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Treatment Options

The past treatment of pectoralis major ruptures has been controversial. There have been studies advocating conservative treatment, some operative repair , and several have included both in their descriptions . More recently, most authors advocate early repair of these injuries . The pectoralis major functions to adduct, forward flex, and internally rotate the shoulder.

Several […]

Basic Science-Anatomy

The anatomy of the LHB has been thoroughly examined and little controversy exists in this realm. The LHB originates at and around the supraglenoid tubercle. Although it is intra-articular, it is extrasynovial. Its blood supply is dependant on the portion of tendon in question.

The proximal and middle portions receive blood supply from branches of […]

Subscapularis Deficiency

Rupture of the subscapularis after an anterior open instability repair causes significant functional disability, which may or may not be associated with recurrence of instability.

Often such tears go unrecognized when patients present postoperatively with weakness and pain but no clear evidence of recurrent instability. A high index of suspicion and a careful physical examination […]

Resisted flexion of the elbow

Positioning.

The subject stands with the arm alongside the body, the elbow bent to a right angle and the forearm in full supination. The examiner stands level with the subject’s hand.One hand is on top of the shoulder and the other on the distal aspect of the forearm.

Procedure. Resist the subject’s attempt to […]

Resisted internal rotation

Positioning.

The subject stands with the upper arm against the body and the elbow flexed to a right angle. The forearm is held in the sagittal plane, so keeping the shoulder in a neutral position. The examiner stands level with the subject’s arm. He places one hand on the opposite shoulder and the other hand […]

ISOMETRIC CONTRACTIONS

Resisted adduction Positioning.

The subject stands with the arm hanging and slightly abducted. The examiner stands level with the subject’s arm. He places one hand against the ipsilateral hip and the other hand against the inner aspect of the elbow. Procedure.

Resist the subject’S attempt to adduct her arm. Common mistakes:

• The […]