scholarly journals Closed Reduction of Bilateral Posterior Shoulder Dislocation with Medium Impression Defect of the Humeral Head: A Case Report and Review of Its Treatment

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Soorena Rezazadeh ◽  
Amir Reza Vosoughi
Keyword(s):  
Humeral Head ◽  
External Rotation ◽  
Articular Surface ◽  
Surface Damage ◽  
Recurrent Dislocation ◽  
Medium Size ◽  
Rare Injury ◽  
Electrical Shock ◽  
The Right ◽  
Bilateral Posterior Shoulder Dislocation

Bilateral dislocation of the shoulder is a rare injury. The main causes are electrical shock, extreme trauma, and epilepsy. A 25-year-old athletic-body man had sustained bilateral shoulder pain and restricted external rotation following electrical shock for five days. Although articular surface damage was about 50% in the right side and 30% in the left, it could be managed successfully by close reduction without pinning. During one-year follow-up, no recurrent dislocation or limitation of motion was seen. Closed management of medium size defect of the humeral head after posterior dislocation can be performed in cooperative and especially muscular patients.

ULTRASONIC EVALUATION OF ANTERIOR SHOULDER TRANSLATION IN NORMAL SHOULDERS

2003 ◽  
Vol 07 (02) ◽  
pp. 125-134 ◽  
Author(s):  
Joo Seng Yeap ◽  
Alison H. McGregor ◽  
Keith Humphries ◽  
Andrew L. Wallace
Keyword(s):  
Internal Rotation ◽  
Humeral Head ◽  
External Rotation ◽  
Correlation Coefficients ◽  
Observer Variation ◽  
Present Moment ◽  
Anterior Translation ◽  
Ultrasonic Evaluation ◽  
Displacement Force ◽  
The Right

Anterior translation in the right shoulders of 23 volunteers was evaluated using ultrasound from an anterior approach with a 10 MHz, 6 cm wide linear transducer. A translatory force of 90 N was used to translate the humeral head in the adduction and internal rotation position, while a translatory force of 60 N was used in the more clinically relevant position of 90° abduction and external rotation position. The overall intra-observer coefficients of variation ranged from 0–13.0% (mean 3.8 ± 2.5%) for examiner I and 0.5–20.9% (mean 5.1 ± 3.9%) for examiner II. The overall inter-observer variation ranged from 0–29.8% (mean 9.3 ± 7.3%). The anterior translation of the humeral head in adduction and internal rotation following 90 N displacement force ranged from -2.6 to 12.9 mm (mean 2.1 ± 3.1 mm) for examiner I and from -4.1 to 4.7 mm (mean 1.1 ± 2.2 mm) for examiner II. The anterior translation of the humeral head in abduction and external rotation following 60 N displacement force ranged from -3.3 to 3.7 mm (mean 0.3 ± 1.9 mm) for examiner I and from -8.3 mm to 4.5 mm (mean -0.7 ± 2.6 mm) for examiner II. The intra-class correlation coefficients (r) for the measured anterior translation between the two examiners for the 2 positions were 0.029 and -0.058 respectively. We concluded that the inter-observer coefficient of variation remained excessive and the agreement in the measured anterior translation between the two examiners was poor. The finding of negative values in the measured anterior translation despite the use of 90 N and 60 N translatory force raises further concerns about the prospective clinical use of this technique at the present moment.

