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Scapular fractures
Published in Charles M Court-Brown, Margaret M McQueen, Marc F Swiontkowski, David Ring, Susan M Friedman, Andrew D Duckworth, Musculoskeletal Trauma in the Elderly, 2016
Malreduction of the glenoid fossa fragment results in residual incongruity. Hardegger et al.20 had to reoperate for joint instability. Malunion of the inferior scapular angle was recorded by Bartoníček et al.14 Several cases of hetero-topic ossification have been described, in one of which there occurred entrapment of the axillary nerve requiring surgical decompression.18 Acromial impingement after internal fixation of the glenoid has had to be treated by acromioplasty.23 Prominence of implants, requiring their removal, is a problem mainly in fractures of the acromion, scapular spine, or associated clavicular fractures.18,30 One report also describes a late infection, 11 months after operation, requiring hardware removal.23 In addition, one breakage of a plate was recorded after several years in a healed scapular fracture.23
The Shoulder
Published in Louis Solomon, David Warwick, Selvadurai Nayagam, Apley and Solomon's Concise System of Orthopaedics and Trauma, 2014
Louis Solomon, David Warwick, Selvadurai Nayagam
If the patient has a useful range of movement, adequate strength and well-controlled pain, nonoperative measures are adequate. If symptoms do not subside after 3 months of conservative treatment, or if they recur persistently after each period of treatment, an operation is considered preferable to prolonged and repeated treatment with anti-inflammatory drugs and local corticosteroids. The indication is more pressing if there are signs of a partial rotator cuff tear and in particular if there is good clinical evidence of a full thickness tear in a younger patient. The object is to decompress the rotator cuff (acromioplasty) by removing the structures pressing upon it – the coracoacromial ligament, the anterior part of the acromion process and osteophytes at the acromioclavicular joint. This can be achieved by open surgery or arthroscopically. If tears are encountered they can be repaired.
Acute pulmonary embolism after arthroscopic glenoid labral repair and subacromial decompression: case report and review of the literature
Published in The Physician and Sportsmedicine, 2018
Michelle Yagnatovsky, Amos Z Dai, Michael Zacchilli, Laith M Jazrawi
Two months later, she returned to the clinic with increased shoulder pain after aggravating it during the holidays. The patient subsequently underwent right shoulder arthroscopy with subacromial decompression, acromioplasty, arthroscopic superior labrum anterior and posterior and labral repair and synovectomy. The patient was placed in the lateral decubitus position. The operative arm was placed under 12 lb of simple longitudinal traction. The procedure lasted 1 h and 40 min and blood loss was estimated to be less than 25 mL. Patient was given a standard postoperative protocol, with formal physical therapy beginning 4 weeks after surgery.