Effect of Cortical Bone Thickness on the Magnitude and Classification of Hill Sachs Lesions Verses Glenoid Lesions

2010 ◽  
Author(s):  
Brooklynn P. Rowland ◽  
Steven M. Smith ◽  
Carrie A. Voycheck ◽  
Jon K. Sekiya ◽  
Richard E. Debski
Keyword(s):  
Humeral Head ◽  
Glenohumeral Joint ◽  
The Body ◽  
Bone Thickness ◽  
Compression Fractures ◽  
Testing Protocol ◽  
Bony Lesions ◽  
Injury Models ◽  
Repair Techniques

The shoulder is the most dislocated major joint in the body; approximately 2% of the population will dislocate their glenohumeral joint between the ages of 18 and 70 [1]. Hill-Sachs lesions, compression fractures resulting from the impaction of the posteroloateral humeral head against the solid anterior rim of the glenoid, occur in roughly 30–40% of all anterior dislocations. Humeral head defects have been linked to postoperative recurrent dislocations and overall instability of the shoulder following stabilization procedures for the capsule [2]. However, the forces and deformations required to create these lesions during shoulder dislocation should be identified to properly develop injury models and new repair techniques. Therefore, the objective of this study was to determine the forces required to create bony lesions on the humeral head and quantify the size of the resulting lesions. In order to achieve this objective, a repeatable testing protocol was developed to consistently produce Hill Sachs lesions.

Effects of Gender on the Mechanical Properties of the Glenohumeral Capsule: Implications for Surgical Repair Techniques

2007 ◽  
Author(s):  
Eric J. Rainis ◽  
Carrie A. Voycheck ◽  
Elizabeth A. Timcho ◽  
Patrick J. McMahon ◽  
Richard E. Debski
Keyword(s):  
Mechanical Properties ◽  
Surgical Repair ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Joint Stiffness ◽  
The Body ◽  
Males And Females ◽  
Glenohumeral Capsule ◽  
Gender Specific ◽  
Repair Techniques

The glenohumeral joint is the most dislocated major joint in the body and the axillary pouch of the glenohumeral capsule is the primary stabilizer at the extreme ranges of external rotation. [1] Procedures to repair the capsule following dislocation result in 12–25% of patients still experiencing pain and instability. [2] Studies performing clinical exams have found inconsistent data on differences between males and females. Increased laxity in the glenohumeral joint of females has been found as well as overall hypermobility when compared to males. [3,4] However, others have found no differences in overall joint stiffness between genders. [5] These findings suggest that a difference in the mechanical properties might exist between genders. Therefore, the objective of this study was to determine the effects of gender on the mechanical properties of the axillary pouch during tensile loading. A combined experimental and computational approach was used to evaluate the properties of the tissue. This data could potentially be utilized to improve surgical procedures and necessitate gender-specific repair techniques.

Effects of Simulated Injury on Tissue Deformation and Mechanical Properties of the Anteroinferior Glenohumeral Capsule

2008 ◽  
Author(s):  
Carrie A. Voycheck ◽  
Andrew J. Brown ◽  
Patrick J. McMahon ◽  
Richard E. Debski
Keyword(s):  
Mechanical Properties ◽  
Glenohumeral Joint ◽  
Permanent Deformation ◽  
Tensile Elongation ◽  
The Body ◽  
Joint Stability ◽  
Glenohumeral Ligament ◽  
Inferior Glenohumeral Ligament ◽  
Patients Experience ◽  
Repair Techniques

The glenohumeral joint is the most dislocated major joint in the body with most dislocations occurring anteriorly. [1] The anterior band of the inferior glenohumeral ligament (AB-IGHL) is the primary passive restraint to dislocation and experiences the highest strains during these events. [2,3] It has been found that injuries to the capsule following dislocation include permanent deformation, which increases joint mobility and contributes to recurrent instability. [4] Many current surgical repair techniques focus on plicating redundant tissue following injury. However, these techniques are inadequate as 12–25% of patients experience pain and instability afterwards and thus may not fully address all capsular tissue pathologies resulting from dislocation. [5] Therefore, the objective of this study was to determine the effect of permanent deformation on the mechanical properties of the AB-IGHL during a tensile elongation. Improved understanding of the capsular tissue pathologies resulting from dislocation may lead to new repair techniques that better restore joint stability and improve patient outcome by placating the capsule in specific locations.

