Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Sep 2009
Comparative StudyEffects of shoulder position on axillary nerve positions during the split lateral deltoid approach.
The axillary nerve may be injured during percutaneous fixation of proximal humerus fractures. This study investigated the kinematic behavior of the superior and inferior borders of the axillary nerve under varying shoulder positions. This information may reduce iatrogenic neurologic injury during fracture reduction and hardware placement. ⋯ The main determinant of axillary nerve position with respect to the acromion is vertical abduction. Axillary nerve position is essentially unaffected by varying degrees of humeral rotation and forward flexion. Vertical glenohumeral abduction to 60 degrees is required to move the nerve significantly closer to the acromion.
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Chondrolysis has been observed after shoulder arthroscopy and results in severe glenohumeral complications. ⋯ Chondrolysis is a devastating complication of arthroscopic shoulder surgery that can result in long-term disabling consequences. Further research is required to specifically identify causative factors. Until this is a available, we strongly advise against the use of large doses of intra-articular placement of local anesthetics.
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J Shoulder Elbow Surg · Sep 2009
Comparative StudyEffects of flexor-pronator muscle loading on valgus stability of the elbow with an intact, stretched, and resected medial ulnar collateral ligament.
The medial ulnar collateral ligament (MUCL) is an important passive stabilizer to the valgus stresses that athletes experience during overhead throwing motion. However, the role of the flexor-pronator muscles as active stabilizers to valgus stress is not well defined in the literature. The objectives of this study were to quantify the relative contribution of the individual flexor-pronator muscles to valgus stability of the elbow and how this relationship was affected by ligament status. ⋯ The FDS, PT, and FCU are all active stabilizers of the elbow to valgus stress. The FDS is the biggest contributor amongst the flexor-pronator muscles.
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J Shoulder Elbow Surg · Jul 2009
Comparative StudyNovel method to treat sterno-clavicular joint instability and medial clavicle fracture symptomatic nonunion.
Stabilization of the medial clavicle is traditionally associated with relatively high complication and failure rate. This is a retrospective, case series study to assess outcome of a novel two-stage surgical treatment of sterno-clavicular joint instability or symptomatic medial clavicle fracture non-union. ⋯ We cautiously recommend this method to experienced surgeons. A larger number of patients is required to endorse wider generalization of the results.