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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 […]

Proximal Humerus Fractures

Few areas of fracture management have been the subject of as much controversy, new information, and revisionist thinking as the management of proximal humerus fractures. Proximal humerus fractures account for 2% to 4% of all upper extremity fractures. They occur most often in older patients and represent complex injuries often including bony fragment displacement associated […]

Suture Anchor Technique

Tenodesis with suture anchors was first described by Gartsman and Hammerman and subsequently by Nord et al. Each used suture anchors inserted in different locations to obtain fixation to the proximal humerus or the greater tuberosity. Two suture anchors are inserted through the subclavian portal (Nord) or from the anterior portal (Gartsman). The method described […]

Basic Science-Anatomy and Biology

The rotator cuff consists of the supraspinatus, infraspinatus, teres minor, and subscapularis muscles, all of which arise from the scapula and insert into the proximal humerus. The subscapularis muscle is innervated by the upper and lower scapular nerves, and arises from the anterior surface of the scapula, inserting into the lesser tuberosity.

The nerve supply […]

Anesthesia and Positioning for Arthroscopy

Interscalene regional blockade has been effective in providing early postoperative pain relief and in decreasing overall narcotic requirements following surgery . Following adequate preoperative anesthesia, the choice of patient position (either beach-chair or lateral decubitus) must be tailored to the surgeon such that comprehensive visualization and repair of the pathologic structures are not compromised.

Lateral […]

Humerus

The proximal humerus is composed of the humeral head, the lesser and greater tuberosities, the bicipital groove, and the proximal humeral shaft, and it is highly variable. The anatomical neck lies at the junction of the articular surface of the head and the greater tuberosity and humeral shaft. The surgical neck lies below the greater […]

Shoulder Anatomy and Biomechanics

Key Points

The shoulder complex is composed of three bones—the clavicle, the scapula, and the humerus—as well as four articulations—the acromioclavicular (AC), the sternoclavicular (SC), the scapulothoracic, and the glenohumeral (GH) joints. The clavicle serves a variety of functions. It acts as a rigid base for muscular attachments of the shoulder, neck, and chest. It […]

Pectoralis Muscle Rupture

SYMPTOMS

Sudden onset of localised pain in the anterior part of the shoulder and upper arm after excessive abduction and external rotation such as in a rugby tackle. There is weakness on internal rotation and forward flexion.

AETIOLOGY

The pectoralis muscle insertion at the upper humerus or muscle bulk can rupture partially or completely.

CLINICAL […]

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 […]

Giant Cell Tumor

Basics Description A benign but often locally aggressive neoplasm, characterized by large numbers of uniformly distributed, osteoclastlike giant cells and a background population of plump, epithelioid-to-spindle mononuclear cells. The vast majority of these tumors are located near the articular end of a tubular bone; ~50% occur in the knee. Other frequently involved sites: Distal […]