– Discussion: – impingement syndrome describes pain in subacromial space when the humerus is elevated or internally rotated; – during humeral flexion, the supraspinatus tendon and bursa become entrapped between the anteroinferior corner of the acromion (and CA ligament) and the greater tuberosity; – this syndrome is thought to precipitate attritional changes in the rotator … Read more
– Classic Neer Impingment Sign: (see impingement syndrome) – is tested by having the patient place his hand on the unaffected shoulder and gradually forward flexing the shoulder; – impingement sign is elicited w/ pt seated and the examiner standing; – scapular rotation is prevented w/ one hand while … Read more
– See: – Obstetrical Paralysis – Erb’s Palsy – Discussion: – following Erb’s palsy, shoulder may end up with medial rotation-adduction contracture w/ or w/o shoulder subluxation; – due to overpull of the subscapularis, pectoralis major and minor, latissimus, and teres major … Read more
– See: Total Shoulder Replacement – Technique: – deliver the proximal humerus: – anteriorly dislocate the humeral head by extending, abducting, and externally rotating the arm; – a blunt Homan retractor is then placed behind the humeral head to maintain its dislocated position; … Read more
– Discussion: – its essential to restore anatomic length of humerus to provide proper amount of tension in deltoid so that patient will maintain the ability to forward flex; – in the case of a hemiarthroplasty performed for 4 part frx, length will always have to be regained; … Read more
– Discussion: – see anatomy of the scapula – most common scapular frx are frx of the body, followed by the neck, glenoid, and acromion; – associated injuries: seen in upto 80-90% of patients; – pulmonary injuries and pneumothorax (23%) and pulmonary contussion; … Read more
– See: – Bone Bridge – Distal Femoral Physeal Fractures – Epiphyseal Artery – Epiphyseal Plate – Humeral Physeal Injuries – Suprachondylar Fractures of the Humerus – … Read more
– Discussion: – TKR: effects of malrotation – patellar effects: – malrotation of femoral component may lead to patellofemoral dislocation or subluxation; – slight external rotation of femoral component on femur places patellofemoral groove more laterally, enhances patellofemoral stability (external rotation moves … Read more
– Discusssion: – remove 1-2mm of bone using the intramedullary guide. – be aware of the preoperative flexion stability and ROM in choosing posterior slope; – for example, if the knee was unstable in flexion preoperatively, 0 degrees posterior slope may help reduce some of the flexion gap; … Read more