Hypoplasia of the glenoid. A review of sixteen patients.

We reviewed the records of sixteen patients, fifteen to sixty-two years old, who had glenoid hypoplasia with or without an associated deformity of the humeral head. The patients were divided into three groups: those who had bilateral glenoid hypoplasia without instability of the shoulder (Group I), those who had bilateral glenoid hypoplasia with instability of the shoulder (Group II), and those who had unilateral glenoid hypoplasia with deformity of the humeral head (Group III). When first seen by us, thirteen of the sixteen patients had pain in the shoulder, which they had noted after an increase in their previous level of activity. All were managed with a specific rehabilitation program for the shoulder. The patients were followed for an average of five years, and most were able to return to their previous level of activity with the resolution of the symptoms.

Shoulder impingement syndrome: diagnosis, radiographic evaluation, and treatment with a modified Neer acromioplasty.

Seventy-one patients who had shoulder impingement syndrome were managed operatively with a modified Neer acromioplasty: thirty-seven, who had an intact rotator cuff, had a modified acromioplasty, and thirty-four, who had a torn cuff, had a modified acromioplasty and repair of the cuff. In the classic anterior acromioplasty as described by Neer, emphasis is placed on resection of the inferior prominence of the acromion. We believe that the removal of only the inferior prominence is insufficient, as often too much of the anterior aspect of the acromion protrudes beyond the anterior border of the clavicle. This portion of the acromion continues to irritate the subacromial bursa and the rotator cuff and to produce symptoms of impingement. Our modified acromioplasty is done in two steps: the portion of the acromion that projects anteriorly beyond the anterior border of the clavicle is resected vertically and then an anteroinferior acromioplasty is performed. We studied the results in patients who had been operated on by the senior one of us and who had been followed clinically for a minimum of two years. At the most recent follow-up visit, no difference in terms of pain and function was found between the patients who had had the modified acromioplasty only (Group I) and the patients who had had the modified acromioplasty and repair of the rotator cuff (Group II); thirty-three (89 per cent) of the patients in Group I and thirty (88 per cent) of those in Group II had a good or excellent result.

Industrial nail gun injuries.

Five cases of industrial nail gun injury are described. These cases demonstrate the variety of injuries inflicted by such tools, and stress the potential for lethal accidents if strict safety standards are not observed. The wide range of these injuries is discussed in a review of other reports of such injuries; the causes of these industrial accidents and current safety requirements are described.