Operative management of grade iii acj injuries olivia flannery
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This document discusses the operative management of grade III acromioclavicular joint (ACJ) injuries. It reviews the evidence for surgery versus non-surgical treatment, noting that early studies found non-surgical treatment had better outcomes. However, more recent studies using newer surgical techniques like the Ligament Augmentation and Reconstruction System (LARS) ligament and tightrope fixation have reported good to excellent results in 87.5-93.3% of surgical patients, compared to 58.8-0% of non-surgical patients. The document concludes that with advances in surgical techniques, surgery is now the better option for treating type III ACJ injuries.
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The document traces the origins and development of shoulder arthroplasty implants from the late 19th century to modern designs. It discusses early pioneers like Jules Pean and Charles Neer who developed hemiarthroplasty and total shoulder replacement designs. Key advances included the introduction of modular components, inverted shoulder designs by Grammont to address rotator cuff deficiency, and trabecular metal and augmented glenoids to improve fixation and stability. The document outlines the progression from monoblock to anatomically designed implants to current reverse, anatomic, and resurfacing options to best address different clinical presentations.
Calcific tendonitis james wilson
Calcific tendonitis is characterized by the deposition of calcium hydroxyapatite in tendons, most commonly in the shoulder. The exact pathogenesis is unclear but it involves a cell-mediated process with formative, calcific, resorptive, and reparative phases. Diagnosis is typically made based on x-ray or ultrasound findings of calcific deposits. Initial treatment involves rest, NSAIDs, physiotherapy, and steroid injections. If conservative treatment fails, extracorporeal shockwave therapy or surgical debridement may be considered to remove the calcium deposits and relieve symptoms.
Addressing bone loss in shoulder instability lennard funk
This document discusses approaches to measuring and treating bone loss in the glenoid and humeral head that can contribute to shoulder instability. It addresses how to measure glenoid and Hill-Sachs lesions using various imaging modalities and arthroscopy. It presents studies examining the amount of glenoid and humeral head bone loss that significantly increases instability risk. The document also introduces the "glenoid track" and "Funky Pizza method" to assess if a Hill-Sachs lesion is engaging or non-engaging. It concludes with an overview of treatment approaches based on the size of glenoid and Hill-Sachs defects.
Clinical assessment of the rotator cuff david copas
The document provides an overview of assessing the rotator cuff, including:
1) It describes the four muscles that make up the rotator cuff - supraspinatus, subscapularis, infraspinatus, and teres minor - and their functions.
2) Numerous clinical tests used to assess each muscle are outlined, such as Jobb's test for supraspinatus and Gerber's lift-off test for subscapularis.
3) Assessment involves taking a history, inspecting for deformities, and performing special tests like Codman's drop arm sign and the external rotation lag sign to isolate weaknesses in the rotator cuff muscles.
The role of suprascapular nerve decompression - Jeremy Granville-Chapman
The role of suprascapular nerve decompression - Jeremy Granville-ChapmanWrightington Upper Limb Unit
The document discusses the role of suprascapular nerve decompression. It covers the epidemiology, anatomy, etiology, diagnosis, and management options for suprascapular nerve neuropathy. For younger overhead athletes with a space-occupying lesion and EMG changes, surgery such as SLAP repair alone often provides good results. For non-compressive lesions in younger patients, conservative treatment can be as effective as surgery. For older patients without a rotator cuff tear, decompression of the suprascapular nerve at the suprascapular notch through surgery has shown effectiveness if conservative treatment fails. For massive rotator cuff tears, repair or partial repair is considered, and if not possible, decompression or nerveMore from Wrightington Upper Limb Unit (17)
Is volar locking plate better than kwiring for colles fractures
Is volar locking plate better than kwiring for colles fractures
Acromion - Os-acromiale Fractures and Insufficiency
Acromion - Os-acromiale Fractures and Insufficiency
Addressing bone loss in shoulder instability lennard funk
Addressing bone loss in shoulder instability lennard funk
Clinical assessment of the rotator cuff david copas
Clinical assessment of the rotator cuff david copas
The role of suprascapular nerve decompression - Jeremy Granville-Chapman
The role of suprascapular nerve decompression - Jeremy Granville-Chapman
Operative management of grade iii acj injuries olivia flannery
- 1. Opera&ve Management of Grade III ACJ Injuries Olivia Flannery Upper Limb Fellow
- 3. Why surgery • Persistent pain • Func8onal deficit • Significant deformity • Ten8ng of skin • Young, ac8ve pa8ents
- 4. Surgery v non surgery Level II evidence • Imatani et al JBJS Am 1975 • Larsen et al JBJS Am 1986 • Bannister et JBJS Br 1989 • Fixa8on technique with AO screw or k-‐wires • Conclusion: beRer results in non op group
- 5. Surgery v non surgery Level III evidence • TaS et al JBJS Am 1987 • Press et al Bull Hosp Jt Dis 1997 • Galpin et al Clin Orth Relat Res 1985 • Fremerey et al J Orthop Traumatol 2005 • Calvo et al JSES 2006 • GsteRner et al JSES 2008 • Fraschini et al Injury 2010
- 6. Early studies • Non surgery beRer • Old news • Screws/ k-‐wires out • Newer techniques…….
- 7. Recent studies • Good to excellent results • 87.5% surgery group c/w 58.8% non surgery (GsteRner et al 2008) • 93.3% surgery group (LARS) c/w 0% non surgery (Fraschini et al 2010)
- 8. BeHer surgical techniques • LARS ligament • Provides immediate stability and allow early rom • Tightrope • Good-‐excellent clinical results • BeRer restora8on of horizontal and ver8cal stability • No need for further surgery for r/o metalwork • Lu et al Knee Surg Sports Traumatol Arthrosc 2013 • Jensen et al Knee Surg Sports Traumatol Arthrosc 2014
- 9. Conclusion With new advances in surgical technique Surgery beRer op8on for treatment of type III ACJ injuries