Specialists

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Clinical Evaluation-Radiographic Evaluation

Accurate radiographic evaluation of the fracture of the proximal humerus is essential for diagnosis and treatment. The trauma series is still the standard initial method for evaluating proximal humeral fracture. This consists of anteroposterior (AP) view of the scapula, a lateral, Y-view of the scapula, and axillary view. This series allows evaluation of the fracture […]

Basic Science-Anatomy and Biomechanics

The humerus is the largest bone of upper extremity. The proximal humerus is composed of the humeral head, the greater and lesser tuberosities, the anatomic and surgical necks of the humerus. The humeral head is the most proximal, ball-like region of the humerus that is retroverted (28 to 40 degrees) and articulates with the glenoid […]

Allograft Tissues

Allograft tissues have been employed to reconstruct a variety of joint surfaces, and the humerus is certainly no different. The use of smaller focal defects, however, is not extensively described in the literature with the exception of a few case series. In one study, Gerber et al.It employed a large segmental humeral head allograft to […]

Autologous Tissues

The use of autologous tissues about the knee has been commonplace for several years, and has included the transplantation of local tissue, transfer of remote tissue, and finally the genetic production of cloned tissue from knee cartilage cells .

A technique that has been used in the knee is transfer of autologous tissue from other […]

Diagnosis of Cartilage Lesions

Much effort has been directed at the development of imaging techniques that effectively diagnose cartilage lesions in the shoulder. The thrust of the research has employed a variety of magnetic resonance imaging techniques to delineate not only the actual lesions, but also something about their physiology.

It is well established that cartilage functions as the […]

Impact of Cartilage Lesions

The spectrum of pathology includes a gradation in the severity of cartilage damage beginning with simple delamination of a small area and ending with complete degeneration of the articular surfaces, i.e., osteoarthritis.

Although the glenohumeral joint surface geometry historically has been considered less of a stabilizing factor as a result of the smaller surface area […]

Biceps Tendon Rupture

Although acute ruptures of the LHB do occur, they are more commonly the end result of chronic biceps tendinitis. Acute ruptures can occur with a violent force placed on the LHB such as with a fall on an outstretched hand. Another traumatic event, which can cause significant damage to the LHB, is rapid deceleration of […]

Massive Rotator Cuff Tears

These tears usually exceed 4 to 5 cm in dimension, but can be deceiving. Clearly a tear retracted in a lateral to medial direction of 5 cm presents as a very challenging repair whereas a tear extending 5 cm in an anterior to posterior direction without significant retraction is a much easier surgical problem to […]

Partial Thickness Rotator Cuff Tears: Treatment

It is important to understand that not all full thickness rotator cuff tears are alike, and that some complete tears are compatible with excellent function and minimal discomfort. Armed with biomechanical models, basic engineering principles, and kinematic studies of patients with known rotator cuff tears, Burkhart defined the “functional rotator cuff tear.”

His reasoning was […]

Diagnostic Imaging

It is essential that the initial evaluation of the painful shoulder include quality plain radiographs. The standard radiographs should include a true anterior-posterior view with the shoulder in the internal and neutral position, an axillary view, and the outlet (supraspinatus) view described by Neer and Poppen, which is used to evaluate and classify acromial morphology […]