Humeral head articular surface damage due to bioabsorbable tack placement: A case report

2004 ◽  
Vol 13 (4) ◽  
pp. 463-466
Author(s):  
Onur Tetik ◽  
Kevin Sumida ◽  
John Nyland ◽  
Scott Mair ◽  
David N.M Caborn
Keyword(s):  
Case Report ◽  
Humeral Head ◽  
Articular Surface ◽  
Surface Damage

Legal Update: North Dakota Supreme Court: Third Edition of Guides is “Most Current”

1999 ◽  
Vol 4 (1) ◽  
pp. 6-7
Author(s):  
James J. Mangraviti
Keyword(s):  
Internal Rotation ◽  
External Rotation ◽  
Measurement Techniques ◽  
Fourth Edition ◽  
Hip Motion ◽  
The Difference ◽  
The Right ◽  
Hip Flexion ◽  
Hip Rotation ◽  
Hip Extension

Abstract The accurate measurement of hip motion is critical when one rates impairments of this joint, makes an initial diagnosis, assesses progression over time, and evaluates treatment outcome. The hip permits all motions typical of a ball-and-socket joint. The hip sacrifices some motion but gains stability and strength. Figures 52 to 54 in AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, illustrate techniques for measuring hip flexion, loss of extension, abduction, adduction, and external and internal rotation. Figure 53 in the AMA Guides, Fourth Edition, illustrates neutral, abducted, and adducted positions of the hip and proper alignment of the goniometer arms, and Figure 52 illustrates use of a goniometer to measure flexion of the right hip. In terms of impairment rating, hip extension (at least any beyond neutral) is irrelevant, and the AMA Guides contains no figures describing its measurement. Figure 54, Measuring Internal and External Hip Rotation, demonstrates proper positioning and measurement techniques for rotary movements of this joint. The difference between measured and actual hip rotation probably is minimal and is irrelevant for impairment rating. The normal internal rotation varies from 30° to 40°, and the external rotation ranges from 40° to 60°.

Força dos Músculos Rotadores do Ombro em Indivíduos Saudáveis/ Rotator Cuff Muscle Strength in Healthy Individuals

1970 ◽  
Vol 1 (1) ◽  
pp. 78-82
Author(s):  
Paulo José Oliveira Cortez ◽  
José Elias Tomazini ◽  
Mauro Gonçalves
Keyword(s):  
Rotator Cuff ◽  
Muscle Strength ◽  
Internal Rotation ◽  
Upper Limb ◽  
Statistical Difference ◽  
External Rotation ◽  
Healthy Individuals ◽  
Average Strength ◽  
Strength Tests ◽  
The Right

Introdução: A diminuição da capacidade de exercer esforços por parte dos músculos rotadores pode criar uma variedade de problemas. O conhecimento preciso do nível de força muscular de um indivíduo é importante, tanto para a avaliação da capacidade funcional ocupacional, como para uma apropriada prescrição de exercícios atléticos e de reabilitação. Percebe-se escassez de informação sobre as articulações do ombro, bem como os fatores envolvidos na força muscular dessa região. O objetivo deste estudo foi comparar a força gerada pelos músculos do manguito rotador entre o membro superior direito e o membro superior esquerdo em indivíduos saudáveis. Métodos: Participaram do estudo 22 sujeitos do sexo masculino, com idade de 18 e 19 anos, militares, saudáveis e sem história clínica de patologia ortopédica ou qualquer tipo de lesão no sistema musculoesquelético. Foram aplicados dois testes de força: Rotação Interna e Rotação Externa. Resultado : A força média de rotação interna no membro superior direito (MSD) foi maior que a força média de rotação interna no membro superior esquerdo (MSE) (p=0,723) e a força de rotação externa no MSD foi menor que a força média de rotação externa no MSE (p=0,788). Não houve diferença estatística na comparação dos valores de força de todos os testes de força isométrica. Conclusão: Para amostra estudada e metodologia utilizada na avaliação da força muscular, não houve diferença estatística na comparação da força gerada pelos músculos do manguito rotador do membro superior direito e do membro superior esquerdo.Rotator Cuff Muscle Strength in Healthy Individuals Introduction: Decreased ability to exert efforts by the rotator muscles can create a variety of problems. The precise knowledge of the level of muscular strength of an individual is important for both the functional capacity evaluation for occupational as an appropriate exercise prescription and rehabilitation of athletic. It is perceived scarcity of information on the shoulder joints as well as factors involved in muscle strength in this region. Objective: Develop a device for measuring the strength generated by the muscles of the upper limbs and the verification of efficiency and adaptability of this device through a comparative study of muscle strength in healthy subjects. Methods: The study included 22 male subjects, aged 18 and 19 years, military personnel, body mass between 57.7 and 93 kg (71.8 ± 9.45 kg) and height between 1.67 and 1.90 m (1.75 ± 0.06 m), healthy and without a history of orthopaedic disease or any kind of damage to the musculoskeletal system. Three strength tests were applied: Internal Rotation and External Rotation. For each type of effort three maximum voluntary contractions were required for 10 seconds, with an interval of 30 seconds between each contraction.  Results: Internal rotation in the right upper limb (RUL) was higher than the average strength of internal rotation in the left upper limb (LUL) (p = 0, 723) and the external rotation strength in RUL was lower than the average strength of external rotation in the LUL (p=0,788).  No statistical difference in comparing the strength values of all isometric strength tests. Conclusion: For sample and methodology used to assess muscle strength, there was no statistical difference in comparing the force generated by the muscles of the rotator cuff of the right and left upper limb.

