ABSTRACT
Patients with sudden loss of active motion after an external rotation or hyperextension injury should be viewed with a high index of suspicion for a subscapularis tear. Exaggerated external rotation and the presence of a positive lift off or belly press test on physical examination combined with appropriate imaging studies will lead to an early diagnosis. Careful surgical repair combined with a thoughtful rehabilitation program will lessen both the length and degree of disability from this clinical entity.
Subject(s)
Joint Instability/diagnosis , Joint Instability/surgery , Rotator Cuff Injuries , Scapula , Shoulder Injuries , Tendon Injuries , Tendon Injuries/diagnosis , Tendon Injuries/surgery , Accidental Falls , Biomechanical Phenomena , Humans , Joint Instability/etiology , Joint Instability/physiopathology , Magnetic Resonance Imaging , Postoperative Care/methods , Range of Motion, Articular , Risk Factors , Rotation , Rupture , Suture Techniques , Tendon Injuries/etiology , Tendon Injuries/physiopathology , Treatment OutcomeABSTRACT
Although degeneration and strain of musculotendinous structures are frequent causes of shoulder pain, sudden violent injuries in young individuals can lead to complete musculotendinous ruptures. Some of these conditions lend themselves well to nonoperative treatment. This article will enable the physician to determine the clinical diagnosis and formulate a treatment plan for each patient as an individual. Some patients may be satisfied with an accurate diagnosis only, while others demand more aggressive operative care.
Subject(s)
Shoulder Injuries , Tendon Injuries , Biomechanical Phenomena , Humans , Muscle, Skeletal/injuries , Rupture , Tendons/pathology , Wounds and Injuries/diagnosis , Wounds and Injuries/physiopathology , Wounds and Injuries/therapyABSTRACT
Because of the nature of committees, evaluating their effectiveness is highly subjective. The ultimate test is whether the group is able to arrive at good solutions and decisions which can be implemented. Author Robert Travis, M.B.A., looks at three actual committees, offering reasons for the success or failure of each, and then gives several pointers on creating effective committees.
