The Hip - book

Winging Scapula

– Discussion:    – injuriy to long thoracic nerve (serratus anterior) leads to medial winging; – injury to the spinal accessory (trapezius) leads to lateral winging; – diff dx: – brachial plexus injury /preganglionic injury – serratus anterior / long thoracic nerve – trapezius – fascioscapulohumeral muscular dystrophy – parsonage turner   Original Text by Clifford R. Wheeless, III, … Read more

Zanca View (AC Joint View)

– Discussion:     – used to better visualized the acromio-clavicular joint by eliminating overlying structures; – Technique:     – AP view w/ beam is directed at the a-c joint with 10 deg cephalic tilt;     – use 1/3 to 1/2 the voltage used for the AP shoulder view (soft tissue technique)

West Point Axillary View

– Discussion:     – useful in identifying anterior glenoid abnormalities (Bankart Lesion) in pts w/ hx indicating traumatic instability of the shoulder; – Technique:     – pt is placed prone on x-ray table w/ involved shoulder on a pad raised 7.5 cm from the top of the table;     – head & … Read more

Types of Anterior Dislocation

– See: Multidirectional Instability:  – Radiographic Subtypes:     – Subcoracoid          – most common type of anterior dislocation          – head of humerus is displaced anteriorly w/ respect to glenoid, & is inferior to coracoid process;          – greater tuberosity is fixed on anterior glenoid rim;          – neck … Read more

Type I Epiphyseal Injury: of Proximal Humerus

– Discussion:     – encountered in infants and young children;     – this frx is difficult to diagnose since humeral epiphysis since it is mostly cartilage; – Treatment:     – if arm is shortened and abducted then restore length & alignment by applying longitudinal traction w/ arm in 90 deg of abduction, … Read more

Total Shoulder Replacement

– Discussion:     – see shoulder replacement discussion (total shoulder vs hemiarthroplasty vs reverse arthroplasty)     – the indications for total shoulder arthroplasty (versus hemiarthroplasty) are controversial;            – there is some controversy regarding pain relief and component survivorship;            – Gartsman GM, et al (2000), the authors compared hemiarthroplasty (24 … Read more