shoulder

PURPOSE: The purpose of this study is to evaluate the frequency of glenohumeral joint extravasation of Ultrasound (US) guided biceps tendon sheath injections. METHODS: Fifty shoulders with a clinical diagnosis of bicipital tenosynovitis pain received an ultrasound guided biceps sheath injection with anesthetic, steroid and contrast (5.0 mL mixture) followed immediately by orthogonal radiographs to localize the anatomic distribution of the injection. Radiographic evaluation of contrast localization was determined and interobserver reliability calculated...

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PURPOSE: There is no consensus on the optimal operative technique for humeral shaft fractures. This meta-analysis aims to compare minimal-invasive plate osteosynthesis (MIPO) with nail fixation for humeral shaft fractures regarding healing, complications and functional results. METHODS: PubMed/Medline/Embase/CENTRAL/CINAHL were searched for randomized clinical trials (RCT) and observational studies comparing MIPO with nailing for humeral shaft fractures. Effect estimates were pooled across studies using random effects models and presented as weighted odds ratio (OR), risk difference (RD), mean difference (MD) and standardized mean difference (SMD) with corresponding 95% confidence interval (95%CI)...

This study was performed to propose a method, the Feature Ambiguity Mitigate Operator (FAMO) model, to mitigate feature ambiguity in bone fracture detection on radiographs of various body parts. A total of 9040 radiographic studies were extracted. These images were classified into several body part types including 1651 hand, 1302 wrist, 406 elbow, 696 shoulder, 1580 pelvic, 948 knee, 1180 ankle, and 1277 foot images. Instance segmentation was annotated by radiologists. The ResNext-101+FPN was employed as the baseline network structure and the FAMO model for processing...

The anterior cruciate ligament (ACL) is the most frequently injured knee ligament. In previous studies, it was demonstrated that patients following ACL reconstruction may present motor deficits which may be related to increased risk of injury. The objective of the study was to determine whether players who have passed RTS assessment still have deficits in movement patterns or in neuromuscular control after such a serious injury as ACL rupture and reconstruction,. Sixty-five male football players (age 18-25 years), recruited from regional teams, were divided into three groups: (1) ACL group-subjects after ACL rupture and reconstruction (n = 24); (2) Mild Injury (MI) group-subjects after mild lower limb injuries (n = 21); and (3) Control (C) group-subjects without injuries (n = 20)...

Implant-associated infections are challenging to diagnose and treat. Fluorescent probes have been heralded as a technologic advancement that can improve our ability to non-invasively identify infecting organisms, as well as guide the inexact procedure of surgical debridement. This study's purpose was to compare two fluorescent probes for their ability to localize Staphylococcus aureus biofilm infections on spinal implants utilizing noninvasive optical imaging, then assessing the broader applicability of the more successful probe in other infection animal models...

INTRODUCTION: The Latissimus Dorsi Myocutaneous Flap (LDMF) is used in post-mastectomy reconstruction. This study has evaluated long-term (up to 12 years) surgical- and patient-reported outcomes from LDMF procedures. METHOD: A retrospective analysis of consecutive LDMF procedures in two UK hospitals, performed between 2006 and 2016. Case notes were reviewed for indications and outcomes. Patients were sent the BREAST-QⓇ survey by post. Outcomes, including surgical adverse events, revision, and implant loss rates, were correlated with patient risk factors...

Background: The aim of this study was to compare the effects of complex decongestive therapy (CDT) accompanied by resistance exercises on extremity circumference, lymphedema volume, grip strength, functional status, and quality of life in the treatment of breast cancer-related lymphedema (BCRL) in patients with and without pain. Methods and Results: Fifty patients with unilateral BCRL were divided into groups: with pain (Group 1, n  = 25) and without pain (Group 2, n  = 25). Thirty minutes of manual lymphatic drainage and multilayered short-stretch bandaging were applied to all patients five times a week for 4 weeks...

CASE: A 43-year-old man with chronic right shoulder pain and dysfunction due to recurrent anterior instability, irreparable subscapularis tear, and glenohumeral arthritis presented to our practice. After workup and counseling, he was treated with anatomic total shoulder arthroplasty augmented by anterior capsular reconstruction using human acellular dermal allograft. At 15 months postoperatively, his forward elevation, external rotation, and internal rotation were 160, 45, and T12, nearly equal to contralateral values...

