scholarly journals Rapid Destruction of the Humeral Head Caused by Subchondral Insufficiency Fracture: A Report of Two Cases

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Kenichi Goshima ◽  
Katsuhiko Kitaoka ◽  
Junsuke Nakase ◽  
Hiroyuki Tsuchiya
Keyword(s):  
Shoulder Pain ◽  
Humeral Head ◽  
Elderly Women ◽  
Total Shoulder Arthroplasty ◽  
Insufficiency Fracture ◽  
Joint Destruction ◽  
Acute Onset ◽  
Joint Effusion ◽  
Left Shoulder ◽  
Rapid Destruction

Rapidly destructive arthritis (RDA) of the shoulder is a rare disease. Here, we report two cases, with different destruction patterns, which were most probably due to subchondral insufficiency fractures (SIFs). Case 1 involved a 77-year-old woman with right shoulder pain. Rapid destruction of both the humeral head and glenoid was seen within 1 month of the onset of shoulder pain. We diagnosed shoulder RDA and performed a hemiarthroplasty. Case 2 involved a 74-year-old woman with left shoulder pain. Humeral head collapse was seen within 5 months of pain onset, without glenoid destruction. Magnetic resonance imaging showed a bone marrow edema pattern with an associated subchondral low-intensity band, typical of SIF. Total shoulder arthroplasty was performed in this case. Shoulder RDA occurs as a result of SIF in elderly women; the progression of the joint destruction is more rapid in cases with SIFs of both the humeral head and the glenoid. Although shoulder RDA is rare, this disease should be included in the differential diagnosis of acute onset shoulder pain in elderly female patients with osteoporosis and persistent joint effusion.

Severe Referred Shoulder Pain Following Revision Fundoplication From a Stich on the Diaphragm

2021 ◽  
pp. 000313482110111
Author(s):  
Kevin J. Gale ◽  
Santana Sanchez ◽  
Thomas J. Sorenson ◽  
Todd D. Elftmann
Keyword(s):  
Hiatal Hernia ◽  
Shoulder Pain ◽  
Medical Management ◽  
Nissen Fundoplication ◽  
Left Shoulder ◽  
Toupet Fundoplication

Complications following fundoplication surgery for hiatal hernias are rare. Herein, we present the case of a 61-year-old woman who underwent a Nissen fundoplication, complicated by dysphagia, and a revision modified Toupet fundoplication for a hiatal hernia, after which she began to experience severe prandial referred left shoulder pain that was refractory to medical management. We hypothesized that a diaphragmatic suture placed during the revision fundoplication could be the source of the pain, and we elected to remove the suture, resulting in resolution of the pain. This pain remained resolved at the most recent follow-up on postoperative week six, and the patient had no further concerns.

Static posterior humeral head subluxation and total shoulder arthroplasty

2009 ◽  
Vol 18 (4) ◽  
pp. 505-510 ◽  
Author(s):  
Christian Gerber ◽  
John G. Costouros ◽  
Atul Sukthankar ◽  
Sandro F. Fucentese
Keyword(s):  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Total Shoulder Arthroplasty

The role of eccentric and offset humeral head variations in total shoulder arthroplasty

2013 ◽  
Vol 22 (7) ◽  
pp. 886-893 ◽  
Author(s):  
Adam Sassoon ◽  
Bradley Schoch ◽  
Peter Rhee ◽  
Cathy D. Schleck ◽  
William S. Harmsen ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Total Shoulder Arthroplasty

Postarthroscopic Humeral Head Osteonecrosis Treated With Reverse Total Shoulder Arthroplasty

Orthopedics ◽  
2013 ◽  
Vol 36 (3) ◽  
pp. e377-e380 ◽  
Author(s):  
Matthew F. Dilisio ◽  
Jeffrey S. Noble ◽  
Robert H. Bell ◽  
Curtis R. Noel
Keyword(s):  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder

scholarly journals Geometric Morphology of the Coracoacromial Ligament: A Cadaveric Study

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Mehmet Demir ◽  
Bülent Güneri
Keyword(s):  
Statistical Analysis ◽  
Shoulder Pain ◽  
Humeral Head ◽  
Common Knowledge ◽  
Coracoid Process ◽  
Coracoacromial Ligament ◽  
Death Time ◽  
The Mean ◽  
Geometric Morphology ◽  
Digital Caliper

The coracoacromial ligament (CAL), which restrains superior displacement of humeral head, connects the acromion and coracoid process. Due to the ligament’s variations and its role in shoulder pain, CAL was investigated in this study. Sixty shoulders of 34 cadavers, from persons aged 61-98 (80.95 ± 8.81) years at death time, were dissected. The lengths of lateral (LBL) and medial borders (MBL), widths of acromial (AIW) and coracoid insertions (CIW), and thicknesses of lateral (LSTAI) and medial (MSTAI) sides of acromial insertions were measured by digital caliper. The data were subjected to statistical analysis. 24 (40%) V-shaped, 12 (20%) broad-banded, 9 (15%) quadrangular, 9 (15%) Y-shaped, and 6 (10%) multiple-banded types were identified. The mean total LBL, MBL, AIW, CIW, LSTAI, and MSTAI were 34.94 ± 4.59 mm, 33.58 ± 5.31 mm, 29.82 ± 9.48 mm, 12.62 ± 3.95 mm, 1.29 ± 0.17 mm, and 0.90 ± 0.22 mm, respectively. The mean LBL (39.12 ± 4.29 mm), MBL (36.48 ± 3.9 mm), and CIW (37.01 ± 3.39 mm) were significantly greatest in quadrangular type (p<0.001). The mean AIW was slightly greatest in quadrangular type (p=0.069). The mean LSTAI was significantly greatest in multiple-banded type (1.45 ± 0.10 mm, p<0.001) whereas the mean MSTAI was significantly greatest in quadrangular type (1.23 ± 0.23 mm, p<0.001). CAL is quite variable regarding morphology, dimensions, and insertion features. Despite common knowledge, MSTAI and MBL of CAL can be greater than lateral counterparts in some types. To obtain complete release of CAL at acromion, the clearance of ligament fibers in an area with the dimensions of around 16 mm in mediolateral and 15 mm in anteroposterior direction, beginning from the lateral edge of acromial insertion, is recommended.

