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Operative Treatment for Adhesive Capsulitis

Manipulation Under Anesthesia

Manipulation under anesthesia (MUA) has been used to treat adhesive capsulitis for many years. This treatment has commonly been described to prospective patients as “stretching the tight capsule” or “breaking up adhesions” within the shoulder joint. Arthroscopic visualization of the glenohumeral joint after this procedure, however, reveals that a MUA does not […]

Demographic Factors Associated with Adhesive Capsulitis

Adhesive capsulitis is commonly observed in patients during their fifth and sixth decades of life with an incidence of 2% to 5% in this age group, and a greater frequency in women than men. There is an increased occurrence in patients having suffered closed head injuries (as high as 25%), Parkinson disease (13%), autonomic disorders […]

Adhesive Capsulitis

Key Points

True shoulder stiffness is the loss of passive range of motion in the shoulder. Many patients who complain of stiffness do not have true shoulder stiffness. Rather, they have pain and inflammation, and because movement results in discomfort, they guard against painful movement and appear to have lost range of motion. Stiffness arising […]

Spine Fusion

Basics Description Spine fusion is a surgical procedure that causes 2 or more vertebral levels to be joined with solid bony healing in the spine. It is performed to correct spinal instability from traumatic, degenerative, or iatrogenic causes and to prevent spinal deformity progression. Epidemiology Incidence Over the last 2 decades, the incidence of […]

Shoulder/Proximal Humerus Fracture

Basics Description The proximal humerus consists of the articular surface of the shoulder joint and the attachments of the rotator cuff to the greater and lesser tuberosities. Most of the blood supply to the humeral head comes from the anterior humeral circumflex branch of the axillary artery. >90% of proximal humeral fractures result from […]

Septic Arthritis

Basics Description Septic arthritis is an infection of the joint. In infants, the capillaries penetrating the physeal plate into the epiphysis persist until age 18 months, so spread of infection may occur from the metaphysis indirectly to the epiphysis and then to the joint. Possible irreparable damage to growth plate occurs. Classification: Polyarticular septic […]

Quadriceps Tendon Rupture

Basics Description Rupture of the quadriceps tendon (knee extensor mechanism) results in an inability to extend the leg. In patients >40 years old, rupture may be secondary to tendon degeneration. Classification: Complete versus incomplete General Prevention Stretching before athletics and thigh-strengthening exercises in patients with chronic tendinitis could provide some protection. Epidemiology A rare […]

Posterior Tibial Tendon Rupture

Basics Description PTT dysfunction or rupture is the most common cause of adult acquired flatfoot deformity. A working knowledge of the anatomy and function of the PTT in the normal foot is necessary to understand the pathophysiology that results from dysfunction. Origin: Posterior aspect of the tibia, the fibula, and the interosseous membrane Course: […]

Friedreich Ataxia

Basics Description Friedreich ataxia is an uncommon, heritable disorder causing progressive spinocerebellar degeneration. Scoliosis, ataxia, and foot deformities are the most common findings. Systems affected: Central nervous system; Heart; Skeleton Classification: No subclassifications are used in Friedreich ataxia. It is classified under the category spinocerebellar degeneration, and it is the most common example of […]

Claw Toes

Basics Description The term claw toes describes a hyperextension deformity of the MTP joint of the lesser toes with flexion deformity of the PIP joint . General Prevention Use of appropriate shoe wear (wide shoes with a high toe box) can prevent the development of claw toes in many cases. Epidemiology Incidence Increases with […]