scholarly journals Fashioning Osteochondral Allograft for Humeral Head Defects in Reverse Hill-Sachs Lesions – A Proposed Surgical Technique

2021 ◽  
Vol 11 (9) ◽  
Author(s):  
Vivek Dubey ◽  
Parisah Seyed-Safi ◽  
Daoud Makki
Keyword(s):  
Emergency Department ◽  
Humeral Head ◽  
Glenohumeral Joint ◽  
Case Series ◽  
Defect Size ◽  
Osteochondral Allograft ◽  
Bony Defect ◽  
Correct Orientation ◽  
Joint Dislocations ◽  
Bony Lesions

Introduction:Posterior glenohumeral joint dislocations with associated bony lesions are challenging to treat; namely, reverse Hill-Sachs’s lesions increase humeral head excursion predisposing to recurrent dislocations. To add to the complexity of management, posterior shoulder dislocations are often missed on plain radiographs, leading to chronicity in presentation. Case Report:We describe here our technique in our case series of three patients. Case I, 32 years, gentleman, presented 3 days after injury. He had a locked posterior dislocation of shoulder which he sustained while he fell asleep and hit a glass table. Shoulder was not reducible in emergency department. Reverse Hill- Sachs’s lesion involved 40% of humeral head. Case II, a 54- years- old gentleman, a keen gym trainer . Following sudden withdrawal of diazepam, he woke up lying on the floor and started experiencing shoulder pain. He presented a week following the injury. The dislocated shoulder could not be reduced in emergency department. Bony defect involved 50% of humeral head. Case III, 45 years gentleman who fell off from bike, presented on the same day to the emergency department. The dislocated shoulder was reduced. Defect size was 40% of humeral head. A thorough physical and radiological examination was performed to evaluate the lesion. Delto-pectoral approach was utilized for surgical exposure. Once fully assessed, the lesion is outlined and an oscillating saw is used to create uniform edges - – a regular “orange slice”- shaped defect. The prepared defect size is measured. Calcium phosphate cement is used to fill the defect and form a mould that represents the dimensions of allograft required to recreate the native sphericity of the humeral head. This mould then acts as a reference when fashioning the osteochondral femoral allograft to make sure this fits the defect anatomically. Once the graft is prepared, it is placed into the defect in the correct orientation and fixed in situ using headless s

Glenohumeral Joint Trauma

2019 ◽  
pp. 52-57
Author(s):  
Michael O’Keeffe ◽  
Kiran Khursid ◽  
Peter L. Munk ◽  
Mihra S. Taljanovic
Keyword(s):  
Surgical Treatment ◽  
Humeral Head ◽  
Glenohumeral Joint ◽  
The Body ◽  
Bone Lesions ◽  
Glenoid Fossa ◽  
Rotator Cuff Injuries ◽  
Joint Dislocations ◽  
Bony Bankart ◽  
Joint Trauma

Chapter 12 discusses glenohumeral joint trauma. The shoulder is one of the most frequently dislocated joints in the body. The glenohumeral joint is ball and socket articulation between the humeral head and scapular glenoid. The humeral head is significantly larger than the glenoid fossa, which predisposes this joint to instability. Anterior shoulder dislocations are more common than those occurring posteriorly, and true inferior dislocations are rare. Bone injuries associated with anterior glenohumeral joint dislocations are the bony Bankart and Hill-Sachs lesions. The diagnosis of dislocation is made on radiographs. CT examination is useful in the evaluation of associated bone lesions and glenoid bone loss. Magnetic resonance arthrography (MRA) is the study of choice in the evaluation of associated glenolabral and rotator cuff injuries. Initial treatment is closed reduction with immobilization and subsequent physical therapy. Surgical treatment is indicated for complicated dislocations with instability.

