib fracture after trauma, aseptic loosening, and atrophy of the deltoid muscle occurred in 1, 1, and 1 case, respectively. The other related complication was not observed. At last follow-up, the MSTS score was 26.1±1.4, and the flexion, extension, and abduction range of motion of shoulder joint were (70.0±7.5), (31.2±11.3), and (54.4 ±12.5) °, respectively. Conclusion: Reconstruction with total scapular arthroplasty after total scapulectomy can obtain a satisfactory shoulder contour and an acceptable functional outcomes in patients with scapular tumors.

Differences in Scapular Movement and Muscle Activity of the Periscapular Muscle According to the Belt-tying Movement Method / The Japanese Journal of Rehabilitation Medicine

Objective：The belt-tying movement is of two types. One uses an abduction method in which the scapular on the same side as the upper limb to be moved is touched. The other type uses an adduction method in which the scapular on the opposite side is touched. The purpose of this study was to determine the scapular movement and muscle activity of the periscapular muscle in each method.Methods：Ten healthy men performed abduction and adduction belt-tying movements. The scapular upward rotation, anterior tilt, and internal rotation angles were measured using a three-dimensional operation analysis device. The joint angles were compared between the abduction and adduction methods by using a multiple comparison procedure. In addition, the muscle activities of the trapezius upper, middle, lower, and serratus anterior muscles were measured and analyzed using surface electromyography.Results：The abduction method involved an anterior tilt and upward rotation of the scapular muscle. By contrast, the adduction method involved an upper limb descent at the L5/T12 level, a scapular anterior tilt and upward rotation, and a scapular downward rotation at a level higher than L5/T12. The muscle activity of the upper trapezius muscle fiber was always increased between the ptosis and T7 by the abduction method but was attenuated at a higher level than T12 by the abduction method.Conclusion：Rehabilitation therapy that focuses on scapular anterior tilt and downward rotation, and the muscle activity of the upper trapezius muscle fiber is important for acquiring the belt-tying movement ability using the adduction method.

Presença de retroversão umeral e discinesia escapular em praticantes de tiro de laço

RESUMO Objetivo: Avaliar a presença de retroversão umeral e discinesia escapular em praticantes de tiro de laço. Métodos: Estudo transversal com 129 sujeitos. Foram avaliados a presença de discinesia, a força muscular, a amplitude de movimento, o nível de funcionalidade e a dor no ombro. Resultados: A rotação externa foi maior (p = 0,005) e a rotação interna menor no ombro dominante (p = 0,0001). O movimento rotacional total do ombro dominante foi menor, em comparação com o não dominante (p = 0,0001). A presença de discinesia escapular foi de 32,6%, predominou a discinesia do tipo II (50%). A pontuação do Spadi foi significativamente maior nos praticantes com sintomas de dor (p < 0,05). Conclusão: Os praticantes de tiro de laço demonstraram retroversão umeral no ombro dominante e prevalência alta de discinesia escapular.

ABSTRACT Objective: The objective of the present study was to evaluate the presence of humeral retroversion and scapular dyskinesis in these practitioners. Methods: This cross-sectional study enrolled 129 subjects. The state of dyskinesis, muscle strength, range of motion, level of functionality and shoulder pain were evaluated. Results: The external rotation was higher (p = 0,005) and minor internal rotation on the dominant shoulder (p = 0,0001). The total movement of the dominant shoulder was lower, compared to the non-dominant (p = 0.0001). The presence of Scapular dyskinesis was 32,6%, predominantly type II dyskinesis (50%). The Spadi score was significantly higher in those with pain symptoms (p <0.05). Conclusion: People who practice tie-down roping showed humeral retroversion on the dominant shoulder and higher prevalence of scapular dyskinesis.