A Rake’s Progress

2020 ◽  
pp. 169-174
Author(s):  
Pat Croskerry
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Shoulder Pain ◽  
Heart Attack ◽  
Correct Diagnosis ◽  
Uneventful Recovery ◽  
Left Shoulder ◽  
Loss Of Consciousness ◽  
Middle Aged ◽  
Rake's Progress

This case discusses a middle-aged male who experiences abdominal pain and loss of consciousness at a mall. His wife believes he is having a heart attack and rushes him to a nearby emergency department. He is also experiencing some left shoulder pain and diaphoresis, which is misinterpreted at triage. This communication error leads to him being misassigned to a cardiac area. Eventually, the correct diagnosis is made, and the patient makes an uneventful recovery.

scholarly journals Rapid Destructive Arthrosis Due to Subchondral Insufficiency Fracture of the Shoulder: Clinical Characteristics, Radiographic Appearances, and Outcomes of Treatment

Diagnostics ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 885
Author(s):  
Chul-Hyun Cho ◽  
Byung-Woo Min ◽  
Kyung-Jae Lee ◽  
Jun-Young Kim ◽  
Du-Han Kim
Keyword(s):  
Bone Marrow ◽  
Clinical Characteristics ◽  
Bone Marrow Edema ◽  
Insufficiency Fracture ◽  
Joint Effusion ◽  
Radiographic Appearance ◽  
Subchondral Insufficiency Fracture ◽  
Subchondral Fracture ◽  
The Mean ◽  
Marrow Edema

The purpose of our study was the clinical characteristics, radiographic appearance, and outcomes after treatment in patients with rapid destructive arthrosis (RDA) due to subchondral insufficiency fracture (SIF) of the shoulder. Twenty-two cases of RDA of the shoulder were retrospectively reviewed. Clinical outcomes for 15 cases who underwent shoulder arthroplasty were evaluated at an average of 41.4 months. The mean age of patients was 73.7 years (range 50–83 years), and there were 20 women and 2 men. The mean time from onset of symptoms to head collapse was 6.8 months (range 1–12 months). The mean t-score of bone mineral density was −3.1. Nine patients had pseudoparalysis. Based on radiographic appearance, a diversity of types of head destruction with subchondral fracture, bone marrow edema, joint effusion, and synovitis were observed in all cases. In conclusion, RDA due to SIF of the shoulder, presenting with severe short-term pain and functional disability, commonly occurred in elderly women with bone fragility. MRI revealed bone marrow edema, extensive joint effusion, and synovitis as well as a diversity of types of head destruction with subchondral fracture within several months from onset of symptoms.

scholarly journals Near-simultaneous bilateral reverse total shoulder arthroplasty for the treatment of bilateral fracture dislocations of the shoulder

2019 ◽  
Vol 12 (10) ◽  
pp. e230212 ◽  
Author(s):  
Alexander Wendling ◽  
Matthew L Vopat ◽  
Shang-You Yang ◽  
Bradley Saunders
Keyword(s):  
Shoulder Arthroplasty ◽  
Treatment Plan ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Left Shoulder ◽  
Fracture Dislocations ◽  
Bilateral Fracture ◽  
Reverse Total Shoulder

A man in his mid-80s presented with bilateral posterior fracture dislocations of the humerus after suffering a seizure. He had Parskinson’s disease and lived with his wife at home. His left shoulder was not felt to be reconstructable. The initial treatment plan was to perform reverse total shoulder arthroplasty (rTSA) on the left and non-operatively reduce his right shoulder. A left rTSA was performed, but his right shoulder was unstable due to a glenoid fracture and soft tissue instability. In order to preserve the patient’s quality of life, a right rTSA was performed 4 days later. In the follow-up period, the patient was able to regain enough pain-free range of motion on activities of daily living. The patient died from complications of Parkinson’s disease 10 months postoperatively.

scholarly journals Eccentric Reaming for B2 Glenoids: History, Preoperative Planning, Surgical Technique, and Outcome

2019 ◽  
Vol 3 ◽  
pp. ???
Author(s):  
Matthew J Smith ◽  
Christopher M Loftis ◽  
Nathan W Skelley
Keyword(s):  
Surgical Technique ◽  
Cortical Bone ◽  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Preoperative Planning ◽  
Total Shoulder Arthroplasty ◽  
Joint Line ◽  
Neutral Position ◽  
Anterior Portion ◽  
Surgical Options

Background The biconcave (B2) glenoid is characterized by preservation of the anterior portion of the native glenoid with asymmetric wear of the posterior glenoid. Surgical options for glenoid correction have evolved. The goal of shoulder arthroplasty is to place the implants in such a manner to return the humeral head to a centered position and restore the joint line to a neutral position. There is no current consensus on method of treatment and correction. Methods The current and historical literature on total shoulder arthroplasty was used to examine technique viability. Results Asymmetric remaining can be used to address up to 15° of version correction without compromise of cortical bone. It is important to have the proper presurgical planning, to understand the limitations of correction, and to have other options available to treat the biconcave glenoid.

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