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Arthroscopic superior capsular reconstruction
Published in Andreas B. Imhoff, Jonathan B. Ticker, Augustus D. Mazzocca, Andreas Voss, Atlas of Advanced Shoulder Arthroscopy, 2017
Matthew P. Noyes, Patrick J. Denard, Stephen S. Burkhart
Our general rehabilitation philosophy for SCR patients is similar to massive and revision rotator cuff repairs. The incidence of postoperative stiffness decreases as tear size increases. Patients are placed in a sling for 6 weeks and may remove it for showering. Elbow, hand, and wrist exercises start immediately postoperatively. We begin passive external rotation with a stick immediately postoperatively if the subscapularis is intact. If there is an associated full-thickness subscapularis repair, we restrict external rotation to neutral. Strengthening is delayed until 16 weeks postoperatively. A 1-year restriction is placed on overhead lifting and sport participation.
Introduction to the clinical stations
Published in Sukhpreet Singh Dubb, Core Surgical Training Interviews, 2020
Patients should be placed in a sling for approximately 3 weeks following reduction to aid support and recovery. In young patients below the age of 25, an orthopaedic referral is mandated due to the high risk of recurrence, and there is now a move to initiate primary stabilization through a Bankart's repair.
Injuries of the Shoulder, Upper Arm and Elbow
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
An x-ray is taken to confirm reduction and exclude a fracture. When the patient is fully awake, active abduction is gently tested to exclude an axillary nerve injury or rotator cuff tear. The arm is then supported in a sling.
Predictors of the effect of an arm sling on gait efficiency in stroke patients with shoulder subluxation: a pre-post design clinical trial
Published in Physiotherapy Theory and Practice, 2022
Yeon-Gyu Jeong, Yeon-Jae Jeong, Hyun-Sook Kim, Kyu Hoon Lee
Individuals with hemiplegia after stroke commonly exhibit not only shoulder subluxation, but also reductions in walking speed, cadence, and step length among temporo-spatial gait parameters (Allet et al., 2009). The reported incidence of shoulder subluxation in hemiplegic individuals ranges from 17% to 81% depending on the assessment method used and the time interval over which it is assessed (Ada, Foongchomcheay, and Canning, 2005). An arm sling is widely used in shoulder subluxation to counteract the downward pull of gravity on the affected arm and repositioning of the humeral head in the glenoid fossa. An arm sling may also provide auxiliary support to help regain scapular symmetry, support the forearm in a flexed arm position, and improve anatomic alignment (Acar and Karatas, 2010; Hartwig, Gelbrich, and Griewing, 2012). A previous study on intramuscular injection of botulinum toxin into upper limb muscles to treat spasticity after stroke, including the elbow, wrist flexors, and finger flexors, showed that altering the biomechanics of the arm can improve gait symmetry (Smith, Ellis, White, and Moore, 2000), implying that arm movements influence the lower extremities while walking (Stephenson, De Serres, and Lamontagne, 2010). Although prior studies have described balance, gait function, and temporo-spatial gait patterns related to use of an arm sling (Acar and Karatas, 2010; Yavuzer and Ergin, 2002), the effect of supporting the affected arm on energy consumption has not been studied in individuals with hemiplegia after stroke.
Comparison of immediate effects of sling-based manual therapy on specific spine levels in subjects with neck pain and forward head posture: a randomized clinical trial
Published in Disability and Rehabilitation, 2020
In this study, manual therapy is divided into passive joint mobilization (3 min) and segmental motor control training (3 min). Passive mobilization produced large-amplitude (Maitland grade III) oscillatory mobilization on both articular pillars of the vertebrae. This technique was repeated 3 times for 60 s with oscillations at 1 Hz, with a 1 min interval between each repetition. Segmental motor control training produced repeated movements of each motion at a rhythm of one repetition per 4-s and 10-s holding time (in the end range) for 1 min. The therapist assisted the correct segmental movement through the hands. Moreover, all interventions performed in this study were performed with a sling device. The purpose of the sling device is to give a neutral position and unloading (soft-tissue tension) effect on the targeted segment. In order to set the neutral position of the neck, a non-elastic cord was used to support the head. Then, the mediator provided a comfortable neck position as the tone of the SCM and AS muscles was reduced through palpation. Chest straps and elastic cords were also set up in the cervicothoracic junction group to assist in moving target segments.
A late complication developing 12 years after a transobturator tape procedure: vulvar abscess with vaginocutaneous fistula
Published in Journal of Obstetrics and Gynaecology, 2018
Moon Kyoung Cho, Min Youp Choi, Chul Hong Kim
Surgical treatment for female stress urinary incontinence (SUI) has become very popular after the introduction of the synthetic suburethral sling operation. Minimally invasive surgery helps to reinforce urethral structures in a tension-free manner (Delorme 2001). However, the synthetic materials used in slings can cause problems, including erosion into the urinary tract and vagina, dyspareunia or, rarely, abscess formation. Voiding dysfunction, detrusor overactivity and urinary retention are also known complications of the procedure (Kaelin-Gambirasio et al. 2009; García et al. 2011; Karabulut et al. 2014). However, only two cases of vaginocutaneous fistula following the operation have been reported in the literature (Sahin et al. 2013; Karabulut et al. 2014). In this article, we present another case of vaginocutaneous fistula formation with an inguinal abscess that occurred 12 years after transobturator tape (TOT) surgery.