scholarly journals Recurrent Intraocular Lens Dislocation in a Patient with Familial Ectopia Lentis

2021 ◽  
Vol 18 (9) ◽  
pp. 4545
Author(s):  
Tomasz K. Wilczyński ◽  
Alfred Niewiem ◽  
Rafał Leszczyński ◽  
Katarzyna Michalska-Małecka
Keyword(s):  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Vision Loss ◽  
Silicone Oil ◽  
Single Case ◽  
Recurrent Dislocation ◽  
Ectopia Lentis ◽  
Pars Plana ◽  
The Right

A 36-year-old patient presented to the hospital with recurrent dislocation of the intraocular lens (IOL). The patient with the diagnosis of familial ectopia lentis was first operated on for crystalline lens subluxation in the left eye in 2007 and in the right eye in 2009. In both eyes, lens extraction with anterior vitrectomy and transscleral fixation of a rigid IOL was performed. In 2011, the IOL in the right eye luxated into the vitreous cavity due to ocular trauma. The patient underwent a pars plana vitrectomy with the IOL resuturation to the sclera. Seven years later, a spontaneous vision loss in the right eye was caused by a retinal detachment. The pars plana vitrectomy with silicone oil tamponade and a consequential oil removal three months later were performed in 2018. The follow-up examination revealed recurrent IOL dislocation in the same eye. Due to a history of previous suture-related complications a decision was made to remove the subluxated rigid polymethyl-methacrylate (PMMA) IOL and fixate to sclera a sutureless SOLEKO FIL SSF Carlevale lens. The purpose of this report is to present a single case of a 36-year-old patient who was presented to the hospital with recurrent dislocation of the intraocular lens. In a three-month follow-up period, a good anatomical and functional outcome was finally obtained with transscleral sutureless intraocular lens. This lens is an option worth considering especially in a young patient with a long life expectancy and physically active.

scholarly journals Differences in soft tissue damage using a percutaneous versus open approach for antegrade straight humeral nailing: a quantitative and qualitative anatomical study

2021 ◽  
Vol 29 (2) ◽  
pp. 230949902110105
Author(s):  
Christian Fang ◽  
Dennis KH Yee ◽  
Tak Man Wong ◽  
Evan Fang ◽  
Terence Pun ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Humeral Head ◽  
External Rotation ◽  
Biceps Tendon ◽  
Anatomical Study ◽  
Percutaneous Technique ◽  
Open Approach ◽  
Entry Site ◽  
Intramedullary Canal ◽  
Percutaneous Insertion

