Acromioplasty for impingement with an intact rotator cuff.
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This is a retrospective review of 108 patients who underwent decompressive anterior acromioplasty for chronic impingement in the absence of a full thickness rotator cuff tear. Before operation, all the patients had had shoulder pain for at least one year despite conservative treatment. At operation, the rotator cuff tendons were explored and were intact. Anterior acromioplasty, followed by rehabilitation was successful in 87% of patients. The operation was less successful in women, in those who had diminished movement before operation, who were involved in worker's compensation claims, and whose pain followed direct trauma. Appropriate selection of patients is considered the key to success. (+info)
The coraco-acromial ligament and projection index in man and other anthropoid primates.
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The coraco-acromial ligament in man is a trait shared only with other hominoids (apes) among anthropoid primates. The associated form of the coracoid process and acromion, their lateral projections and the shape of the glenoid cavity likewise distinguish the Hominoidea. These anatomical features add credence to the view that the living hominoids share an independent ancestry within the Anthropoidea associated with the development of several unique locomotor/feeding adaptations. (+info)
Sources of innervation of the neuromuscular spindles in sternomastoid and trapezius.
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The sources of innervation of neuromuscular spindles in sternomastoid and trapezius have been investigated in rats and mice, by degeneration experiments. The entire motor supply, both extrafusal and intrafusal, to both muscles, was from the spinal accessory nerve. The sensory supply to the spindles in sternomastoid and rostral trapezius was from cervical spinal nerves, and to those in the caudal trapezius was from thoracic spinal nerves. (+info)
The operative treatment of scapular fractures.
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Fractures of the scapula occur mainly from direct trauma involving considerable violence and associated injuries of the shoulder and thorax are common. In most cases early functional treatment gives good or excellent results. Operative treatment may, however, be indicated, especially with displaced intra-articular fractures, fractures of the glenoid rim associated with humeral head subluxation, or unstable fractures of the scapular neck. Between 1967 and 1981, we treated 37 such fractures by open reduction and stable osteosynthesis. We were able to follow up 33 cases (89%), of which 21 (64%) had complete functional recovery. The other 12 had varying degrees of pain, loss of mobility, and weakness. Overall, however, 79% of the patients had good to excellent results. (+info)
The 'hooked' acromion revisited.
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Examination was made of 750 scapular dry bone specimens from museum collections and 80 cadaver shoulders. Hooking of the acromion was not found in subjects under the age of 30 years. The hooked configuration developed at later ages in an increasing proportion of subjects as a result of calcification of the acromial attachment of the coracoacromial ligament. (+info)
Os acromiale: anatomy and surgical implications.
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We examined 270 scapular bones and found an incidence of os acromiale of 8.2%. In most cases, the free fragment was approximately one-third of the overall length of the acromion, and included the acromioclavicular facet and the principal areas of attachment of the coracoacromial ligament. Two-thirds of the specimens showed a distinctive pattern of osteophytic lipping. Based on this study, we devised operative procedures for symptomatic patients, and operated upon seven, with good results in six. (+info)
Comparison between open and arthroscopic acromioplasties: evaluation of absenteeism.
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OBJECTIVE: To evaluate the rate of absenteeism from work in patients who had undergone open or arthroscopic acromioplasty. DESIGN: A retrospective case series. SETTING: A university hospital. PATIENTS: Eighteen patients with excellent results after open acromioplasty performed by one orthopedic surgeon and 20 patients with excellent results after arthroscopic acromioplasty performed by another orthopedic surgeon. MAIN OUTCOME MEASURE: The time between operation and return to work. RESULTS: There were no statistical differences between the two techniques with respect to the return to work, age, sex and type of work. The overall time off work averaged 203 days (range from 42 to 840 days) for the arthroscopic group compared with 144 days (range from 60 to 540 days) for the open group. CONCLUSIONS: Open acromioplasty, a safe and reliable procedure for the general orthopedic surgeon, is associated with a shorter, thought not significant, delay in return to work than the arthroscopic technique. (+info)
The anatomy of the anterior origin of the deltoid.
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We studied the origin of the anterior deltoid from the lateral third of the clavicle and the leading anterior edge of the acromion in 18 cadaver shoulders by anatomical and histological methods. The main origin of the deltoid was from the superior surface of the anterior acromion, but muscle and tendinous attachments were also seen on the entire anterior surface of the acromion, its anteroinferior surface and on the whole width of the anterior surface of the clavicle. Mock arthroscopic acromioplasty was shown to detach deltoid fibres from the anterior surfaces, leaving the superior attachment in continuity. Potentially, arthroscopic subacromial and clavicular resection can detach deltoid fibres originating from the anterior and anteroinferior surfaces of the acromion and clavicle and thus weaken the anterior deltoid. (+info)