CASE: We performed arthroscopic superior capsule reconstruction (ASCR) for cuff tear arthropathy (CTA) with humeral head deformity. A 62-year-old man presented with severely limited shoulder motion and recalcitrant omalgia. He had a history of dental implant removal due to metal allergy, and his Constant score was 21 points. We diagnosed CTA with Hamada classification grade 5 and performed ASCR to avoid allergic reactions. Severe night pain improved within 1 week of ASCR, and his Constant score after 2 years was 74 points...

METHODS: This article describes a rehabilitation program and the long-term results after its application in 2 double-hand transplantation patients after 9- and 4-year follow-up periods. A personal rehabilitation program was planned to commence as early as possible after postoperative patient stabilization. Splinting, edema, positioning, passive and active joint movements, daily life activity modification and education, and occupational therapy were also emphasized. RESULTS: Positioning, edema, and passive joint movements were started in the acute phase...

BACKGROUND: Chikungunya fever is an arboviral disease, caused by an alphavirus, the Chikungunya virus, characterized by fever and joint pain that is generally disabling in the acute phase and may last from months to years, with the potential to evolve into chronic musculoskeletal symptoms, as polyarthralgia and arthritis, which can lead to significant impairment of physical function. The non-pharmacological treatment is very important for these patients, and resistance exercises may be one rehabilitation option...

Objective: To investigate the effectiveness of double internal fixations of clavicle and scapula and intraoperative reduction of glenopolar angle in the treatment of floating shoulder injuries. Methods: Between January 2010 and June 2019, 13 patients with floating shoulder injury were treated with double internal fixation of clavicle and scapula and intraoperative reduction of glenopolar angle. There were 11 males and 2 females with an average age of 48 years (range, 25-65 years)...

Objective: To review the research progress of treatment for massive rotator cuff tears. Methods: The domestic and foreign literature about the treatment of massive rotator cuff tears was reviewed. The methods and effectiveness were extensively summarized. Results: The treatment of massive rotator cuff tears still needs long-term research to promote its continuous improvement. The main goal of treatment is to relieve the symptoms and improve the shoulder joint function...

PURPOSE: Total elbow arthroplasty (TEA) is associated with a relatively high complication rate, and exceptionally catastrophic complications might lead to amputation. The purpose of this study was to determine the incidence and aetiology of amputation performed at our institution in upper extremity limbs with a prior TEA. METHODS: Between 1973 and 2018, 1906 consecutive TEAs were performed at our institution. Upper extremity amputation was performed in seven (0...

A definitive consensus on the optimal limb salvage protocol for infected total joints does not currently exist. Popular, is the two-stage revision which calls for the use of an antibiotic loaded spacer followed by a delayed exchange. Our question is whether single-stage revisions for biofilm based infected arthroplasties results in comparable or possibly better patient outcomes as compared to those reported for two-stage revisions. We retrospectively reviewed 500 cases of one-stage revisions for periprosthetic joint infections (PJI) using dual setup with radical debridement, definitive reconstruction with antibiotic loaded cement and implantation of antibiotic calcium sulfate pellets between the years 2005-2017...

Background: Long head of biceps tendon pathology is a well-described source of pain in the anterior adult shoulder. Shoulder arthroscopic surgeons face this condition on a frequent basis because of the increasing aging population. Trends in treatment for this condition have varied over recent decades. An understanding of these trends may help orthopaedic surgeons counsel these patients. Purpose: To evaluate trends in treatment selection, patient population, and complications in recent part II examinees of the American Board of Orthopaedic Surgery (ABOS) board examination...

Background: Prospectively collected responses to Patient Acceptable Symptom State (PASS) questions after shoulder instability surgery are limited. Responses to these outcome measures are imperative to understanding their clinical utility. Purpose/Hypothesis: The purpose of this study was to evaluate which factors predict unfavorable patient-reported outcomes after shoulder instability surgery, including "no" to the PASS question. We hypothesized that poor outcomes would be associated with male adolescents, bone loss, combined labral tears, and articular cartilage injuries...

Background: This study evaluated the association between psychological distress and development of type 2 diabetes (T2D) among male individuals in the workplace. Methods: This observational cohort study enrolled 6,326 male participants aged 18 - 65 years (mean age 47.4 ± 9.5 years, body mass index 23.4 ± 3.4 kg/m2 , hemoglobin A1c 5.5±0.3%), who received annual health checkups from April 2016 to March 2017. Those who had a hemoglobin A1c level ≥ 6.5%, previous history of diabetes, or used diabetes medication were excluded from the analysis...

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