Current concepts in anterior glenohumeral instability: diagnosis and treatment

The glenohumeral joint is the most dislocated articulation, accounting for more than 50% of all joint dislocations. The reason behind shoulder instability should be investigated in detail for successful management, and the treatment plan should be individualized for all patients. Several classification systems have been proposed for glenohumeral instability. A physical exam is mandatory no matter what classification system is used. When treating patients with anterior shoulder instability, surgeons need to be aware of the critical size of the bone loss, which is commonly seen. The glenoid track concept was clinically adopted, and the measurement of the glenoid track for surgical decision-making is recommended. Detailed assessment of existing soft tissue injury to the labrum, capsule, glenohumeral ligaments, and rotator cuff is also mandatory as their presence influences the surgical outcome. Rehabilitation, arthroscopic repair techniques, open Bankart procedure, capsular plication, remplissage, Latarjet technique, iliac crest, and other bone grafts offer the surgeon different treatment options according to the type of patient and the lesions to be treated. Three-dimensional (3D) technologies can help to evaluate glenoid and humeral defects. Patient-specific guides are low-cost surgical instruments and can be used in shoulder instability surgery. 3D printing will undoubtedly become an essential tool to achieve the best results in glenohumeral instability surgery.

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Intra-articular Calcaneus Fractures: Current Concepts Review

Foot & Ankle Orthopaedics ◽

10.1177/2473011420927334 ◽

2020 ◽

Vol 5 (3) ◽

pp. 247301142092733

Author(s):

Paul R. Allegra ◽

Sebastian Rivera ◽

Sohil S. Desai ◽

Amiethab Aiyer ◽

Jonathan Kaplan ◽

...

Keyword(s):

Tissue Injury ◽

Soft Tissue Injury ◽

Treatment Strategies ◽

Late Complications ◽

Classification Systems ◽

Surgical Approaches ◽

Calcaneal Fractures ◽

Level Of Evidence ◽

Tarsal Bones ◽

Calcaneus Fractures

Calcaneal fractures are the most common fracture of the tarsal bones and represent 1% to 2% of all fractures. Roughly 75% of these fractures include intra-articular involvement of the posterior facet of the calcaneus. Intra-articular calcaneal fractures are challenging injuries to manage for both patients and surgeons given their association with both early and late complications. This article aims to review the management, classification systems, surgical approaches, and care regarding intra-articular calcaneal fractures. A review of the current literature yielded treatment strategies that aim to reduce complications such as soft tissue injury or loss of articular reduction while maintaining satisfactory clinical outcomes. The purpose of this article is to review these current concepts in the management of intra-articular calcaneal fractures. Level of Evidence: Level V, expert opinion.

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Linear Impulse Osteotome for Rhinoplasty

American Journal of Rhinology ◽

10.2500/105065896781795021 ◽

1996 ◽

Vol 10 (2) ◽

pp. 73-82 ◽

Cited By ~ 1

Author(s):

John C. Mason ◽

Stephen S. Park ◽

Charles W. Gross

Keyword(s):

Soft Tissue ◽

Tissue Injury ◽

Soft Tissue Injury ◽

Air Pressure ◽

Surgical Instruments ◽

Nasal Dorsum ◽

Accuracy And Precision ◽

Single Operator ◽

Unique Method ◽

Hump Reduction

The 2500 Impactor linear impulse osteotome (MicroAire® Surgical Instruments, Charlottesville, VA) is a new power instrument for the rhinoplasty surgeon. Air pressure drives the osteotome in linear, oscillating pulses, which allows for easy bone cuts. Dorsal hump reduction and a variety of osteotomies were performed on seven cadavers; results were compared with those from traditional osteotome and mallet. Results show equal accuracy and precision, with the degree of soft tissue injury and bone comminution being minimal by each technique. Dorsal hump reduction with the Impactor was performed in a single maneuver starting at the anterior septal angle, cutting easily through the rigid cartilaginous dorsum. The Impactor was used to perform osteotomies on two patients with nasal deformities and satisfactory reductions were achieved. The major distinction with this instrument is the tremendous ease with which bone cuts are made. Minimal pressure is needed as the Impactor advances through bone. In addition, the Impactor offers single operator use and a unique method of reducing a prominent nasal dorsum.

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3D printing in shoulder surgery

Orthopedic Reviews ◽

10.4081/or.2020.8681 ◽

2020 ◽

Author(s):

Vincenzo Campana ◽

Valentina Cardona ◽

Valeria Vismara ◽

Andrea Stefano Monteleone ◽

Piero Piazza ◽

...