The Effect of Anterior Dislocation on the Mechanical Properties of the Inferior Glenohumeral Ligament

2012 ◽  
Author(s):  
Daniel P. Browe ◽  
Carrie A. Rainis ◽  
Patrick J. McMahon ◽  
Richard E. Debski
Keyword(s):  
Mechanical Properties ◽  
Glenohumeral Joint ◽  
Permanent Deformation ◽  
Recurrent Dislocation ◽  
The Body ◽  
Anterior Dislocation ◽  
Glenohumeral Ligament ◽  
Inferior Glenohumeral Ligament ◽  
Glenohumeral Capsule ◽  
Repair Techniques

The glenohumeral joint is the most frequently dislocated major joint in the body with about 2% of the population dislocating their shoulders between the ages of 18 and 70 [1]. Instability due to permanent deformation of the glenohumeral capsule is commonly associated with dislocation [2]. Current surgical repair techniques for shoulder dislocations typically consist of plication of the glenohumeral capsule, or folding the tissue over on itself, to reduce redundancy in the capsule and restore stability to the shoulder. Up to 25% of patients who undergo surgery for a shoulder dislocation still experience pain, instability, and recurrent dislocation after surgery [3]. It is hypothesized that the mechanical properties of the glenohumeral capsule change in response to dislocation. In addition, the magnitude and location of these changes may have implications for the ideal location and extent of plication. Therefore, the objective of this study was to quantify the mechanical properties of the axillary pouch of the glenohumeral capsule in tension and shear after anterior dislocation.

Injury to the Glenohumeral Capsule During Anterior Dislocation Results in Damage to the Anteroinferior Capsule

2011 ◽  
Author(s):  
Daniel P. Browe ◽  
Carrie A. Voycheck ◽  
Patrick J. McMahon ◽  
Richard E. Debski
Keyword(s):  
Surgical Repair ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Permanent Deformation ◽  
The Body ◽  
Anterior Dislocation ◽  
Recoverable Strain ◽  
Glenohumeral Capsule ◽  
Anterior Direction ◽  
Repair Techniques

The glenohumeral joint is the most frequently dislocated major joint in the body with about 2% of the population dislocating their shoulders between the ages of 18 and 70 [1]. About 80% of these shoulder dislocations occur in the anterior direction, and they most commonly occur in the apprehension position, which is characterized by 60° of glenohumeral abduction and 60° of external rotation [2]. The most common pathology associated with dislocation is instability due to permanent deformation [3]. Current surgical repair techniques for shoulder dislocations are inadequate with about 25% of patients still experiencing pain and instability after surgery [4]. By assessing the strain distribution, it is possible to determine the stabilizing function of the various capsular regions. In addition, surgeons could benefit from knowing the location and extent of tissue damage when placating the capsule during repair procedures. Therefore, the objective of this study was to determine the location and extent of injury to the anteroinferior capsule during anterior dislocation by quantifying the strain at dislocation and the non-recoverable strain following dislocation.

Three new species, two new genera, and new family Biphragmosagittidae (Сhaetognatha) from Southwest Pacific Ocean

2011 ◽  
Vol 20 (1) ◽  
pp. 161-173
Author(s):  
A.P. Kassatkina
Keyword(s):  
New Species ◽  
Type Species ◽  
Morphological Characters ◽  
The Body ◽  
New Order ◽  
New Genera ◽  
New Family ◽  
The Family ◽  
Three New Species

Resuming published and own data, a revision of classification of Chaetognatha is presented. The family Sagittidae Claus & Grobben, 1905 is given a rank of subclass, Sagittiones, characterised, in particular, by the presence of two pairs of sac-like gelatinous structures or two pairs of fins. Besides the order Aphragmophora Tokioka, 1965, it contains the new order Biphragmosagittiformes ord. nov., which is a unique group of Chaetognatha with an unusual combination of morphological characters: the transverse muscles present in both the trunk and the tail sections of the body; the seminal vesicles simple, without internal complex compartments; the presence of two pairs of lateral fins. The only family assigned to the new order, Biphragmosagittidae fam. nov., contains two genera. Diagnoses of the two new genera, Biphragmosagitta gen. nov. (type species B. tarasovi sp. nov. and B. angusticephala sp. nov.) and Biphragmofastigata gen. nov. (type species B. fastigata sp. nov.), detailed descriptions and pictures of the three new species are presented.