Background: Percutaneous insertion of third-generation straight humeral nails is a recent alternative to the conventional open method. Rather than splitting, retracting and subsequently repairing the supraspinatus fibers to visualize the humeral head entry site, the percutaneous approach utilizes a cannulated awl to enter the intramedullary canal through the supraspinatus fibers without visualizing internal shoulder structures. Despite recent evidence demonstrating satisfactory outcomes in the percutaneous method, the potential for iatrogenic injury to the rotator cuff and other shoulder structures is not fully understood. Materials and Methods: We performed an anatomical study of 46 shoulders in 23 cadavers to compare damage caused to internal shoulder structures between the open and percutaneous techniques. Dimensions and morphologies of supraspinatus and humeral head perforations were recorded. Results: The percutaneous technique produced greater latitudinal tearing ( p = 0.002) and less longitudinal tearing ( p < 0.001) of muscle fibers, however there was no difference in supraspinatus hole area ( p = 0.748). The long head biceps tendon was within 3 mm of the bone entry hole in 13 (28%) shoulders, with one shoulder in the open group exhibiting full tendon transection. Conclusions: Percutaneous insertion of intramedullary nails using a cannulated awl appears to produce similar soft tissue and bone entry site morphology as compared to the conventional open technique. The percutaneous method was associated with slightly greater latitudinal tearing, however the effects of this remain to be clarified through clinical studies. External rotation should be avoided during instrumentation to reduce the risk of biceps tendon transection.

scholarly journals Electromyographic Evaluation of the Shoulder Muscle after a Fatiguing Isokinetic Protocol in Recreational Overhead Athletes

2021 ◽  
Vol 18 (5) ◽  
pp. 2516
Author(s):  
Sebastian Klich ◽  
Adam Kawczyński ◽  
Bogdan Pietraszewski ◽  
Matteo Zago ◽  
Aiguo Chen ◽  
...  
Keyword(s):  
External Rotation ◽  
Shoulder Girdle ◽  
Median Frequency ◽  
Shoulder Injury ◽  
Overhead Athletes ◽  
Upper Trapezius ◽  
Main Effect ◽  
Shoulder Girdle Muscles ◽  
Exercise Induced ◽  
The Right

The goal of our study was to examine the muscle activity of the shoulder girdle after isokinetic fatigue, which may simulate muscle activities commonly occurring during specific sport-related activities in recreational overhead asymptomatic athletes. We hypothesized that exercise-induced fatigue, reported after isokinetic protocols, may cause a decrease in the median frequency (MF) of the upper trapezius (UT), infraspinatus (IS), and deltoid muscles. Twenty-four male overhead volleyball (n = 8), handball (n = 8), and tennis (n = 8) athletes participated in this study. All subjects were without shoulder injury history. The surface electromyography (SEMG) was collected on the right (dominant) side of the shoulder girdle muscles in the following order: UT, IS and anterior (DA), and posterior deltoideus (DP). The fatigue protocol consisted of three sets of 32 maximum isokinetic concentric contractions while performing shoulder internal and external rotation at an isokinetic speed of 120 o/s. The resultant difference in median frequency (ΔMF) values consistently dropped after the fatiguing tasks across all recorded muscles, in terms of the initial MF (MFINI = 65.1 ± 1.1 Hz) and final MF (MFFIN = 57.9 ± 0.9 Hz), and the main effect of time was significant (F(1,22) = 43.15, p < 0.001). MF values decreased mostly for IS (ΔMFIS = −9.9 ± 1.6 Hz) and DP (ΔMFPD = −9.5 ± 1.9 Hz) muscles, while DA and UT showed smaller changes (ΔMFDA = −6.9 ± 1.5 Hz) and (ΔMFUT = −3.2 ± 1.3 Hz). The results of our study show a meaningful contribution in determining increased fatigue of the shoulder girdle muscles during repeated isokinetic internal-external rotation protocols. We have also demonstrated a significant decrease in MF in all examined muscles, especially IS and DA.

