ABSTRACT
PURPOSE: To assess the magnetic resonance (MR) imaging appearance of the successfully repaired rotator cuff in an asymptomatic population. MATERIALS AND METHODS: Fifteen subjects who had undergone clinically successful rotator cuff repair were included in the study. All underwent functional testing of the affected shoulder and had good to excellent scores on the Constant scale. Standard MR imaging sequences were performed at 1.5 T, including oblique coronal fast spin-echo T2-weighted MR imaging with fat saturation. RESULTS: Three (10%) of 30 supraspinatus and infraspinatus tendons had normal signal intensity, and 16 (53%) had mildly increased signal intensity on fast spin-echo T2-weighted fat-saturated images, compatible with tendonitis or tendinosis. Three partial and four complete tears of the supraspinatus tendon and two partial and two complete tears of the infraspinatus tendon were seen. Other findings included subacromial-subdeltoid effusion (10 subjects), joint effusions (five subjects), and bone marrow edema (six subjects). CONCLUSION: Postoperative signal intensity changes consistent with tendonitis or tendinosis were common, and clinically "silent" partial and complete rotator cuff tears were seen. Such postoperative MR imaging findings should be interpreted with caution, and meticulous correlation with symptoms and clinical results is recommended.
Subject(s)
Magnetic Resonance Imaging , Postoperative Complications/diagnosis , Rotator Cuff/surgery , Tendinopathy/diagnosis , Tendon Injuries/surgery , Aged , Bone Marrow/pathology , Edema/diagnosis , Female , Humans , Male , Middle Aged , Rotator Cuff/pathology , Rotator Cuff Injuries , Shoulder Joint/pathology , Tendon Injuries/diagnosisABSTRACT
Compression fractures of the thoracic and lumbar spine have a worse prognosis than is commonly realized. A study of 142 patients with this type of injury reveals several important features which affect the long term prognosis in these injuries. Severe compression, comminution, disc space narrowing adjacent to the fracture site, a low anatomical level of the fracture site, a low anatomical level of the fracture, and body cast immobilization in those with mild or moderate type fractures, are some of the factors associated with persistent long term back problems.
Subject(s)
Fractures, Bone , Lumbar Vertebrae/injuries , Occupational Diseases , Thoracic Vertebrae/injuries , Adolescent , Adult , Age Factors , Aged , Disability Evaluation , Female , Fractures, Bone/etiology , Fractures, Bone/therapy , Humans , Male , Middle Aged , Occupational Diseases/etiology , Occupational Diseases/therapy , Pressure , Prognosis , Retrospective StudiesABSTRACT
Twenty-nine patients with non-union of the humeral shaft, who were treated in 3 major Vancouver hospitals, were studied. Reasons for non-union, effectiveness of various treatment methods, and complications are discussed. Fractures occurring in the middle third of the humeral shaft, comminuted or open fractures and those treated early by open reduction, are more prone to non-union. Nearly 50% of the patients with non-union were chronic alcoholics. Compression plating with cancellous bone grafting gave the best rate of healing. However, both early and late operative treatment gave a relatively high complication rate.
Subject(s)
Fractures, Ununited/therapy , Humeral Fractures/therapy , Adult , Aged , Bone Plates , Casts, Surgical , Female , Fracture Fixation, Internal/adverse effects , Fracture Fixation, Internal/methods , Humans , Male , Middle Aged , Pseudarthrosis/etiology , Pseudarthrosis/therapy , Wound HealingSubject(s)
Lumbar Vertebrae/surgery , Spinal Fusion , Adult , Back Pain/diagnosis , Back Pain/diagnostic imaging , Back Pain/surgery , British Columbia , Employment , Health , Humans , Lumbar Vertebrae/diagnostic imaging , MMPI , Middle Aged , Military Medicine , Neurologic Examination , Occupations , Prognosis , Psychological Tests , Radiography , Recurrence , Surgical Procedures, Operative , Veterans Disability Claims , Wounds and Injuries/complicationsABSTRACT
Two types of assessment were used in our evaluation of the long-term results of excisional MCP arthroplasty in the rheumatoid hand: a standard surgeon-patient assessment, and a functional test model applied to 17 rheumatoid hands before and after operation.The surgeon-patient overall assessment at the time of follow-up indicated satisfaction with the results in 15 of 17 hands, whereas the occupational therapists' objective functional testing indicated a less positive end result - improvement in 6 of the 17 hands and worsening in 8.The discrepancy need not negate the validity of either finding but would suggest that factors other than function as measured give patient satisfaction. These include such features as pain relief, ability to put on gloves again and improved appearance.
