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At least 109 records · Page 6Linked to original sources
PubMed1996

[Lesions to the axillary nerve].

PURPOSE OF THE STUDY: The authors have reviewed 67 axillary nerve lesions from 1987 to 1993. 35 times the lesion was isolated; 20 times it was associated to other nerve lesions (9 times supra scapular nerve, 3 times musculocutaneous nerve, 8 times posterior cord) and 12 times lesions were associated to rotator cuff injury. MATERIAL AND METHODS RESULTS DISCUSSION: Injury corresponded 9 times to stretching mechanism in upper limb traction and came 58 times with osteoarticular lesions (30 anterior dislocations and 28 shoulder fractures). In 11 cases, shoulder active abduction was normal, inspite of deltoïd's complete palsy and this accounted for diagnosis delay. Concerning axillary nerve isolated lesions (35 cases), 7 recovered spontaneously and 28 have been operated. Surgical operation was undertaken 9 months after injury using a combined anterior and posterior approach. Rupture was located in the quadrilateral space and 23 nerve grafts, 4 neurolysis and 1 direct suture were performed. Results were good (muscle measured to M4) and excellent (muscle measured to M5) in 57 per cent of cases. Concerning axillary nerve lesions associated to suprascapular nerve lesions (9 cases) and musculocutaneous nerve (3 cases), all axillary nerve lesions were grafted with 50 per cent of good and very good results. The scapular nerve was neurolysed 6 times with 4 good and excellent results and evaluated irreparable in 3 cases. Musculocutaneous nerve was grafted in all cases with 2 good results out of 3. Posterior cord lesions (8 cases) required an osteotomy of the clavicle. Five grafts and 3 neurolysis were performed with aleatory results. At last, when associated lesions of the rotator cuff muscle were found (12 cases), 6 cases recovered spontaneously and 3 times cuff rupture was small enough to be reinserted with 2 good results. The 6 other cases corresponded to an axillary nerve rupture which were all grafted with 2 good results. On the cuff, result was in relation with lesion's type. Twice a supraspinatus tendon rupture was reinserted with 1 good result and 1 fair result. In 3 older patients, there was a small size rupture which has been reinserted with 1 good result, 1 fair result and 1 failure. At last, one surgical repair of a large rupture couldn't be justified. CONCLUSION: These encouraging results suggest to propose repair of axillary nerve when deltoid muscle palsy does not recover until 3 to 6 months. Rupture diagnosis is then suspected and the best surgical technique is a nerve graft.

Accidents, Traffic↗
PubMed1989

[Radiodiagnosis of the reparative osteogenesis during the treatment of comminuted fractures of the humerus].

Roentgenoradiological control of a reparative process after diaphysial comminuted shoulder fractures was exercised at all stages of the treatment after G. A. Ilizarov's method. Osteoscanning permitted the assessment of the viability of bone splinters on the first days after trauma and quantitative assessment of the activity of osteogenesis. A study of the optical density of radiograms provided an opportunity for evaluation of mineral content in regenerating bones, their structure only at late stages of treatment when it was rather high.

Adult↗
PubMed2005

Posterior shoulder dislocations and fracture-dislocations.

Posterior shoulder dislocations and fracture-dislocations are uncommon injuries that most often occur during seizures or as a result of high-energy trauma. Despite advances in imaging, they are frequently diagnosed late. Detection is facilitated by heightened clinical suspicion of the injury in high-risk individuals together with appropriate radiographic investigation. A wide variety of operative techniques, ranging from simple closed reduction to soft-tissue and bone stabilization procedures to prosthetic arthroplasty, are available to treat these injuries. Selection of the most appropriate treatment option is complex and multifactorial. Because of the rarity of these injuries, evidence-based treatment protocols are difficult to devise. Good functional outcomes are associated with early detection and treatment of isolated posterior dislocations that are associated with a small osseous defect and are stable following closed reduction. Poor prognostic factors include late diagnosis, a large anterior defect in the humeral head, deformity or arthrosis of the humeral head, an associated fracture of the proximal part of the humerus, and the need for an arthroplasty.