Biomechanical Evaluation of Glenoid Reconstruction With an Implant-Free J-Bone Graft for Anterior Glenoid Bone Loss

2017 ◽  
Vol 45 (12) ◽  
pp. 2849-2857 ◽  
Author(s):  
Leo Pauzenberger ◽  
Felix Dyrna ◽  
Elifho Obopilwe ◽  
Philipp R. Heuberer ◽  
Robert A. Arciero ◽  
...  
Keyword(s):  
Bone Graft ◽  
Bone Grafting ◽  
Humeral Head ◽  
External Rotation ◽  
Glenoid Defect ◽  
Contact Patterns ◽  
Grafting Technique ◽  
The Mean ◽  
The Creation ◽  
Glenoid Reconstruction

Background: The anatomic restoration of glenoid morphology with an implant-free J-shaped iliac crest bone graft offers an alternative to currently widely used glenoid reconstruction techniques. No biomechanical data on the J-bone grafting technique are currently available. Purpose: To evaluate (1) glenohumeral contact patterns, (2) graft fixation under cyclic loading, and (3) the initial stabilizing effect of anatomic glenoid reconstruction with the implant-free J-bone grafting technique. Study Design: Controlled laboratory study. Methods: Eight fresh-frozen cadaveric shoulders and J-shaped iliac crest bone grafts were used for this study. J-bone grafts were harvested, prepared, and implanted according to a previously described, clinically used technique. Glenohumeral contact patterns were measured using dynamic pressure-sensitive sensors under a compressive load of 440 N with the humerus in (a) 30° of abduction, (b) 30° of abduction and 60° of external rotation, (c) 60° of abduction, and (d) 60° of abduction and 60° of external rotation. Using a custom shoulder-testing system allowing positioning with 6 degrees of freedom, a compressive load of 50 N was applied, and the peak force needed to translate the humeral head 10 mm anteriorly at a rate of 2.0 mm/s was recorded. All tests were performed (1) for the intact glenoid, (2) after the creation of a 30% anterior osseous glenoid defect parallel to the longitudinal axis of the glenoid, and (3) after anatomic glenoid reconstruction with an implant-free J-bone graft. Furthermore, after glenoid reconstruction, each specimen was translated anteriorly for 5 mm at a rate of 4.0 mm/s for a total of 3000 cycles while logging graft protrusion and mediolateral bending motions. Graft micromovements were recorded using 2 high-resolution, linear differential variable reluctance transducer strain gauges placed in line with the long leg of the graft and the mediolateral direction, respectively. Results: The creation of a 30% glenoid defect significantly decreased glenohumeral contact areas ( P < .05) but significantly increased contact pressures at all abduction and rotation positions ( P < .05). Glenoid reconstruction restored the contact area and contact pressure back to levels of the native glenohumeral joint in all tested positions. The mean (±SD) force to translate the humeral head anteriorly for 10 mm (60° of abduction: 31.7 ± 12.6 N; 60° of abduction and 60° of external rotation: 28.6 ± 7.6 N) was significantly reduced after the creation of a 30% anterior bone glenoid defect (60° of abduction: 12.2 ± 6.8 N; 60° of abduction and 60° of external rotation: 11.4 ± 5.4 N; P < .001). After glenoid reconstruction with a J-bone graft, the mean peak translational force significantly increased (60° of abduction: 85.0 ± 8.2 N; 60° of abduction and 60° of external rotation: 73.6 ± 4.5 N; P < .001) compared with the defect state and baseline. The mean total graft protrusion under cyclical translation of the humeral head over 3000 cycles was 138.3 ± 169.8 µm, whereas the mean maximal mediolateral graft deflection was 320.1 ± 475.7 µm. Conclusion: Implant-free anatomic glenoid reconstruction with the J-bone grafting technique restored near-native glenohumeral contact areas and pressures, provided secure initial graft fixation, and demonstrated excellent osseous glenohumeral stability at time zero. Clinical Relevance: The implant-free J-bone graft is a viable alternative to commonly used glenoid reconstruction techniques, providing excellent graft fixation and glenohumeral stability immediately postoperatively. The normalization of glenohumeral contact patterns after reconstruction could potentially avoid the progression of dislocation arthropathy.

