– 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
– 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
– 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: – 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
– See: Total Shoulder Replacement – Technique: – deliver the proximal humerus: – anteriorly dislocate the humeral head by extending, abducting, and externally rotating the arm; – a blunt Homan retractor is then placed behind the humeral head to maintain its dislocated position; … Read more
– Discussion: – its essential to restore anatomic length of humerus to provide proper amount of tension in deltoid so that patient will maintain the ability to forward flex; – in the case of a hemiarthroplasty performed for 4 part frx, length will always have to be regained; … Read more
– Anterior Portal: – anterior portal is usually used for introduction of instruments; – this portal is placed under arthroscopic visualization from the posterior portal; – the needle is placed halfway between the AC joint and the lateral aspect of the coracoid; – this … Read more
– Discussion: – may be indicated for shoulder instability; – in the report by Greis PE, et al, the authors evaluated 4 cases in which axillary nerve injury which was observed after radiofrequency capsular shrinkage of the shoulder; – authors conclude that injury to the … Read more
– Discussion: – see Static Stabilizers – because of shallow socket of GHJ, stability is conferred by capsle, ligaments, & muscle rather than bone; – capsule is somewhat loose & approx double size of humeral head, allowing for extensive range of motion; – shoulder capsule maintains a … Read more
– See: – massive rotator cuff tear – disscussion – shoulder hemiarthroplasty – Discussion: – by definition, a massive RTC tear invovles tears of more than 5 cm and involves more than than one tendon; – further, massive tears cannot be repaired … Read more