PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Shoulder Injuries”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 433 records · Page 24Linked to original sources
PubMed1991

Repairs of the rotator cuff. Correlation of functional results with integrity of the cuff.

We evaluated the results of 105 operative repairs of tears of the rotator cuff of the shoulder in eighty-nine patients at an average of five years postoperatively. We correlated the functional result with the integrity of the cuff, as determined by ultrasonography. Eighty per cent of the repairs of a tear involving only the supraspinatus tendon were intact at the time of the most recent follow-up, while more than 50 per cent of the repairs of a tear involving more than the supraspinatus tendon had a recurrent defect. Older patients and patients in whom a larger tear had been repaired had a greater prevalence of recurrent defects. At the time of the most recent follow-up, most of the patients were more comfortable and were satisfied with the result of the repair, even when they had sonographic evidence of a recurrent defect. The shoulders in which the repaired cuff was intact at the time of follow-up had better function during activities of daily living and a better range of active flexion (129 +/- 20 degrees compared with 71 +/- 41 degrees) compared with the shoulders that had a large recurrent defect. Similar correlations were noted for the range of active external and internal rotation and for strength of flexion, abduction, and internal rotation. In the shoulders in which the cuff was not intact, the degree of functional loss was related to the size of the recurrent defect.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Sports traumatology today. A review of common current sports injury problems.

Increasing participation and training intensity in sports and physical activity has resulted in an increasing number of injuries as well as recognition of "new" injuries. Improved diagnostic techniques such as MRI, CT scan, scintigraphy and ultrasound have proven to be valuable in the diagnosis of especially soft tissue injuries. Surgery is today generally accepted as the treatment of choice for anterior cruciate ligament injuries in the active population. Arthroscopic reconstruction using the bone-patellar tendon-bone graft is considered to be the "gold standard". Alternative grafts such as semitendinosus and gracilis can also be used. The use of artificial ligaments and allografts is still experimental. Most posterior cruciate ligament injuries are today treated conservatively, and so are ankle ligament injuries. There is still no final solution how to treat articular cartilage lesions although interest is being focussed on cartilage resurfacing. Overuse tendon injuries often become chronic and are then associated with persistent structural alteration. Chronic overuse injuries are characterized by a failure to develop adequate scar tissue restoration. The reason for this delayed healing is still unclear. The treatment of these injuries include, today, early strength and stretching training, but the main concepts are still controversial due to lack of scientific evidence. Our understanding of shoulder injuries in athletes has developed enormously during the last few years. The use of arthroscopy when performing subacromial decompression and surgery of labral tears have allowed more athletes to return early to sports than before. Laboratory studies have increased our understanding of muscle injuries and they show the importance of early mobilization. Prevention will be a major issue for research within the next decade. It is the author's opinion that within the next decade, sports traumatology will take a leading role in orthopaedic and sports medicine research.

Athletic Injuries↗
PubMed1991

Magnetic resonance imaging of the shoulder. Sensitivity, specificity, and predictive value.

The sensitivity, specificity, and predictive value of magnetic resonance imaging in the diagnosis of lesions of the rotator cuff, glenohumeral capsule, and glenoid labrum were evaluated in ninety-one patients and fifteen asymptomatic volunteers. Magnetic resonance imaging demonstrated 100 per cent sensitivity and 95 per cent specificity in the diagnosis of complete tears, and it consistently predicted the size of the tear of the rotator cuff. There was a definite correlation between atrophy of the supraspinatus muscle and the size of a complete, chronic tear of the rotator cuff. The sensitivity and specificity of magnetic resonance imaging in the differentiation of tendinitis from degeneration of the cuff were 82 and 85 per cent, and in the differentiation of a normal tendon from one affected by tendinitis with signs of impingement the sensitivity and specificity were 93 and 87 per cent. The formation of spurs around the acromion and acromiocalvicular joint correlated highly with increased age of the patient and with chronic disease of the rotator cuff. The sensitivity and specificity of magnetic resonance imaging in the diagnosis of labral tears associated with glenohumeral instability were 88 and 93 per cent. The study showed that high-resolution magnetic-resonance imaging is an excellent non-invasive tool in the diagnosis of lesions of the rotator cuff and glenohumeral instability.

Acromioclavicular Joint↗
PubMed1991

Full-thickness rotator-cuff tear. An analysis of results.

A retrospective review is reported on 68 patients with 72 full-thickness rotator-cuff tears treated surgically. Duration of symptoms before surgery averaged 18 months (range, one month to ten years). Tears of the rotator cuff were divided into small (12 shoulders), medium (26 shoulders), large (17 shoulders), and massive (17 shoulders). Rotator-cuff tears were repaired by use of a bony trough in 88% of patients. All patients were treated with decompression acromioplasty. In addition, an acromioclavicular arthroplasty was performed in 29 patients. Forty-seven men and 21 women with an average age of 58 years (range, 31-76 years) were followed for an average of 24 months (range, nine to 57 months). Excellent results are reported in 46 shoulders, good in 20, fair in four, and poor in two. The size of tear and duration of symptoms did not significantly affect results.

