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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 […]

Clinical Evaluation

The most common mechanism for sustaining a pectoralis muscle injury is from weight-lifting or athletics. Wolfe et al.It described the transition period from eccentric loading to concentric loading (bench press position) as the most stressful to the inferior muscle fibers of the pectoralis muscle. The patient typically presents after sudden onset of pain in the […]

Anatomy

The anatomy of the pectoralis major muscle demonstrates two distinctively different parts—the clavicular head and the sternal head . We feel that when evaluating injuries to the pectoralis it is important to understand the anatomy of the pectoralis major muscle complex.

Unfortunately, many of the published reports never comment on this difference, or describe it […]

Pathoanatomy

Before describing the mechanics of rotator cuff pathology, post-mortem studies provide an interesting backdrop to the issue of etiology. There is little doubt that rotator cuff tearing is a function of age among other factors. Post-mortem studies have indicated an incidence of full or partial thickness tears ranging from 5% to nearly 40% . Fukuda […]

Principles of Instability Surgery

The goal of treatment in both open and arthroscopic instability surgery is twofold: to restore the labrum to its anatomic attachment site and to re-establish the appropriate tension to the inferior capsuloligamentous complex of the joint. Cadaveric studies have shown that both the labrum and the capsule must be injured for a dislocation to occur.

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Anterior drawer test in external rotation

Positioning.

The subject is positioned as for the previous test. The lower leg and foot are externally rotated as far as is comfortably possible.The examiner places both hands around the upper part of the tibia with the index fingers on the hamstring tendons and the thumbs at the anterior border of the joint .

Procedure. […]

Knee extension mechanism injuries

The knee extension mechanism includes the quadriceps muscle-tendon, the patellar bone, the patellar tendon, and its insertion into the tibia. Injuries can occur in all these structures.

Quadriceps tendon injuries The distal quadriceps tendon attaches to the patella and its adjacent soft tissue structures (the retinaculum). It is important for the extensor mechanism. This tendon […]

Dislocation of PIP Joint

Dislocation of the PIP joint is a common injury which often affects team handball, basketball and volleyball players, and cricketers. In 80% of cases it is the little finger that is damaged. The most common mechanism of injury is axial loading and hyperextension of the joint causing dorsal dislocation (dislocation upwards and backwards). The dorsal […]

Anterior elbow injuries

Rupture of the distal part of the biceps tendon

The biceps tendon inserts distally into the radial tuberosity in the proximal forearm. It is responsible for flexion in the elbow and also for some supination. The tendon is susceptible to degenerative changes and ruptures occur in athletes over 35 years old. The injury mechanism is […]

Insertionitis (Tenoperiostitis)

Attachment of a muscle to bone involves a gradual transition from muscle-tendon to cartilage and from mineralized cartilage to bone. Bone-tendon junctions are poorly supplied with blood because the fibrocartilage creates a ‘barrier’; this may explain why these injuries often take a long time to heal and may become chronic.

Inflammation of the muscle-tendon attachment […]