Keyword(s):

3D Printing ◽

Shoulder Instability ◽

Shoulder Arthroplasty ◽

Three Dimensional ◽

Shoulder Surgery ◽

Surgical Instruments ◽

Patient Specific ◽

Anterior Shoulder Instability ◽

Glenoid Component ◽

Custom Made

Three-dimensional (3D) printing is a novel modality with the potential to make a huge impact in the surgical field. The aim of this paper is to provide an overview on the current use of 3D printing in shoulder surgery. We have reviewed the use of this new method in 3 fields of shoulder surgery: shoulder arthroplasty, recurrent shoulder instability and orthopedic shoulder traumatology. In shoulder arthroplasty, several authors have shown that the use of the 3D printer improves the positioning of the glenoid component, even if longer clinical follow-up is needed to determine whether the cost of this system rationalizes the potential improved functional outcomes and decreases glenoid revision rates. In the treatment of anterior shoulder instability, the literature agrees on the fact that the use of the 3D printing can: enhance the dept and size of bony lesions, allowing a patient tailored surgical planning and potentially reducing operative times; allow the production of personalized implants to restore substantial bone loss; restore glenohumeral morphology and instability. In orthopedic trauma, the use of 3D printing can be helpful to increase the understanding of fracture patterns, facilitating a more personalized planning, and can be used for resident training and education. We can conclude the current literature regarding the use of 3D printed models in orthopedic surgery agrees finding objective improvements to preoperative planning and to the surgical procedure itself, by shortening the intraoperative time and by the possibility to develop custom-made, patient-specific surgical instruments, and it suggests that there are tangible benefits for its implementation.

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Electrical stimulation for rehabilitation after surgery for soft-tissue injury of the knee in adults

10.1002/14651858.cd001826 ◽

2001 ◽

Cited By ~ 2

Author(s):

E Telaro ◽

S Pogliaghi ◽

D Malgrati ◽

S Green ◽

A Cunningham

Keyword(s):

Electrical Stimulation ◽

Soft Tissue ◽

Tissue Injury ◽

Soft Tissue Injury

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Auto seat restraint soft-tissue injury

American Journal of Roentgenology ◽

10.2214/ajr.148.2.458-a ◽

1987 ◽

Vol 148 (2) ◽

pp. 458-458 ◽

Cited By ~ 2

Author(s):

DR Pennes ◽

WA Phillips

Keyword(s):

Soft Tissue ◽

Tissue Injury ◽

Soft Tissue Injury

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143  Incidence of soft tissue injury and hours of daily paddock turnout in non-elite performance horses

Journal of Equine Veterinary Science ◽

10.1016/j.jevs.2021.103606 ◽

2021 ◽

Vol 100 ◽

pp. 103606

Author(s):

A.C. Reilly ◽

J.A. Bryk-Lucy

Keyword(s):

Soft Tissue ◽

Tissue Injury ◽

Soft Tissue Injury

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A Rare Complication of Tuberculous Meningitis Pediatric Anterior Glenohumeral Instability

Case Reports in Orthopedics ◽

10.1155/2012/385782 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Kerem Bilsel ◽

Mehmet Erdil ◽

Mehmet Elmadag ◽

Hasan H. Ceylan ◽

Derya Celik ◽

...

Keyword(s):

Central Nervous System ◽

Tuberculous Meningitis ◽

Shoulder Instability ◽

Rare Complication ◽

Central Nervous System Infection ◽

Arthroscopic Stabilization ◽

Anterior Instability ◽

Glenohumeral Instability ◽

Rehabilitation Protocols ◽

Anterior Glenohumeral Instability

Dislocation and instability of the shoulder joint are rare occurrences in childhood. Traumatic, infectious, congenital, and neuromuscular causes of pediatric recurrent shoulder dislocations are reported before. Central nervous system infection in infancy may be a reason for shoulder instability during childhood. This situation, which causes a disability for children, can be treated successfully with arthroscopic stabilization of the shoulder and postoperative effective rehabilitation protocols. Tuberculous meningitis may be a reason for neuromuscular shoulder instability. We describe a 12-year-old child with a recurrent anterior instability of the shoulder, which developed after tuberculous meningitis at 18 months of age. We applied arthroscopic treatment and stabilized the joint.

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