Adult↗
PubMed1991

Arthroscopic treatment of massive rotator cuff tears. Clinical results and biomechanical rationale.

Ten patients with painful, massive (greater than 5 cm), complete rotator cuff tears involving primarily the supraspinatus were treated with arthroscopic acromioplasty and rotator cuff debridement. All patients except one had normal active motion and strength preoperatively. All patients had roentgenographically normal acromiohumeral distance and an anterior-inferior acromial osteophyte. The goal was to obtain pain relief without loss of motion of strength. This was accomplished in all patients. This study shows that normal shoulder function is possible with a massive unrepaired tear of the rotator cuff. Normal function in the face of an unrepaired cuff tear can occur only if there is a balance of two important force couples, one in the coronal plane and the other in the transverse plane. This balance depends upon the functional integrity of the anterior cuff, the posterior cuff, and the deltoid. In patients whose cuff tears satisfy these anatomic and biomechanical criteria, the achievement of pain relief through arthroscopic debridement and decompression seems to be all that is necessary for normal pain-free function.

Aged↗
PubMed1991

Rotator cuff pathology. Arthroscopic assessment and treatment.

The results of 50 operative arthroscopies for impingement syndrome were reviewed. Preoperative arthrography was correlated with arthroscopic findings, which were pathologically graded. Results of arthroscopic surgery were assessed. Preoperative arthrography predicted 78% of the complete tears of the rotator cuff and only 25% of the partial tears. Of 40 shoulders followed for at least one year postoperatively, 87.5% had satisfactory results. Arthrography was not as reliable as arthroscopy in predicting partial tears of the rotator cuff. Arthroscopy permitted detailed intraarticular and subacromial visualization and classification of partial and complete tears of the rotator cuff. The early results of arthroscopic acromioplasty and debridement are comparable to those obtained with open operations.

Adolescent↗
PubMed1990

[Rupture of the rotator cuff].

Spontaneous or traumatic ruptures almost always occur in a cuff that has degenerated due to overuse. Despite the lack of absolute anatomico-clinical correlation, two clinical types can be described: a conflictual, often hyperalgesic shoulder with its painful arch corresponding to a small anterosuperior rupture, or a pseudo-paralytic shoulder betraying a major posterosuperior rupture. Standard radiography with Leclercq's manoeuvre is performed primarily to find out whether the cuff is continent or incontinent. Modern medical imaging (ultrasonography or MRI) adds precision to the lesions when surgery is contemplated. When medical treatment has failed, partial ruptures are treated by arthrolysis; ruptures of the superficial and deep layers of the cuff without calcification benefit from endoscopy; ruptures involving tendons or associated with calcifications are treated by surgery. Small and medium ruptures with a continent cuff require endoscopic or surgical anterior decompression combined, in cases where the intra-articular long head of the biceps is exposed, with repair, usually by suture. Extensive ruptures with an incontinent cuff are treated by muscle transfer alone of combined with arthroplasty, or by semi-constrained total prosthesis when arthrosis of the humeral joint is present.

Humans↗
PubMed1990

[Factors affecting the surgical results of treatment of rotator cuff tears in the shoulder].

The work presents the outcomes of clinical, radiological and mathematical analyses of 42 patients with the rupture of the whole width of the cuff of shoulder rotators treated operatively. The group comprised 34 male and 8 female patients, the average age 55.5 years. The mean period between the operation and final clinical evaluation was 23 months. According to the method chosen for the evaluation of the results by means of 100-point score acceptable result was achieved in 90 per cent of cases (excellent in 64 per cent, good in 26 per cent). Double t-test showed that significantly participating in the results were the following factors: the period between the origin of complaints and operation (p less than 0.001), degenerative changes of the greater tubercle of humerus (p less than 0.001), atrophy of supraspinatus muscle and infraspinatus muscle (p less than 0.001), the degree of difficultness of the patient's work (p less than 0.005), indication for operation (pain, limited range of motion) (p less than 0.025). According to the mathematical analysis these factors independently influenced the final results.

Female↗
PubMed1989

[Radiographic signs of rotator cuff tears in the shoulder].

In 42 patients affected by disruption of the whole layer of the shoulder rotator collar the authors compared radiographic changes on a simple radiograph in anterior-posterior projection with operation findings. The proliferative changes on the large trochanter of humerus and the humeroacromial distance were decisive for prognosis of the operation therapy for the disrupted collar. The patients with a shorter humeroacromial distance were affected, after the operation, by a worse external rotation of the arm, worse extension and muscular strength of the arm in the extension position. Radiographic changes observed on the shoulder together with other factors are decisive for the strategy of conservative and operation therapy.

Adult↗
PubMed1989

Ultrasonography of the tendons of the shoulder.

