- Congenital Partial Aplasia of the Atlas Causing Functional Angular Displacement of the Posterior Arch. [Journal Article]
- PM RPM R 2018 Jun 14
- Points & Pearls: Managing Shoulder Injuries in the Emergency Department: Fracture, Dislocation, and Overuse. [Journal Article]
- EMEmerg Med Pract 2018 Jun 01; 20(Suppl 6):1-2
- The complex structures of the shoulder can be injured by fracture, dislocation, and overuse, and correctly identifying and classifying injury is essential to avoiding pain, disability, and life- and ...
The complex structures of the shoulder can be injured by fracture, dislocation, and overuse, and correctly identifying and classifying injury is essential to avoiding pain, disability, and life- and limb-threatening complications. This issue presents a systematic approach to classifying shoulder injuries based on the mechanism of injury and clinical presentation, choosing appropriate imaging, and determining the best strategies for treatment, including reduction, surgical consultation, or outpatient referral. Newer recommendations on intra-articular versus intravenous analgesia are presented to increase patient comfort and improve reduction outcomes. [Points & Pearls is a digest of Emergency Medicine Practice.].
- Rotator Cuff Matrix Augmentation and Interposition: A Systematic Review and Meta-analysis. [Journal Article]
- AJAm J Sports Med 2018 Jun 01; :363546518774762
- CONCLUSIONS: In the meta-analysis, graft augmentation or interposition appeared to provide a lower retear rate and improved ASES scores when compared with RCR alone. Future prospective, randomized, controlled, and appropriately powered trials are needed for more definitive recommendations.
- Huge Bursitis and Bursal Synovial Osteochondromatosis associated with Scapular Osteochondroma Mimicking a Giant Calcific Mass of the Chest Wall: A Case Report. [Journal Article]
- AJAm J Phys Med Rehabil 2018 Jun 13
- Osteochondroma is the most common benign bone tumor but it rarely arises from the scapula. Scapulothoracic bursitis is quite rare and osteochondroma is one of the unusual causes of this condition. Sy...
Osteochondroma is the most common benign bone tumor but it rarely arises from the scapula. Scapulothoracic bursitis is quite rare and osteochondroma is one of the unusual causes of this condition. Synovial chondromatosis may occur extremely uncommonly in this bursa. We reported an unusual case of scapulothoracic bursitis with synovial chondromatosis which is caused by osteochondroma. To the best of our knowledge, there is no defined chondromatosis in the scapulothoracic bursa secondary to scapular osteochondroma in the literature.An osteochondroma originating from the inner surface of the scapula can irritate this bursa and scapulothoracic bursitis may develop. Clinical manifestations are usually pain and swelling on the posterior chest wall. Patients may also declare crepitation by shoulder rotation. Ultrasonography can reveal a fluid collection between the serratus anterior muscle and chest wall. On computed tomography (CT) a hypodense, well-demarcated cystic mass may be seen at this location. Its magnetic resonance (MR) imaging features are similar to other cystic lesions. It is hypointense on T1-weighted images and hyperintense on T2-weighted images. Synovial chondromatosis or osteochondromatosis is a benign synovial metaplastic proliferation that occurs extremely uncommonly in bursae. When we searched 'large scapulothoracic bursa chondromatosis' phrases in lliterature review of Chochran Database and Web of Science, we could not find any case reports of synovial chondromatosis in large scapulothoracic bursa. The bursal chondroid bodies appear hypointense on T1-weighted images and hyperintense on T2-weighted images but the signal intensity decreases in all sequences as the calcific or ossific component of these nodules increases. We here report an unusual case of scapulothoracic bursitis with synovial osteochondromatosis which is caused by osteochondroma. A written informed consent was taken from the patient.
- Home-based exercise enhances health-related quality of life in persons with spinal cord injury: A randomized controlled trial. [Journal Article]
- APArch Phys Med Rehabil 2018 Jun 11
- CONCLUSIONS: A 6-week upper-body exercise intervention improved indices of HRQOL in persons with SCI. Improvements were associated with increases in ESE. While this intervention demonstrated a positive impact on perceived physical functioning, future interventions should aim to support social and mental functioning and exercise maintenance.
