ABSTRACT
Progress in shoulder arthroscopy has led to the identification of previously undiagnosed lesions involving the superior labrum and the biceps tendon anchor. Additional research has substantiated the role of the long head of the biceps tendon in anterior and rotational glenohumeral stability. Careful attention to the history and physical examination and directed diagnostic imaging may arouse suspicion of injury to the biceps tendon and the superior labral complex. Identification of injuries to the superior labrum extending from anterior to posterior, or "SLAP" injuries, can be made with diagnostic glenohumeral arthroscopy. Appropriate treatment can then be based on the type of lesion encountered (generally, debridement of most type I and III lesions and repair of type II and many type IV lesions).
Subject(s)
Shoulder Injuries , Tendon Injuries , Arthroscopy , Debridement , Diagnostic Imaging , Humans , Medical History Taking , Physical Examination , Range of Motion, Articular , Rotation , Shoulder Joint/pathology , Shoulder Joint/physiology , Shoulder Joint/surgery , Surgical Stapling , Suture Techniques , Tendons/pathology , Tendons/physiology , Tendons/surgeryABSTRACT
Closed intramedullary shortening has become a popular treatment method for limb-length inequality in adolescents. An important, potentially devastating complication of closed intramedullary fixation only recently described is avascular necrosis of the femoral head. We believe alternative treatment options must be considered to avoid this irreversible and catastrophic complication. A larger series may define the inherent risks of this complication and help determine the ideal treatment for femoral shortening and stabilization in the adolescent.
Subject(s)
Bone Lengthening/adverse effects , Femur Head Necrosis/etiology , Adolescent , Female , Femur Head Necrosis/diagnostic imaging , Femur Head Necrosis/physiopathology , Humans , Radiography , Range of Motion, Articular , Treatment OutcomeSubject(s)
Arthroplasty , Joint Dislocations/surgery , Metatarsophalangeal Joint/surgery , Female , Humans , Middle AgedSubject(s)
Carcinoma, Transitional Cell/secondary , Fingers , Soft Tissue Neoplasms/secondary , Urinary Bladder Neoplasms/pathology , Carcinoma, Transitional Cell/diagnostic imaging , Carcinoma, Transitional Cell/pathology , Humans , Male , Middle Aged , Radiography , Soft Tissue Neoplasms/diagnostic imaging , Urinary Bladder Neoplasms/diagnostic imagingABSTRACT
The purpose of this study was to investigate the ligamentous stabilizing mechanisms preventing anterior instability in the glenohumeral joint. Six freshly thawed, unembalmed cadaveric shoulders were dissected, preserving the joint capsule and glenohumeral ligaments, the coracohumeral ligament, and the subscapularis tendon. Hall-effect strain transducers were placed on the superior, middle, and inferior glenohumeral ligaments. The humerus and scapula were fixed in a specifically designed mounting apparatus that allowed the glenohumeral joint to be placed in 0 degree, 45 degrees, or 90 degrees of abduction. The mounting apparatus was placed in a model TTC Instron Universal Testing Instrument, which applied an external rotation torque to the humerus. Strain produced in the three glenohumeral ligaments was recorded on a three-channel X-Y chart recorder. At 0 degree of abduction, the superior and middle glenohumeral ligaments developed the most strain. At 45 degrees of abduction, the inferior and middle glenohumeral ligaments developed the most strain, with considerable strain also being developed in the superior glenohumeral ligament. At 90 degrees of abduction, the inferior glenohumeral ligament developed the most strain, with strain also seen in the middle glenohumeral ligament.