Humans↗
PubMed2000

Posterior dislocation fractures of the shoulder in seizure disorders--two case reports and a review of literature.

We present two patients with complaints of shoulder pain after an epileptic seizure. Both patients had a posterior dislocation fracture of the shoulder. After reviewing the literature the following conclusions can be drawn: (1) A posterior shoulder dislocation fracture is rare. (2) One should not underestimate the muscular forces in seizure disorders and be alert for dislocation fractures of the shoulder and/or other joints. (3) The diagnosis is frequently missed, but an axillary radiograph or a CT scan always reveals the fracture.

Adult↗
PubMed1984

Open radiocarpal fracture-dislocations.

Ten open radiocarpal fracture-dislocations in nine patients were treated by wound debridement, open reduction, and maintenance of reduction by casting supplemented with internal or external fixation. Eight patients had associated fractures or dislocations of the ipsilateral extremity: elbow fracture or dislocation (three patients), shoulder fracture (one patient), fractured humerus (two patients), and phalangeal fractures (three patients). In seven of ten cases the median and/or ulnar nerve was severely contused and required immediate decompression. Six patients were followed at least 15 months. All had mild asymptomatic sensory neurologic deficit, diminished range of motion of the wrist, and wrist pain with activity. The prognosis should be guarded.

Adult↗
PubMed1987

Internal fixation techniques for proximal humeral fractures.

Operative treatment of proximal humeral fractures is performed with a variety of fixation techniques. Selection of the optimum device for fixation is dependent on anatomic considerations, fracture characteristics, surgical exposure, and biomechanical features of fixation devices. Fixation objectives are evaluated in light of Neer's four segment classification. An extended deltopectoral approach with release of anterior deltoid distal insertion as well as the proximal pectoralis major raphe provides a wide exposure. The approach heals rapidly and allows rapid rehabilitation. The shoulder fracture fragments are adaptable to tension band wiring. With loss of bone stock, tension band wiring becomes increasingly important because compression or shearing forces can be expended in the tendinous insertion of the fragments. Fixation principles are applied according to specific fracture patterns. Whatever the choice of fixation method, a protracted and vigorous rehabilitation program is essential to achieve maximal functional recovery.

Fracture Fixation, Internal↗
PubMed1992

[Dislocation fractures of the shoulder. Special status and therapeutic concepts].

Shoulder dislocations associated with a displaced fracture of the humeral head or glenoid require different treatment than shoulder dislocations without fracture. If the humeral head is fractured, two possible complications must be considered:impairment of the subacromial gliding mechanism and insufficient blood supply to the humeral head. In glenoid fractures, instability may be induced. The degree of instability depends on the size of the fragment. In fractures of the humeral head, in particular of the greater tuberosity, we differentiate between the so-called en bloc fracture and the so-called supra-spinatus avulsion fracture. In "en bloc" fractures, one has to be aware that displacement of the fragment can occur not only in the superior direction but in the posterior direction as well. Posterior displacement is displayed radiologically by the "tangential" view. Both the duration of pain and range of motion depend on the amount of displacement of the fragment. Displacement exceeding 3 min in one direction should be reduced surgically in the active patient. For operative treatment of a displaced "en bloc" fracture, we recommend closed reduction and percutaneous screw fixation performed under regional anesthesia. "Supraspinatus avulsion fractures" ought to be treated like rotator cuff tears because there is no possibility of the small fragments healing due to their placement on the joint cartilage. In fracture dislocations, the blood supply of the humeral head is seriously jeopardized if the fracture is situated in the anatomical neck, whereas this is not the case in a fracture of the surgical neck. The number of displaced fragments allows a prediction concerning the survival of the articular segment of the humeral head.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1980

[Fractures of the shoulder joint (author's transl)].

A classification of fractures of the shoulder is given and diagnostic procedures are discussed. In most of the cases functional therapy is the treatment of choice. There exist a few indications for reduction and operation. Fractures of the scapula are briefly reviewed. For fractures of the proximal humerus in children a conservative approach is indicated. Different forms of fractures require an individual treatment.

Aged↗