Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Dec 2011
Comparative StudyTransfer of latissmus dorsi and teres major tendons without subscapularis release for the treatment of obstetrical brachial plexus palsy sequela.
Patients with obstetrical brachial plexus palsy (OBPP) sequela exhibit adduction and internal rotation contractures. The muscular imbalance may result in secondary bony changes. Tendon transfers and muscular releases may improve shoulder function in these patients. The aim of this study is to evaluate the functional and radiological results of pectoralis major tendon Z-plasty with transfer of latissimus dorsi and teres major tendons to rotator cuff tendons without release of subscapularis muscle in patients with mild sequela of OBPP. ⋯ Pectoralis major tendon lengthening with transfer of latissimus dorsi and teres major tendons to rotator cuff is an effective and reproducible technique and can improve shoulder functions in patients with OBPP. Subscapularis release is not always required to overcome internal rotation contracture. Secondary glenohumeral changes might also be prevented with this approach.
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J Shoulder Elbow Surg · Dec 2011
Comparative StudyA cadaveric model for suprascapular nerve injury during glenoid component screw insertion in reverse-geometry shoulder arthroplasty.
Reverse-geometry shoulder replacement requires fixation of a baseplate (called a metaglene) to the glenoid, to which a convex glenosphere is attached. Most systems use screws to achieve this fixation. The suprascapular nerve passes close to the glenoid and is known to be at risk of injury when devices and sutures are inserted into the glenoid. We investigate the risk posed to the suprascapular nerve by placement of metaglene fixation screws. ⋯ Metaglene fixation with screws poses a significant risk to the suprascapular nerve. Caution should be used when inserting the posterior and superior screws in particular. Short locking screws may allow adequate fixation while minimizing the risk of neurologic injury.
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J Shoulder Elbow Surg · Oct 2011
Randomized Controlled TrialAccuracy of the biceps tendon sheath injection: ultrasound-guided or unguided injection? A randomized controlled trial.
Patients often localize pain in the anterior shoulder; however, this patient-localized pain does not necessarily correlate to the location of disease. Unguided shoulder injections are common in clinical practice. The accuracy of unguided biceps tendon sheath injections has not been studied. Patient management may be aided by the knowledge of injection accuracy. This study compared the accuracy of ultrasound-guided biceps tendon sheath injection with unguided injection. ⋯ Injection into the tendon sheath of the long head of the biceps brachii can be more accurately performed using ultrasound guidance than by the blind method.
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J Shoulder Elbow Surg · Oct 2011
An anatomic and clinical study of the suprascapular and axillary nerve blocks for shoulder arthroscopy.
The combination of suprascapular nerve block (SSNB) and axillary nerve block (ANB) has been reported to provide safe and effective analgesia for arthroscopic shoulder surgery. This study was designed to identify anatomic landmarks of the suprascapular nerve (SSN) and axillary nerve (AN) and to evaluate the effects of SSNB and ANB using the identified landmarks. ⋯ The SSNB and ANB were considered to provide safe and effective analgesia in terms of early postoperative pain in arthroscopic shoulder surgery.