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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 […]

Myotendinous Junction

The myotendinous junction is the interface between muscle and tendon, and it allows the force generated by muscle contraction to be exerted on the skeleton to enact limb locomotion. To maximize the junctional surface area, a region of highly folded membranes in a fingerlike arrangement exists.

This increases the surface area between the muscle and […]

Palpation of soft tissue

Palpation of the biceps muscle and the neurovascular structures in the cubital fossa Keep the subject’s elbow slightly flexed. Ask for an active flexion and palpate meanwhile in the cubital fossa with a pinching grip. Feel for the bicipital tendon as an outstanding taut structure. It runs distally to attach to the radial tuberosity. Medial […]

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 […]

Types of Injury to the Muscle-tendon Complex

Muscles and tendons function together as units. In principle, injuries can affect the muscle origin, the muscle belly, the point at which muscle and tendon merge (the muscle-tendon junction), the tendon itself,and the insertion of the tendon into bone and periosteum. In practice, injuries to the muscles usually occur at the muscle-tendon junction regardless of […]

Muscle Structure

The human body possesses more than 300 clearly defined muscles, comprising about 40% of the total body weight. Each muscle has an upper origin (head) and a lower insertion, with the bulky part between them (the belly) forming the actively contracting portion. The muscle is attached to bone by tendons. A skeletal muscle is composed […]