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Humeral Bone Deficiency

Humeral head defects are commonly present in patients with shoulder instability. The defects are usually small and carry the eponym Hill-Sachs lesion when secondary to anterior instability and reverse Hill-Sachs lesions when secondary to posterior instability.

Although quite ubiquitous in recurrent anterior shoulder instability, the management of large Hill-Sachs defects remains controversial especially in […]

Physical Findings

A systematic evaluation includes observation for abnormal motion patterns and atrophy, palpation to localize painful areas, assessment of both active and passive range of motion, measurement of strength of the rotator cuff, deltoid and scapular stabilizer muscles, neurovascular examination, and finally provocative testing maneuvers for instability. It is important to examine the opposite shoulder for […]

Biomechanics of Shoulder Stability-Static Stability Factor

The glenohumeral joint is inherently unstable, with the large humeral head articulating with the small and shallow glenoid. Static stability is provided by the orientation of the articular surfaces, the articular conformity of humerus and the glenoid, the glenoid labrum, the negative intra-articular pressure, the adhesion-cohesion of synovial joint fluid, and the glenohumeral joint capsule […]

Scapula

The scapula is a flat, triangular-shaped bone that serves as the articulating surface for the head of the humerus as well as provides areas for 17 muscle attachments. With the arm at the side, the scapula overlaps the dorsal surfaces of the second to seventh ribs. It has three prominent projections: the spine, the coracoid […]

Palpation of the subscapularis tendon

The subscapularis muscle belly can only be reached by bringing the hand in between the scapula and the thorax. It cannot really be palpated. The tendinous insertion on the lesser tuberosity, however, can easily be palpated. The subject is in a half lying position on a couch, the upper arm along the body and the […]

Tear and Inflammation of the Deltoid Muscle

Tears of the deltoid muscle, though infrequent, do occur in team handball and volleyball players, American footballers, weightlifters, wrestlers, and other athletes. The muscle is damaged in most cases by direct impact, but it can also be injured by overuse. The tear affects only a small part of the muscle, making it difficult to raise […]

Injury of the Subscapularis Tendon

Injury of the subscapularis tendon

The subscapularis muscle (which originates on the inner surface of the scapula, runs anterior to the shoulder joint, and is inserted high into the anterior aspect of the head of the humerus) is the most important internal rotator of the upper arm. Its tendon can be affected by partial or […]

Classification of Tendon Injuries

‘Tendinitis’ has been the clinical term traditionally applied to virtually all painful tendon structures, including the tendon, the synovial sheath, and the adjacent bursa. It has, however, been established that there is only a limited inflammatory response in the tendon to injury. Injuries are most often associated with a degenerative process, which increases with age […]

Unicameral Bone Cyst

Basics

Description A benign membrane-lined, fluid-filled lesion of bone that develops in childhood and fills in by maturity Location: 80% occur in the proximal humerus and proximal femur. Other, less common, areas are the proximal tibia, distal tibia, distal femur, calcaneus, distal humerus, radius, fibula, ilium, ulna, and rib. Usually centrally located adjacent to the […]

Humeral Shaft Fracture

Basics Description Fractures of the diaphysis (shaft) of the humerus Occur at all ages Classification: AO classification method Anatomic location: Proximal 1/3 of the shaft Medial 1/3 of the shaft Distal 1/3 of the shaft Fracture characteristics: Fracture pattern (transverse versus oblique versus comminuted) Fractures may be open or closed. Pathologic (secondary to underlying […]