RESUMO
Symptomatic muscle herniations are an unusual cause of upper extremity pain in the athlete that is rarely reported in the literature. Out of 18 reported cases of upper extremity herniations, only 3 were caused by strenuous exertion. This article describes a successful repair of a 21-year-old rock climber's ventral forearm herniation with polypropylene mesh.
RESUMO
Heterotopic ossification (HO), a well-known sequela of trauma, burns, head injury, and certain congenital or acquired metabolic conditions, has a predilection for the hip and the elbow. This disease has uncommonly been found after elective open shoulder surgery but extremely seldom after minimally invasive surgery. In our search of the peer-reviewed literature, we found no reports of HO after arthroscopic rotator cuff repair. The clinical importance of heterotopic bone after shoulder surgery remains unclear because of inconsistent definitions, varying correlations of symptom severity and radiographic findings, and lack of treatment efficacy data. Here we report a case of severely symptomatic HO after arthroscopic rotator cuff repair - successfully treated with excision of the heterotopic bone, interval release, and manipulation.
Assuntos
Artroscopia/efeitos adversos , Músculo Deltoide/patologia , Doenças Musculares/etiologia , Ossificação Heterotópica/etiologia , Complicações Pós-Operatórias/etiologia , Manguito Rotador/cirurgia , Idoso , Músculo Deltoide/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Doenças Musculares/patologia , Doenças Musculares/terapia , Ossificação Heterotópica/patologia , Ossificação Heterotópica/cirurgia , Dor/fisiopatologia , Medição da Dor , Complicações Pós-Operatórias/patologia , Complicações Pós-Operatórias/terapia , Amplitude de Movimento Articular , Manguito Rotador/patologia , Lesões do Manguito Rotador , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
The ideal method of fixation in proximal humeral fractures is not well established. Locked plating is a potential solution, but to date, there has been little support shown in the literature. We compared the biomechanical performance of a locked plate with that of an intramedullary humeral nail in a cadaveric model. Paired fresh-frozen cadaveric humeri (N = 5) were instrumented with either a locked plate or an intramedullary nail after creation of a 3-part osteotomy. Construct stiffness, cyclic loading behavior, and load to failure were evaluated. The locked plate was more stiff in valgus loading than the nail (P = .003). All other loading vectors showed no statistical differences in stiffness between the two constructs. The load to failure was 828 N for the plate and 901 N for the nail. The nail showed interfragmentary motion (degrees), or toggle, at zero load, whereas the plate did not. The locked plate, being stable at zero load, may prove useful in earlier pain-free rehabilitation of proximal humeral fractures.
