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Functional Rehabilitation
Published in James Crossley, Functional Exercise and Rehabilitation, 2021
The shoulder or glenohumeral joint is a highly mobile ball and socket joint designed to peform a wide variety of movements over large ranges to orientate the hand. The humeral head sits in a shallow glenoid socket, like a golf ball sitting on a tee, making the glenohumeral joint mobile but also unstable. To increase stability, a fibrocartilage disc known as the glenoid labrum sits on top of the glenoid. The labrum deepens the shallow socket, creating a more stable structure, although the labrum can be torn by traumatic injury.
Orthopaedic Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
Complications include: Dislocation of the humeral head.Complete distraction of the humeral head off the shaft.Axillary (circumflex) nerve damage causing anaesthesia over the upper, lateral aspect of the upper arm and loss of deltoid arm abduction movement.Axillary vessel damage with compromised vascular supply to the humeral head or distal arm.
Musculoskeletal system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Ultrasound has been established as an effective imaging method in the MSK system. Besides the non-ionising nature of ultrasound, the main advantages include the ability to perform dynamic examinations, to conduct side-by-side comparisons on the spot, and to guide interventions such as fluid aspirations or cavity injections. The shoulder joint is a synovial ball-and-socket joint made up of the scapula’s glenoid cavity and the articular surface of the humeral head. It has a wide range of movements and relies on the rotator cuff muscles support for stability.
Mechanisms of Modulation of Automatic Scapulothoracic Muscle Contraction Timings
Published in Journal of Motor Behavior, 2021
Samuele Contemori, Roberto Panichi, Andrea Biscarini
One possibility is related to the line of force of the MD. The downward scapular rotation increases the angle between the force of gravity and the forces expressed by the structures that are responsible for the vertical stability of the humeral head (Neumann, 2010). If this angle is enhanced the summation of the two force vectors results in the decrement of the compressive force, which is responsible for the locking of the humeral head against the glenoid fossa of the scapula. In this configuration, the MD could give a contribution to the humeral head stability by its upward-medial oriented line of force. This might have induced a slight preactivation of the muscle, which may increase the responsiveness of the muscle to the following motor command (Contemori et al., 2020; Wood et al., 2015), thus facilitating the discrimination of the contraction onset time (Contemori et al., 2020). Another possibility is that the downward scapular rotation led to a shortening of the pre-abduction length of the MD, due to the movement of the acroimal origin of the muscle to its humeral insertion. This might result in a mechanical disadvantage of the muscle to initiate the abduction movement and, as a consequence, sharpen the initial response of the muscle, thus facilitating the discrimination of its timing of contraction.
Therapeutic Effect of Resection, Prosthetic Replacement and Open Reduction and Internal Fixation for the Treatment of Mason Type III Radial Head Fracture
Published in Journal of Investigative Surgery, 2021
Hong-Wei Chen, Jia-Liang Tian, Yong-Zhao Zhang
We enrolled 102 patients with radial head fracture who received treatment at the Orthopedics Department of our hospital from January 2009 to June 2017. All the patients underwent computed tomography (CT) scans and CT reconstruction of the elbow joint before the operation to assess the type of fracture and degree of displacement, in order to determine the surgical plan. Magnetic resonance imaging (MRI) was used to diagnose the patients with ligament injury or joint surface injury of the humeral head. The patients were grouped according to the surgical approach agreed on by the doctor and patient. Each treatment group (resection, prosthetic replacement, and ORIF) contained 34 subjects. Inclusion criteria were as follows: (1) patients were diagnosed with closed Mason type III radial head fracture based on examination of x-ray [16], (2) fresh fracture without any prior treatment; (3) patients were generally in good health and in compliance with the indications for surgical treatment; (4) patients signed informed consent for the study. Exclusion criteria were as follows: (1) patients with metabolic and endocrine bone diseases or pathological fractures; (2) patients with old fractures; (3) patients with serious cardiovascular or cerebrovascular diseases or serious primary diseases of liver, kidney and other important organs and hematopoietic system; (4) patients with concurrent mental disorders that would preclude fracture treatment or rehabilitation exercises.
Comprehensive review of the physical exam for glenohumeral instability
Published in The Physician and Sportsmedicine, 2020
Brandon T. Goldenberg, Lucca Lacheta, Samuel I. Rosenberg, W. Jeffrey Grantham, Mitchell I. Kennedy, Peter J. Millett
The rotator cuff and periscapular muscles provide dynamic stabilization to the joint. Historically, cadaveric studies have shown that the long head of the biceps contributes to dynamic stabilization [6]. However, a recent study using biplane fluoroscopy showed that a biceps tenodesis had minimal effects on glenohumeral kinematics [7]. The rotator cuff muscles, consisting of the subscapularis, supraspinatus, infraspinatus, and teres minor, have a shorter lever arm compared to the periscapular muscles and can contract differentially to compress the humeral head into the center of the glenoid (concavity compression), and steer the shoulder in rotation [2,3,5]. The periscapular muscles maintain centralization of the humeral head relative to the glenoid by controlling the position of the scapula during motion of the humerus [4].