- Posterior Shoulder Dislocation During Morning PT: A Case Report. [Journal Article]
- MMMil Med 2018 Jun 13
- Posterior shoulder dislocation should be considered in the differential diagnosis of acute shoulder pain and immobility following trauma. Although far less common then the anterior dislocation, it is...
Posterior shoulder dislocation should be considered in the differential diagnosis of acute shoulder pain and immobility following trauma. Although far less common then the anterior dislocation, it is associated with high rates of comorbidity. Seventy-nine percent of posterior shoulder dislocations are missed on initial presentation, which is partially responsible for the high rate of comorbidity associated with these injuries. The mechanism of injury is varied from generalized seizure to minor trauma, which adds to the complexity of the diagnosis. There is a well-documented "vulnerable position" described as injury to the arm while it is in a flexed, adducted, and internally rotated position that is highly associated with posterior shoulder dislocation. The plain film scapular Y is the most clinically significant imaging and can be used alone to diagnose the injury, although ancillary imaging such as magnetic resonance imaging is often warranted. Once this rare condition has been diagnosed, there are a number of appropriate reduction techniques available to the health care provider. Presented here is a case of posterior shoulder dislocation that occurred while doing pushups for routine morning physical training. Also discussed are keys to recognition and treatment as well as a brief discussion of associated complications of the injury.
- The effect of interscalene block on ipsilateral shoulder pain and pulmonary function in patients undergoing lung lobectomy: A randomized controlled trial. [Journal Article]
- MMedicine (Baltimore) 2018; 97(24):e11034
- CONCLUSIONS: Interscalene block using 10 mL of 0.25% ropivacaine including dexamethasone 5 mg reduced the incidence of post-thoracotomy ipsilateral shoulder pain and did not result in additional impairment of pulmonary function.
- Use of a Reverse Shoulder Arthroplasty Following a Fracture-Dislocation with a Brachial Plexus Palsy: A Case Report. [Journal Article]
- JCJBJS Case Connect 2018 Jun 13
- CONCLUSIONS: Acute RSA with tuberosity repair may be a reasonable treatment modality in the setting of an acute brachial plexus palsy following a comminuted fracture-dislocation of the proximal aspect of the humerus in an elderly patient.
- Dorsolateral Biplane Closing Radial Osteotomy and Lunate Fixation for Stage IIIC Kienböck Disease: A New Surgical Approach. [Journal Article]
- THTech Hand Up Extrem Surg 2018 Jun 11
- The treatment of advanced-stage Kienböck disease (KD) remains highly controversial. Particularly important is stage IIIC KD, which includes patients with a lunate coronal fracture. The purpose of thi...
The treatment of advanced-stage Kienböck disease (KD) remains highly controversial. Particularly important is stage IIIC KD, which includes patients with a lunate coronal fracture. The purpose of this paper was to describe a new approach to KD in patients with Lichtman stage IIIC KD, and our results using it. The procedure combines a dorsolateral biplane closing radial osteotomy and lunate fixation. A total of 11 patients from January 2002 through December 2016 with documented KD who underwent this technique were included. The patients were assessed before surgery, then postoperatively at 1 and 10 days, 3 and 6 weeks, 3 and 6 months, and annually. Wrist range of motion, grip and pinch strength, the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score, a Modified Mayo Wrist Score (MMWS), 10-point visual analog scale, radiologic measurements, and data related to consolidation were collected. All statistical analyses were performed using the statistical software package SPSS. Some degree of pain relief, improvements in the QuickDASH score, MMWS score, grip strength, and the degrees of flexion and extension were observed, the results being statistically significant (P<0.05). After surgery, the values for radial and sagittal tilt were statistically different than those measured before surgery. Carpal collapse was not evident either before or after surgery. In conclusion, combining a dorsolateral radial osteotomy and a lunate compression screw may expand the options for patients with Lichtman stage IIIC KD. Our experience indicates that it is a viable option in challenging clinical scenarios.
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- Effect of a Shoulder Movement Intervention on Joint Mobility, Pain, and Disability in People With Diabetes: A Randomized Controlled Trial. [Journal Article]
- PTPhys Ther 2018 Jun 11
- CONCLUSIONS: A progressive shoulder movement program can have meaningful effects on active motion and symptoms in people with type 2 diabetes and mild-to-moderate shoulder symptoms, with symptom improvement lasting at least 9 months.