scholarly journals Penilaian Kondisi Jalan Poros Sabbang Selatan Menggunakan Metode Surface Distress Index

2021 ◽  
Vol 6 (1) ◽  
pp. 24
Author(s):  
Dewi Artika Sari ◽  
Afdal Kisman
Keyword(s):  
Surface Damage ◽  
Road Surface ◽  
Assessment System ◽  
Pavement Condition ◽  
Surface Conditions ◽  
Traffic Volumes ◽  
Surface Distress ◽  
Left Section ◽  
The Right ◽  
Initial Research

Prasarana jalan jika terbebani volume lalu lintas yang tinggi dan berulang-ulang akan menyebabkan terjadinya penurunan kualitas jalan sehingga dapat mempengaruhi keamanan, kenyamanan dan kelancaran dalam berlalu lintas. Untuk menjaga agar tidak terjadi penurunan kondisi khususnya pada jalan poros Kecamatan Sabbang Selatan Kabupaten Luwu Utara tepatnya di jalan Padang Sarre, Buntu Terpedo sampai jalan Dandang sepanjang 4 km perlu adanya penanganan. Maka perlu dilakukan penelitian awal terhadap kondisi permukaan jalan dengan melakukan survei secara visual dengan cara menganalisa kerusakan berdasarkan jenis dantingkat kerusakannya. Tujuan penelitian yaitu menilai kondisi perkerasan danpenanganan sesuai kondisi permukaan jalan. Penelitian ini menggunakan system penilaian kondisi perkerasan menurut Bina Marga dengan perhitungan Surface Distress Index (SDI) untuk jalan beraspal. Dari hasil penelitian di dapatkan penilaian untuk jenis kerusakan permukaan jalan pada ruas kanan yaitu retak pinggir 1,183%, lubang 0,031%, amblas 0,054%, retak kulit buaya 3,271%, retak kotak-kotak 3,222%, tambalan 0,033% dan pengelupasan butir 0,013%. Sedangkan untuk ruas kiri yaitu retak pinggir 0,035%, lubang 0,051%, amblas 0,000%, retak kulit buaya 0,130%, retak kotak-kotak 2,351%, tambalan 0,000% dan pengelupasan butir 0,150%. Kondisi perkerasan jalan yang menjadi objek penelitian sepanjang 4 km yaitu 85% baik, 0% sedang, 15% rusak ringan, 0% rusakberat.Road infrastructure if it is burdened by high and repetitive traffic volumes will cause a decrease in road quality so that it can affect safety, comfort and smoothness in traffic. To prevent deterioration in conditions, especially on the axis road of South Sabbang District, North Luwu Regency, precisely on Padang Sarre road, Buntu Terpedo to Dandang road along 4 km, it needs handling. So it is necessary to conduct an initial research on road surface conditions by conducting a visual survey by analyzing the damage based on the type and level of damage. The research objective was to assess pavement conditions and handling according to road surface conditions. This study uses a pavement condition assessment system according to Bina Marga with the calculation of the Surface Distress Index (SDI) for asphalt roads. From the research results obtained an assessment for the type of road surface damage on the right side, namely edge cracks 1.183%, holes 0.031%, collapse 0.054%, crocodile skin cracks 3.271%, checkered cracks 3.222%, 0.033% patches and 0.013% peeling grains. Whereas for the left section, the edges cracked 0.035%, holes 0.051%, collapsed 0.000%, crocodile skin cracks 0.130%, checkered cracks 2.351%, fillings 0.000% and peeling 0.150%. The condition of the pavement which is the object of the research along 4 km is 85% good, 0% moderate, 15% lightly damaged, 0% heavily damaged.

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