RESUMEN Objetivo: el objetivo del estudio fue evaluar la existencia de retroversión humeral y discinesia escapular en las personas que practican esta actividad. Métodos: estudio transversal con 129 individuos. Se evaluaron la existencia de discinesia, la fuerza muscular, la amplitud de movimiento, el nivel de funcionalidad y el dolor en el hombro. Resultados: la rotación externa fue mayor (p = 0,005) y la rotación interna, menor en el hombro dominante (p = 0,0001). El movimiento total del hombro dominante fue menor en comparación con el no dominante (p = 0,0001). La existencia de discinesia escapular fue del 32,6%, sobre todo la discinesia de tipo II (50%). La puntuación del SPADI fue considerablemente mayor en los practicantes con síntomas de dolor (p < 0,05). Conclusión: los practicantes de tiro de lazo mostraron retroversión humeral en el hombro dominante y una elevada prevalencia de discinesia escapular.

Reconstrucción anatómica del Acromion en casos de fracturas traumáticas y posterior a artroplastia reversa del Hombro. Reporte de Casos / Anatomic reconstruction of the acromion in cases of traumatic fractures after reverse shoulder arthroplasty. Report of a series of cases

Introducción Tanto las fracturas traumáticas del acromion, así como las fracturas acromiales por insuficiencia posterior a artroplastia reversa del hombro, son entidades poco frecuentes. Con la ampliación des los criterios operativos para la artroplastia reversa del hombro, es de suponer un aumento en el caso des las fracturas acromiales por insuficiencia posteriores a dicho procedimiento quirúrgico. Al ser estas entidades poco frecuentes hacen falta en la literatura recomendaciones basadas en la evidencia para el manejo de estas, las cuales representan un reto para el especialista tratante. Materiales y Métodos Reporte de seis casos entre 2013 y 2016 en el hospital cantonal de Frauenfeld (Suiza) de dos grupos de pacientes con fracturas del Acromion. En el grupo A se clasificaron tres pacientes que presentaron fractura por insuficiencia del acromion posterior a artroplastia reversa del Hombro. En el grupo B clasificaron tres pacientes con fracturas traumáticas del acromion en las cuales el manejo conservador no fue exitoso. Los dos grupos de pacientes fueron sometidos al mismo método quirúrgico con reducción abierta y reconstrucción anatómica del Acromion por medio de fijación con placa y tornillos interfragmentarios. Resultados Posterior a la intervención quirúrgica, la función del hombro se recuperó en todos los pacientes del Grupo A. La flexión anterior aumentó en promedio de 53° a 127°, y la abducción mejoró de 52° a 125°. Las mediciones posteriores al año de la intervención mostraron puntajes constantes entre 55-71, así como un valor subjetivo de hombro (SSV) de 50-90. En el Grupo B, el rango de movimiento preoperatorio se mantuvo constante. La flexión hacia delante mejoró de 133° a 157° y la abducción aumentó de 147° a 153°. Un año después de la cirugía, los puntajes de Constant en el grupo B variaron de 70 a 86 y el SSV se encontró entre 80 a 100. Los tres pacientes del Grupo B consiguieron retomar sus actividades diarias sin dolor y pudieron regresar al trabajo. La extracción de la placa fue necesaria en la mitad de los pacientes de la cohorte (Grupo A n=1, Grupo B n=2). Discusión La fractura del acromion es una condición seria que puede causar daño significativo al funcionamiento del hombro. Tanto en pacientes con ARH así como en pacientes sin ARH previa, nuestra técnica operativa abierta de reconstrucción anatómica del acromion mostró buenos resultados. Recomendamos el manejo quirúrgico por medio de reconstrucción con placa y clavos de fijación. Nivel de evidencia: IV

Aim To propose a surgical technique to treat the traumatic acromion fractures, as well as acromion fractures before reverse total Shoulder Replacement (TSR). Methods Six patients were treated with the same fixation technique between December 2013 and December 2016. Three patients had acromial insufficiency fractures (type II) following TSR (Group A). The other three patients, who had traumatic acromion fractures, underwent unsuccessful conservative treatment (Group B). Surgical treatment involved reconstruction of the acromion using an open technique with plate and interfragmentary screw fixation. Results Following reconstruction, shoulder function was regained in all patients in Group A. Forward flexion increased, on average, from 53° to 127°, and abduction improved from 52° to 125°. Measurements at one-year follow-up were Constant scores from 55-71, and subjective shoulder value (SSV) from 50-90. In Group B, preoperative range of motion was not substantially diminished. Forward flexion improved from 133° to 157°, and abduction increased from 147° to 153°. One year following surgery, the Constant scores in Group B ranged from 70-86, and SSV was 80-100. All three patients performed daily activities without pain, and were able to return to work. Plate removal was necessary in half the patients in the cohort (Group A n=1; Group B n=2). Conclusion An acromion fracture is a serious condition that can cause significant damage to shoulder functioning. In patients with or without previous TSR, this fixation technique was used successfully to reconstruct the anatomic lateral and basal acromion. Evidence Level: IV

