China
Africa
Explore chapters and articles related to this topic
Functional Rehabilitation
Published in James Crossley, Functional Exercise and Rehabilitation, 2021
The shoulder joint is supported by a number of ligaments and a group of muscles, known as the rotator cuff. The rotator cuff is formed by the supraspinatus superiorly, the subscapularis anteriorly, the infraspinatus posteriorly and the teres minor inferiorly (see Figure 7.58). The main function of the rotator cuff is to draw the head of the humerus into the glenoid, stabilizing the shoulder. Dysfunction of the rotator cuff following overuse or overload is a common cause of shoulder dysfunction.
Management of osteoporotic proximal humeral fractures
Published in Peter V. Giannoudis, Thomas A. Einhorn, Surgical and Medical Treatment of Osteoporosis, 2020
Bended nails are designed to be introduced just lateral from the head fragment. Introduction, however, may cause dislocation of the head fragment or fracture of the greater tuberosity, and in case of metaphyseal comminution, there is a risk of varus dislocation (79). Postoperative pain and irritation of the rotator cuff that compromise function are possible complications (80). Therefore, it is advised to introduce both bended and straight nails through the head fragment. The nail has to be advanced into the subchondral bone so it does not protrude into the subacromial space, and at the same time, it is anchored in the subchondral bone plate of the head, fixing the head fragment and preventing varus dislocation. Locking screws provide for rotational and axial stability. As with the plate, locking bolts have to be advanced well into the subchondral bone plate for the best purchase (Figure 17.5). Extra bolts or sutures can be used to reduce and fix the tuberosities to counteract the varus forces of the rotator cuff (81,82). The nail also provides the necessary support for the head at the medial cortex in case of medial comminution. Depending on the nail design, locking bolts can be introduced as medial support screws for the head fragment (83).
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
Following initial investigation by projectional radiography, MDCT is used to assess bone displacement, rotation and integrity of the articular surfaces of the shoulder joint and for quantifying degenerative diseases [28; 29]. MRI and ultrasound are commonly used to examine the rotator cuff [30] and MRI is used to examine joint instability and traumatic joint injury [31]. MDCT arthrography may also be used to assess joint instability [32].
Effects of pain neuroscience education and rehabilitation following arthroscopic rotator cuff repair. A randomized clinical trial
Published in Physiotherapy Theory and Practice, 2023
Felipe Ponce-Fuentes, Iván Cuyul-Vásquez, Luis Bustos-Medina, Jorge Fuentes
Recruitment of patients was by spontaneous consultation in a private rehabilitation clinic. The recruitment occurred between March 2018 and January 2019. The principal researcher, who had no prior contact with the potential patients, was responsible for inviting patients to participate. In the admission assessment, a blind evaluator determined patients who complied with the inclusion criteria and informed them of the aim and details of the investigation. The rotator cuff tear was verified and confirmed by magnetic resonance imaging. The main surgical criteria corresponded to a rupture of 50% or more of tendon thickness in at least 1 rotator cuff tendon, failure of conservative treatment and severe functional disability (Oh et al, 2007). All participants enrolled in this study expressed their understanding and willingness to participate by signing an informed consent. The recruitment schedule is shown in Figure 1.
Reliability, validity, and responsiveness of a Canadian French adaptation of the pain self-efficacy questionnaire (PSEQ)
Published in Disability and Rehabilitation, 2023
Marc-Olivier Dubé, Marianne Roos, François Desmeules, Jean-Sébastien Roy
Adults (>18 years of age) presenting with subacute or chronic (>3 months) RCRSP were recruited from a convenience sample through the electronic mailing lists of Université Laval (>40 000 individuals) and private practice physiotherapy clinics located in Quebec City (Canada). To be eligible to participate, patients had to fulfill the following inclusion criteria: 1) presence of a painful arc in flexion or abduction, 2) presence of a positive Neer sign or Hawkins Kennedy Test, and 3) presence of pain when resisting humeral external rotation or abduction, or a positive Jobe Test. A positive cluster of criteria 1, 2 and 3 represents a valid diagnostic cluster for RCRSP [30]. Participants were excluded if they presented any of the following: 1) clinical signs of massive rotator cuff tears (marked weakness in the absence of limiting pain and/or external rotation lag sign), 2) other shoulder disorders, e.g., frozen shoulder, severe osteoarthritis, fracture, dislocation, severe acromioclavicular joint pathology, 3) symptomatic cervical spine pathology, defined as the reproduction of symptoms with active physiological cervical spine movements, 4) current or past carcinoma, 5) presence of significant co-morbidity, e.g., neurological disorders, rheumatoid arthritis, 6) previous shoulder surgery, and 7) corticosteroid injection in the shoulder in the past 6 weeks.
Evidence of rotator cuff disease after breast cancer treatment: scapular kinematics of post-mastectomy and post-reconstruction breast cancer survivors
Published in Annals of Medicine, 2022
Angelica E. Lang, Stephan Milosavljevic, Clark R. Dickerson, Catherine M. Trask, Soo Y. Kim
Rotator cuff disease is most often a repetitive strain injury, with onset due to overuse and cumulative damage to the rotator cuff tendons [9]. Shoulder biomechanics are considered to play an important role in the development rotator cuff disease, with the injury often initially appearing as supraspinatus impingement [10]. Both humeral and scapular kinematics may contribute to impingement, with the accepted notion that altered kinematics may reduce the subacromial space, causing repeated damage to the bursal side of the tendon [9]. Humeral kinematic changes are often a result of fatigue and lack of endurance of the rotator cuff muscles causing the humeral head to migrate upwards [11], while scapular kinematic changes, often termed “dyskinesis”, can manifest in altered scapular motion in all scapular angles. Reduced upward rotation and increased scapular internal rotation are the common alterations observed in persons with rotator cuff disease [12,13]. However, results are inconsistent [12,14,15] and it is not clear if the scapular kinematic alterations are the cause or result of the injury and pain.