Data Trace Editor – Hyponatremia with serum hypo-osmolarity – Urine that is less than maximally dilute when compared with serum osmolality (ie, a simultaneous urine osmolality that is greater than the serum osmolality – Inappropriately large amounts of urine Na (Ua > 20 mmo/L); – Normal Renal function; – Normal Thyroid function – Normal Adrenal function; – Patient … Read more
– Discussion: – see discussion shoulder arthroplasty and technical considerations with fracture – operative considerations: hemiarthroplasty vs total shoulder arthroplasty – considered in young pt w/ OA, posttraumatic dz (w/ no have glenoid involvement nor erosion), AVN, or massive RTC tear; – approximate survival rate at 10 years is about 80%; … Read more
Positioning: – beach chair position is comfortable for both the patient and the surgeon and allows the option of converting to an open procedure (if necessary); – patients need to be seated with the torso raised to 70 deg with a foled sheet placed on the medial border of the affected scapula … Read more
– Associated Injuries: – Bankart lesion – up to 90% of first time dislocators will have this lesion; – fracture dislocation: – fracture of humeral head, neck, or greater tuberosity; – associated greater tuberosity frx may actually have less … Read more
– See: – Obstetrical Paralysis – Erb’s Palsy – Discussion: – following Erb’s palsy, shoulder may end up with medial rotation-adduction contracture w/ or w/o shoulder subluxation; – due to overpull of the subscapularis, pectoralis major and minor, latissimus, and teres major … Read more
– Classic Neer Impingment Sign: (see impingement syndrome) – is tested by having the patient place his hand on the unaffected shoulder and gradually forward flexing the shoulder; – impingement sign is elicited w/ pt seated and the examiner standing; – scapular rotation is prevented w/ one hand while … Read more
– History: (questions for modified Simple Shoulder Test); – Can patient… – comfortably place are at side? – sleep on side? – eat with utensil – dress … Read more
– Rotator Interval Capsule: – rotator interval is a triangular portion of shoulder capsule which lies between the supraspinatus and subscapularis tendons; – capsular anatomy: (Static Stabilizers / Capsule of the Shoulder) – interval capsule is reinforced by the superior glenohumeral and coracohumeral ligaments; – references: – Capsular ligaments … Read more
– Discussion: – impingement syndrome describes pain in subacromial space when the humerus is elevated or internally rotated; – during humeral flexion, the supraspinatus tendon and bursa become entrapped between the anteroinferior corner of the acromion (and CA ligament) and the greater tuberosity; – this syndrome is thought to precipitate attritional changes in the rotator … Read more
– Discussion: – w/ in joint capsule, variable ligs (superior, middle, & IGHL), are primary components of static restraint in glenohumeral joint. – glenoid version: – Biomechanical Evaluation of Glenoid Version and Dislocation Direction on the Influence of Anterior Shoulder Instability and Development of Hill-Sachs Lesions – Scapulohumeral Ligaments: (5 … Read more