The purpose of the present study was to compare ultrasonographic signs with macroscopic and histological findings in lesions of the rotator cuff and the biceps tendon. Twenty-six shoulder joints from 10 male and 3 female cadavers, ranging in age from 40 to 89 years (mean 65.9), were examined with a linear array real-time ultrasonographic scanner provided with a 7.5 MHz transducer. Arthrotomy and histological preparations were made after ultrasonography. Thinning and discontinuity of echogenic homogenicity of the tendons of the rotator cuff were the most reliable ultrasonographic signs of a total tear of the tendon, but focal hyper- and hypo-echogenic changes of the tendons of the rotator cuff were unreliable criteria. Partial tears of the rotator cuff were difficult to determine with static ultrasonograms. Ultrasonography readily revealed discontinuity of echogenic homogenicity of the biceps tendon as a sign of a rupture of the tendon, which was commonly associated with rotator cuff tears.

Adult↗
PubMedDate not supplied

Ultrasonography in lesions of the rotator cuff and biceps tendon.

Ultrasonography (US) of the shoulder joint was performed in 88 patients, 15 of whom were referred for surgery. US was made with a real-time linear-array scanner, provided with a transducer of 7.5 MHz. Subsequently, all patients underwent single-contrast arthrography of the shoulder. When compared with the arthrographic findings, diagnosis by US showed 21 true positive, 3 false positive, 57 true negative and 7 false negative cases of a full-thickness tear of the rotator cuff. Small tears (2 cm or less in diameter) may be the most difficult to assess. US readily revealed biceps tendinitis and rupture of the biceps tendon, as well as fluid collection in the bursae above the rotator cuff tendons.

Adult↗
PubMed1989

Clinical presentation of complete tears of the rotator cuff.

To determine whether the presence and extent of a tear of the rotator cuff could be predicted on the basis of a patient's history, physical examination, and radiographic findings, detailed data from the histories and physical examinations of 103 patients who were known to have a tear of the rotator cuff were correlated with the radiographic and operative findings on these patients. An age-matched control group of fifty-one patients who had similar symptoms, but whose arthrograms showed normal results, was used to establish a baseline incidence of ten specific radiographic findings in the shoulder. Two discrete groups of patients who had a tear of the rotator cuff were identified. Twenty-eight patients (27 per cent) had a tear of a single tendon; the histories and the physical and radiographic findings in this group were consistent with a symptomatic local mechanical-impingement process in the shoulder. Sixty (80 per cent) of the seventy-five patients in the other group had a history of acute trauma to a shoulder. The patients in this second group were older and were non-athletic, and had not previously had symptoms that were severe enough to need treatment. These patients were subsequently found to have a complete tear of more than one of the tendons of the rotator cuff. Multiple radiographic findings in the shoulder and other coexisting orthopaedic conditions also were more common in these patients. In this group, we believe that acute trauma in a shoulder that had chronic degenerative changes, rather than localized mechanical impingement, caused the tendons to rupture.

Adolescent↗
PubMed1988

Value of ultrasonography in preoperative diagnosis of rotator cuff tears and postoperative follow-up.

Four hundred and six patients presenting with shoulder pain underwent bilateral shoulder ultrasonography. Rotator cuff lesions were diagnosed in 197 patients. In 155 of the 308 patients who had additional arthrographic examinations, the arthrogram documented rotator cuff tears. Sixty-eight patients underwent surgery. There was good correlation between the ultrasonographic and arthrographic findings as well as the surgical results, with a sensitivity of 91% for each examination technique. Thirty-six postoperative patients were studied ultrasonographically; a minor to marked increase in rotator cuff echogenicity was demonstrated in them all. Its high predictive value makes ultrasonography the method of choice in diagnosing rotator cuff tears. Based on the evaluation of particular criteria, rotator cuff tears (greater than 1 cm) are commonly documented by ultrasonography. Only in patients with indeterminate or negative ultrasonograms in whom there is a high index of clinical suspicion, should arthrography be performed as a complementary imaging test. In postoperative follow-up the degree of scar formation at the reinsertion of the tendon is adequately documented by ultrasonography.

Adult↗
PubMed1987

[Ultrasonics of the shoulder. Diagnostic possibilities in lesions of the rotator cuff].

Twenty five healthy people and 25 patients with shoulder pain underwent US control over a 12-month period: 24 patients with shoulder pain had rotator cuff and/or biceps tendon lesions. The US findings on rotator cuff and biceps tendon lesions are compared with those of arthrography and/or surgery (96% sensitivity). US is rapid, safe, non invasive, inexpensive and often more accurate, and its use is recommended for the routine examination of the shoulder joint instead of arthrography.

Adolescent↗
PubMed1986

Chronic rotator cuff tears.

The treatment of chronic rotator cuff tears is a controversial topic. Proponents of conservative therapy cite cadaver studies and postulate that with time the inflammatory reaction will subside and that although the structural integrity of the cuff may not be completely intact, the patient will nevertheless have an excellent functional result. On the other hand, operative intervention proponents contend that better mechanical advantage to shoulder motion will be present with an intact rotator cuff and that excision of necrotic tissue will alleviate impingement and pain. This paper is an overview of the topic and discusses some of the treatment modalities.

Humans↗