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At least 1,477 records · Page 82Linked to original sources
PubMed1984

Arthroscopy of the shoulder joint--a cadaver and clinical study. Part 2: Clinical study.

Shoulder arthroscopy was carried out 56 times on 50 patients. Different types of arthroscopes were employed. Anterior and posterior approaches were used. Diagnoses were 21 cases of glenohumeral instability including 17 of recurrent anterior dislocation and subluxation; 2 of voluntary anterior subluxation and 2 of habitual posterior dislocation, 13 of rotator cuff tear, 6 of chronic subacromial bursitis, 2 of fracture-dislocation, 2 of frozen shoulder, 2 of baseball shoulder, one of rheumatoid arthritis, and 3 miscellaneous. The arthroscopic findings in the instability group and rotator cuff tear group were verified. Bankart lesion and Hill-Sachs lesion were identified arthroscopically. The indications for shoulder arthroscopy are outlined. There was no significant morbidity with this procedure.

Adolescent↗
PubMed2000

The painful shoulder: part II. Acute and chronic disorders.

Fractures of the humerus, scapula and clavicle usually result from a direct blow or a fall onto an outstretched hand. Most can be treated by immobilization. Dislocation of the humerus, strain or sprain of the acromioclavicular and sternoclavicular joints, and rotator cuff injury often can be managed conservatively. Recurrence is a problem with humerus dislocation, and surgical management may be indicated if conservative treatment fails. Rotator cuff tears are often hard to diagnose because of muscle atrophy that impairs the patient's ability to perform diagnostic maneuvers. Chronic shoulder problems usually fall into one of several categories, which include impingement syndrome, frozen shoulder and biceps tendonitis. Other causes of chronic shoulder pain are labral injury, osteoarthritis of the glenohumeral or acromioclavicular joint and, rarely, osteolysis of the distal clavicle.

Acute Disease↗
PubMed2005

[Modern aspects of shoulder injury treatment].

The article describes injuries of soft and bone structures of the shoulder region, with special emphasis on the following clinical forms: instabilities and luxations of the glenohumeral joint, fractures of the proximal humerus, clavicle and the states of painful shoulder. Fractures and dislocations, but also significant entities - painful states caused not only by fractures but also by minor trauma such as tendinitises and m.supraspinatus tendon and bicipital tendon ruptures are discussed in more detail. Moreover, their consequences - painful and stiff shoulder - as well as modern diagnostic and therapeutic procedures applied in the painful shoulder treatment are also discussed.

Humans↗
PubMed1993

Locked intramedullary nailing of humeral fractures.

Of 46 patients, 30 with fresh fractures of the humerus, nine with non-unions and seven with pathological fractures were treated with a new locked intramedullary nail. Of 30 patients with a fresh humeral fracture, three were lost to follow-up. All fresh fractures healed within 4 months. Functional results of the fresh fracture group were excellent in eighteen patients and satisfactory in three patients. Two patients with Neer type 6 fractures had unsatisfactory shoulder function; in the four other patients poor shoulder function resulted from a pre-existing condition. Out of nine non-unions, six united within 6 months. The three other patients with atrophic non-union required bone-grafting later, after which consolidation was obtained. The long functional recovery period of the non-union group was related to the pre-existing limited shoulder function. The seven patients with a pathological fracture died within 8 months of operation. While alive they were free from pain and could be nursed well.

Adolescent↗
PubMed1985

Fracture of the greater tubercle of the humerus in a filly.

A fracture of the caudal portion of the greater tubercle of the humerus was diagnosed in a 16-month-old Thoroughbred filly. Initially the fracture caused severe lameness. Radiography of the affected shoulder revealed the fracture fragment to be extra-articular, with a surrounding bony callus and no evidence of joint disease. After 5 weeks rest in a stall and 11 months at pasture, the filly was trained and raced without lameness.

Animals↗
PubMed1986

Isolated avulsion fracture of the lesser tuberosity of the humerus. A case report.