scholarly journals Factors related to large bone defects of bipolar lesions and a high number of instability episodes with anterior glenohumeral instability

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Noboru Matsumura ◽  
Kazuya Kaneda ◽  
Satoshi Oki ◽  
Hiroo Kimura ◽  
Taku Suzuki ◽  
...  
Keyword(s):  
Humeral Head ◽  
Glenohumeral Joint ◽  
Three Dimensional ◽  
Clinical Results ◽  
Bone Defects ◽  
Symptom Duration ◽  
Glenohumeral Instability ◽  
Explanatory Variables ◽  
Large Bone ◽  
Large Bone Defects

Abstract Background Significant bone defects are associated with poor clinical results after surgical stabilization in cases of glenohumeral instability. Although multiple factors are thought to adversely affect enlargement of bipolar bone loss and increased shoulder instability, these factors have not been sufficiently evaluated. The purpose of this study was to identify the factors related to greater bone defects and a higher number of instability episodes in patients with glenohumeral instability. Methods A total of 120 consecutive patients with symptomatic unilateral instability of the glenohumeral joint were retrospectively reviewed. Three-dimensional surface-rendered/registered models of bilateral glenoids and proximal humeri from computed tomography data were matched by software, and the volumes of bone defects identified in the glenoid and humeral head were assessed. After relationships between objective variables and explanatory variables were evaluated using bivariate analyses, factors related to large bone defects in the glenoid and humeral head and a high number of total instability episodes and self-irreducible dislocations greater than the respective 75th percentiles were evaluated using logistic regression analyses with significant variables on bivariate analyses. Results Larger humeral head defects (P < .001) and a higher number of total instability episodes (P = .032) were found to be factors related to large glenoid defects. On the other hand, male sex (P = .014), larger glenoid defects (P = .015), and larger number of self-irreducible dislocations (P = .027) were related to large humeral head bone defects. An increased number of total instability episodes was related to longer symptom duration (P = .001) and larger glenoid defects (P = .002), and an increased number of self-irreducible dislocations was related to larger humeral head defects (P = .007). Conclusions Whereas this study showed that bipolar lesions affect the amount of bone defects reciprocally, factors related to greater bone defects differed between the glenoid and the humeral head. Glenoid defects were related to the number of total instability episodes, whereas humeral head defects were related to the number of self-irreducible dislocations.

Research of Trusted Network Security Technology

2011 ◽  
Vol 52-54 ◽  
pp. 713-716
Author(s):  
Xiao Ying Gan ◽  
Bin Liu
Keyword(s):  
Data Transmission ◽  
Network Access ◽  
End User ◽  
Security Technology ◽  
Resources Management ◽  
Integrity Verification ◽  
Reliable Model ◽  
User Data ◽  
Repair Techniques

Based on the TNC architecture, using a trusted network of repair techniques in the trusted network access scenario does not meet the requirements of integrity verification solution for end users. Put forward a credible fix the overall network design, reliable model restoration and repair services, network workflow. The system is in need of restoration to provide safe and reliable repair end-user data transmission, providing a humane, reasonable repair services to ensure the credibility of fixed network and the isolation effect of the terminal to be repaired and strengthened the security of fixed server. Realized the classification of various types of repair resources management, restoration of resources in ensuring the transfer of fast, reliable, based on the performance with a certain extension.

Anterior translation of humeral head in glenohumeral joint: Comparison between limb dominance and gender using ultrasonography

2013 ◽  
Vol 20 (2) ◽  
pp. 89-94 ◽  
Author(s):  
Leonard H. Joseph ◽  
Rizuana I. Hussain ◽  
Amaramalar S. Naicker ◽  
Ohnmar Htwe ◽  
Ubon Pirunsan ◽  
...  
Keyword(s):  
Humeral Head ◽  
Glenohumeral Joint ◽  
Anterior Translation ◽  
And Gender ◽  
Limb Dominance
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