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2013年1月7日周一江苏徐州骨科运动创伤、关节镜Journal club预告
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冻结肩
Edinburgh Shoulder Clinic, Royal Infirmary of Edinburgh, Old Dalkeith Road, Edinburgh EH16 4SA, UK.
Frozen shoulder is commonly encountered in general orthopaedic practice. It may arise spontaneously without an obvious predisposing cause, or be associated with a variety of local or systemic disorders. Diagnosis is based upon the recognition of the characteristic features of the pain, and selective limitation of passive external rotation. The macroscopic and histological features of the capsular contracture are well-defined, but the underlying pathological processes remain poorly understood. It may cause protracted disability, and imposes a considerable burden on health service resources. Most patients are still managed by physiotherapy in primary care, and only the more refractory cases are referred for specialist intervention. Targeted therapy is not possible and treatment remains predominantly symptomatic. However, over the last ten years, more active interventions that may shorten the clinical course, such as capsular distension arthrography and arthroscopic capsular release, have become more popular. This review describes the clinical and pathological features of frozen shoulder. We also outline the current treatment options, review the published results and present our own treatment algorithm.
2、
Department of Orthopedic Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, PA 19131, USA. Abstract
Shoulder injuries in the throwing athlete are becoming more frequent. Sports specialization at a younger age, playing multiple seasons, increased awareness of injury and injury prevention, advances in diagnosis, and surgical treatment all play a part in the increase in diagnosis of these injuries. Understanding the biomechanics of throwing and pathologies that are encountered in the throwing athlete can aid the clinician in successful diagnosis and nonoperative/operative treatment of the throwing athlete. This article discusses the relevant anatomy, biomechanics, and pathoanatomy of the throwing shoulder. Additionally, understanding the kinetic chain can assist in the nonoperative rehabilitation of the injured shoulder. Surgical reconstruction is indicated when nonoperative efforts have been exhausted and is directed based on the extent of the pathology to the capsuloligamentous structures, labrum, and rotator cuff.
3、
Department of Orthopedics, Union Memorial Hospital, Baltimore, MD, USA.
Approximately 20% of all shoulder dislocations occur in patients aged >60 years. Older patients who sustain a primary shoulder dislocation are much less likely than younger patients to suffer from recurrence. However, older patients are more likely than younger patients to sustain injuries to the rotator cuff, axillary nerve, or brachial plexus. Rotator cuff tears are significantly more common than nerve palsies, and rotator cuff tears can be mistaken for nerve palsies. Older patients with persistent shoulder pain and dysfunction after dislocation should be carefully evaluated for rotator cuff pathology. Although dislocation is a common injury in the older population, these concomitant injuries-especially of the rotator cuff-are often missed
4、
E Agnelli Hospital, Via Brigata Cagliari 39, 10064 Pinerolo, Turin, Italy. n.lollino@libero.it
Aim of this review is to underline some specific patterns of shoulder pain that are not related to musculoskeletal diseases but are manifestations of gastrointestinal, neurological, cardiological or rheumatological diseases. The most important pathologies (like gallstones, myocardial ischaemia and Parsonage-Turner syndrome...) that can manifest with shoulder pain will be presented by specialty doctors and elements for differential diagnosis will be discussed. Orthopaedic shoulder surgeons should always suspect other causes of pain, different from those related to bone, tendons and joint. If there is something unfair, patients should be referred to family doctor for further investigations in order to exclude major systemic diseases.
5、Rockwood and Matsen's The Shoulder: Expert Consult - Online and Print, 4e
Chapter 9 Fractures of the Proximal Humerus
肱骨近端骨折
Kamal I. Bohsali, MD, and Michael A. Wirth, MD
https://blog.sciencenet.cn/blog-394169-648293.html
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