An extremely rare isolated avulsion fracture of the lesser tuberosity, not complicated with other proximal humeral fractures or posterior shoulder dislocations, occurred in a 12-year-old girl. The avulsion fracture of the upper part of the lesser tuberosity appears to have been caused by hyperextension and hyperexternal rotation of the shoulder. In this position, the coracohumeral ligament, superior glenohumeral ligament, and subscapularis tendon could have pulled out the upper part of the lesser tuberosity. She gained full recovery of left shoulder function after three months of conservative treatment, although follow-up roentgenograms show nonunion of the fracture. An isolated avulsion fracture of the lesser tuberosity is extremely rare. Only 12 cases, none in children, have been found in the literature since Hartigan's report in 1895.

Child↗
PubMed1994

Intramedullary interlocking nailing for humeral fractures: experiences with the Russell-Taylor humeral nail.

The Russell-Taylor intramedullary interlocking nail has been used on 39 patients with fractures that occurred at various levels of the humerus. Thirty patients had acute fractures and nine had pathological fractures. Twenty-five patients with acute fractures were re-examined after their fractures had united and assessed according to Neer's classification of shoulder function. Twenty-two (88 per cent) had excellent and satisfactory shoulder function. Pain relief was achieved in all pathological fractures. Shoulder pain encountered in a few patients in this series, where nailing was performed by the antegrade route, was mainly due to problems associated with the proximal interlocking screw.

Adolescent↗
PubMed2001

[Shoulder joint endoprosthesis in the treatment of multiple fractures of the humeral head. Development and value].

Fractures of the humeral head are still challenging to decisions of indications, surgical skills and physiotherapy. 3- and 4-part-fractures of the humeral head in younger adults are still dominated by reconstructive osteosynthesis. New developments in osteosynthesis materials allow the surgeon to make use of minimal invasive techniques more often. Treatment of elderly patients with these injuries has changed within the last years. When it is obvious that the goal of a stable osteosynthesis can not be reached, shoulder prosthesis has become a primary treatment in elderly patients. New designs in shoulder prosthesis seem to lead to better functional results.

Aged↗
PubMed1989

Seizure as a cause of fracture.

Of 2,800 patients admitted to hospital with a diagnosis of seizure, 1.1% (30/2,800) sustained fracture. Of these, 0.5% (15/2,800) had fracture due to direct trauma, 0.3% (7/2,800) had fracture as a consequence of seizure alone, and in 0.3% (8/2,800) the etiology was not determined. In the trauma group, 11 of 17 fractures involved the skull, nasal bones, and clavicle, while in the nontrauma group, the proximal humerus was the site in 6 of 9 fractures. These findings indicate that fracture is an uncommon complication of seizure and is extremely rare in the absence of trauma where, however, the fracture may be pathognomonic (bilateral posterior dislocation or fracture-dislocation of the shoulder) or highly suggestive (unilateral posterior dislocation, fracture-dislocation of the shoulder) of seizure.

Accidental Falls↗
PubMed2006

Childhood and adolescent sports-related overuse injuries.

Youth sports participation carries an inherent risk of injury, including overuse injuries. Little leaguer's shoulder, a stress fracture of the proximal humerus that presents as lateral shoulder pain, usually is self-limited. Little leaguer's elbow is a medial stress injury; treatment consists of complete rest from throwing for four to six weeks followed by rehabilitation and a gradual throwing program. Spondylolysis is a stress fracture of the pars interarticularis. Diagnostic modalities include plain film radiography, bone scan, computed tomography, single photon emission computed tomography, and magnetic resonance imaging. Treatment usually is conservative. Spondylolisthesis is the forward or anterior displacement of one vertebral body over another and may be related to a history of spondylolysis. Diagnosis is made with plain film radiography and graded according to the amount of displacement. Osgood-Schlatter disease presents as anterior knee pain localized to the tibial tubercle. Diagnosis is made clinically, and most patients respond to conservative measures. Calcaneal apophysitis (or Sever's disease) is a common cause of heel pain in young athletes, presenting as pain in the posterior aspect of the calcaneus.

Adolescent↗
PubMed2007

Paraspinal muscle control in people with osteoporotic vertebral fracture.

