The American journal of sports medicine
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Previous cadaveric studies suggest that positioning the shoulder in an externally rotated position reduces displaced Bankart lesions through a coaptation effect. ⋯ The efficacy of external rotation immobilization after anterior-inferior shoulder dislocation is not likely to be related to coaptation of the Bankart lesion by the subscapularis.
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It has been assumed that patellofemoral pain syndrome results from patellar malalignment. The precise role the vastus medialis obliquus plays in mediating the underlying pathologic abnormality is unclear. ⋯ Vastus medialis obliquus muscle function is important to consider in the rehabilitation of patients with patellofemoral pain syndrome, especially those with extreme patellar tilt and lateral shift malalignments.
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Traumatic proximal tibiofibular dislocation is a rare injury that is often unrecognized or misdiagnosed at the initial presentation because of a lack of clinical suspicion. When diagnosed, the injury should be promptly reduced. Missed injuries or late presentations are a potential source of chronic morbidity. ⋯ In the presence of syndesmotic instability, prompt stabilization is advocated. Whether syndesmotic stabilization is indicated in cases of a syndesmotic sprain is controversial. An illustrative case is also presented of a 28-year-old male soccer player who sustained a proximal tibiofibular dislocation after a violent twisting motion of the right knee.
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Previous studies have demonstrated increased glenohumeral translations with simulated type II superior labral anterior posterior lesions, which may explain the sensation of instability in the overhead-throwing athlete. It is unknown whether this amount of increased translation alters glenohumeral kinematics. ⋯ Findings suggest that in the absence of pain or mechanical symptoms, type II superior labral anterior posterior lesions that do not significantly involve the superior and middle glenohumeral ligaments may not need surgical repair.
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Posttraumatic shoulder dislocations with glenoid rim fractures show high rates of dislocation recurrence. For glenoid rim defects exceeding a certain size, several investigators recommend bone grafting. Few reports on anatomical glenoid reconstruction addressing this problem are published. ⋯ The J-bone graft is capable of creating a stable shoulder joint without causing extensive loss of motion on the long term in patients with traumatic glenoid rim fractures after shoulder dislocation. In some patients, mild to moderate arthropathy develops despite anatomical glenoid reconstruction.