Relationship Between Scapular Muscle Performance And Grip Strength In Lateral Epicondylitis Among Computer Operators

Background: Lateral epicondylitis is an overuse injury of the tendon and involving the extensor muscle of forearm. Induced pain at the upper trapezius (UT) produces an increase in wrist extensor electromyographic activity (EMG) which could potentially lead to overuse injury, such as LE, at the elbow. Some studies found that there is a relation between scapular muscle muscle performance and lateral epicondylitis and loss of grip strength in lateral epicondylitis. There is a lack of literature of similar studies among computer operators. The most common wrong working posture in computer operator is excessive wrist extension it causes to the overuse injury like lateral epicondylitis. The context and purpose of the study: To find out the relationship between scapular muscle performance and grip strength in lateral epicondylitis among computer operators. Result: The correlation between scapular muscle performance and grip strength in LE among computer operators was done using Karl Person correlation coefficient. The result indicated that there is a significant relation between scapular muscle performance and grip strength in lateral epicondylitis. Conclusion: The study showed that there is an impairment of scapular muscle performance and grip strength in lateral epcondylitis among computer operators. Implication: Regular physical activity and proper ergonomics advice can improve quality of life among computer operators.

Study on the incidence of occurrence of the ossification of superior transverse scapular ligament with its clinical implication

Introduction: Supra scapular notch is present on the superior border of the scapula. It gives passage to thesuprascapular nerve. The supra scapular notch is bridged by the superior transverse scapular ligament andconverted into supra scapular foramen. Ossification of this superior transverse scapular ligament may compressor entrap the suprascapular nerve which is passing through the foramen. The present study was undertaken tofind out the incidence of occurrence of the ossification of superior transverse scapular ligament.Materials and methods: 89 scapulae were collected from the Department of Anatomy, Deccan College of MedicalSciences, Hyderabad. Damaged scapulae were excluded. All the scapulae were examined to note the incidence ofoccurrence of the ossification of the transverse scapular ligament and also any variations of it.Results: 15 scapulae were bearing ossified superior transverse scapular ligament in which 6 were of the rightside and 6 were of the left side. Duplication of the superior transverse scapular ligament was observed in one leftscapula. Incomplete ossification was observed in 2 scapulae 1 on the right and another on the left side.Conclusion: Based on the results of the present study, ossification of the transverse scapular ligament is not veryrare in this populations group. So, the knowledge about the ossification of superior transverse scapular ligamentand the risk of supra scapular nerve entrapment is very much essential for the physicians and the surgeons whiledealing with these cases.

An Anatomical Study Of Variations In The Branching Pattern Of Axillary Artery And Its Clinical Significance

Introduction: Variation in the branching pattern of axillary artery is quite common. Accurate knowledge of thenormal and variant arterial anatomy of the axillary artery is important for clinical procedures in axillary andpectoral region. The aim of this study is to find out the incidence and types of variation in the branching patternof axillary artery.Materials and Methods: Dissection of axillary and pectoral region was done on both sides in 25 cadavers in thedepartment of Anatomy, K.P.C. Medical College and Hospital, Kolkata to study the branching pattern of axillaryartery.Results: Variation was present in 16% cases. Among these, 6% variation was present in the second part and 10%variation was present in the third part of axillary artery. Most common variation found was the origin ofsubscapular artery from the second part of axillary artery.Conclusion: Proper knowledge of variations of branching pattern of axillary artery is important for orthopaedic,reconstructive and vascular surgeons to avoid complications during various surgical procedures in axillaryregions and angiographies.