The high risk of sustaining subsequent vertebral fractures after an initial fracture cannot be explained solely by low bone mass. Extra-osseous factors, such as neuromuscular characteristics may help to explain this clinical dilemma. Elderly women with (n = 11) and without (n = 14) osteoporotic vertebral fractures performed rapid shoulder flexion to perturb the trunk while standing on a flat and short base. Neuromuscular postural responses of the paraspinal muscles at T6 and T12, and deep lumbar multifidus at L4 were recorded using intramuscular electromyography (EMG). Both groups demonstrated bursts of EMG that were initiated either before or shortly after the onset of shoulder flexion (P < 0.05). Paraspinal and multifidus onset occurred earlier in the non-fracture group (50-0 ms before deltoid onset) compared to the fracture group (25 ms before and 25 ms after deltoid onset) in the flat base condition. In the short base condition, EMG amplitude increased significantly above baseline earlier in the non-fracture group (75-25 ms before deltoid onset) compared to the fracture group (25-0 ms before deltoid onset) at T6 and T12; yet multifidus EMG increased above baseline earlier in the fracture group (50-25 ms before deltoid) compared to the non-fracture group (25-0 ms before deltoid). Time to reach maximum amplitude was shorter in the fracture group. Hypothetically, the longer time to initiate a postural response and shorter time to reach maximum amplitude in the fracture group may indicate a neuromuscular contribution towards subsequent fracture aetiology. This response could also be an adaptive characteristic of the central nervous system to minimise vertebral loading time.

Aged↗
PubMed2005

Periprosthetic fractures of the humerus.

Periprosthetic humeral fractures present a treatment challenge for the orthopedic surgeon. The overall incidence of fracture is between 0.5% and 3%, with the majority of fractures occurring intraoperatively and involving the humeral diaphysis. Excess torque produced during surgery is usually responsible for intraoperative fractures. Improper canal preparation or prosthetic placement may also increase the chance of sustaining a fracture. Postoperative fractures are most commonly caused by minor trauma, such as a fall. Poor bone quality, female sex, advanced age, and history of rheumatoid arthritis are the risk factors most commonly associated with periprosthetic fractures. All 4 systems used to describe periprosthetic humeral shaft fractures classify fracture patterns according to the anatomic relation of the fracture to the prosthetic stem. Treatment decisions should be made with respect to obtaining fracture stability, initiating early gleno-humeral motion, and restoring shoulder function. Intraoperative fractures and any postoperative fracture resulting in prosthetic instability should be treated with a long-stem prosthesis extending at least 2 to 3 cortical diameters past the fracture site with consideration for rigid plate fixation. Short oblique or transverse postoperative fractures should be managed with early stable fixation. There has been some support for conservative treatment of long oblique or spiral postoperative fractures. Postoperative diaphyseal fractures distal to the stem generally are well maintained with standard fracture management.

Arthroplasty, Replacement↗
PubMedDate not supplied

Management of proximal humeral fractures.

The understanding of early controlled range of motion adapted to the stability of the fracture is crucial in postfracture shoulder therapy. The diagnosis and management of proximal humeral fractures have been reviewed. In addition, the aspects of therapy and the pertinent rehabilitation protocols are outlined. Although this article outlines standard treatment approaches, the specific therapy should be individualized to the patient's goals and abilities, and continuous communication between all persons involved in the patient's care is essential for achieving the best possible outcome.

Exercise Therapy↗
PubMed2003

Fracture strength of cusp replacing resin composite restorations.

PURPOSE: To assess the influence of an additional shoulder preparation on the fracture strength of a cusp-replacing direct resin composite restoration in a premolar that previously had an amalgam MOD restoration followed by fracture of a cusp. MATERIALS AND METHODS: Two preparation designs were tested. In extracted sound premolars an MOD amalgam cavity was simulated followed by fracture of a cusp (Group A). Group B was the same as Group A but a shoulder was added along the cervical outline of the preparation. As a control group, cusp fracture was simulated but no MOD amalgam cavities were prepared. For each group, 14 preparations were made using a copy milling technique. All 42 preparations were restored using a direct resin composite restoration technique. Restorations were loaded until fracture. RESULTS: The fracture strength of the preparation with shoulder was not significantly different from the preparation without the shoulder. The fracture strength of the preparations in the reference group, which had no resistance form, was significantly less than in Groups A and B (ANOVA, P<0.05).

Analysis of Variance↗