OBJECTIVETo explore operative method for the treatment of double injuries of superior shoulder suspensory complex (SSSC).

METHODSFrom January 2008 to March 2010,11 patients wiht SSSC injuries were treated, including 9 males and 2 females with an average age of 38 years (ranged from 20 to 47 years). The patients were treated with 4 methods as follows: 4 patients with fractures of neck of scapula combined with homolateral fracture of clavicle were treated with reconstituted plates; 2 patients with fractures of coracoid process or disruption of coracoclavicular ligament combined with the fracture of extremitas acromialis claviculae or acromioclavicular dislocation were treated with clavicular hook plates and cannulated compression screws; 3 patients with injuries of basilar part of acromial process combined with the glenoid cavity and acromioclavicular articulation were treated with reconstuction plates and clavicular hook plates; 2 patients with fractures of acromial process combined with acromioclavicular dislocation and the fracture of lateral third of clavicle were treated with small "T" plates and clavicular hook plates.

RESULTSAmong 11 patients, 9 patients were followed up with an average duration of 9.2 months (ranged from 6 to 12 months). All the fractures were healed without bone nonunion or failure of internal fixators. The average union time was 2.6 months. The profile of articulatio capitis humeri was normal and hibateral articulatio capitis humeri was symmetrical without crispation, descensus, adduct and adtorsion of articulatio capitis humeri or other abnormity. According to the Constant-Murley evaluation system, the score ranged from 69 to 100, with an average of 89.7, which included average pain score of 10 to 15, daily activities score of 14 to 20, myodynamia score of 15 to 25, territory score of 34 to 40.

CONCLUSIONThe double injuries of SSSC should be treated by types to recover the integrity and constancy of SSSC.

Acromioclavicular Joint ; injuries ; Adult ; Female ; Humans ; Male ; Middle Aged ; Shoulder Dislocation ; surgery ; Shoulder Joint ; injuries

Arthroscopy ; methods ; Humans ; Knee Injuries ; surgery ; Shoulder Joint ; injuries

Arthroplasty, Replacement ; methods ; Clavicle ; injuries ; Fractures, Bone ; surgery ; Humans ; Joint Instability ; surgery ; Shoulder Fractures ; surgery ; Shoulder Injuries ; Shoulder Joint ; surgery

Superior labrum anterior posterior (SLAP) injury is a major challenge for orthopedic surgeons, due to the poor healing ability of the injured labrum. Although arthroscopic surgery is the gold standard for the treatment of SLAP injury, there are still disputes about the adaptation of different surgical techniques, the choice of anchors during operation, knotted or knotless anchors, and fixation methods. The authors believe that arthroscopic repair of SLAP lesions is effective for young patients with intact glenoid labrum(<35 years old) or with extensive activity, where single and knotless anchor is preferred. For the older patients(≥35 years old) with degeneration and wear of glenoid labrum, biceps tenodesis is more preferable, and interference screw fixation technique is recommended. As for patients with failed SLAP repair, biceps tenodesis can achieve a high success rate as a revision surgery. By review of the relevant literature in recent years, this paper summarizes the adaptation of different surgical methods of arthroscopic treatment of SLAP injury, intraoperative anchoring techniques, fixation methods and other improved surgical techniques.
Humans ; Adult ; Shoulder Joint/surgery* ; Arthroscopy/methods* ; Tendon Injuries/surgery* ; Shoulder Injuries/surgery* ; Tenodesis/methods*

Biomechanical Phenomena ; Humans ; Rotator Cuff ; Rotator Cuff Injuries ; Shoulder Joint

Fractures of the humeral neck are relatively common, but their anatomical complexities make closed reduction difficult sometimes, and in case of reduction it is tough to maintain the position. Even open reduction of the fracture also faces multiple problems including poor functional recovery of the shoulder joint. The Department of Orthopedic Surgery of Seoul Adventist Hospital developed a device of external fixation for 13 humeral neck fractures. We used this method for displaced and unstable fractures of humeral neck from December 1987 to March 1989. Satisfactory results were obtained in 11 cases and poor results in 2 cases. We think our method is a effective useful way of treatment for humeral neck fractures, and its main advantages are as follows:1. Using proximal and distal bars, fracture can be easily reduced and firmly maintained. 2. Active motion exercise can be started early and functional recovery of the shoulder joint can be highly predictable. 3. It is quite convenient for treating combined fracture or external wound of same extremity.
Extremities ; Methods ; Neck ; Orthopedics ; Seoul ; Shoulder Joint ; Wounds and Injuries

PURPOSE: The purpose of this study is to determine whether adding an angled oblique sagittal plane to the routine shoulder MRI improves the diagnostic performance in the evaluation of supraspinatus tendon tears with arthroscopic correlation. MATERIALS AND METHODS: The study included 121 patients who had a shoulder MRI followed by arthroscopy. Two radiologists separately evaluated the supraspinatus tendon for tears on shoulder MRI either with or without the angled oblique sagittal images. Arthroscopy was used as the reference standard. The sensitivity and specificity for diagnosing supraspinatus tendon tears were calculated and compared by using McNemar test. Interobserver and intertechnique variability in the interpretation of supraspinatus tendon tears were calculated as a kappa value. RESULTS: Adding the angled oblique sagittal images to the standard shoulder MRI showed improvement in the sensitivity for diagnosing full-thickness supraspinatus tendon tears and also in the sensitivity, specificity and accuracy for the detection of partial-thickness tears. However, there was no statistically significant difference in all of them between with and without the angled set. Interobserver agreement was substantial to almost perfect and intertechnique agreement was moderate. CONCLUSION: Adding an angled oblique sagittal plane image to the routine shoulder MRI showed no significantly different diagnostic performance in detecting the partial- and full-thickness supraspinatus tendon tears, compared to MRI without angled oblique sagittal plane.
Arthroscopy ; Humans ; Magnetic Resonance Imaging* ; Rotator Cuff ; Sensitivity and Specificity ; Shoulder Joint ; Shoulder* ; Tendon Injuries ; Tendons*

variety of sports activities can result in shoulder injuries either by an accidental strong trauma or by repetitive but cumulative stress for a long period. Based on the huge amount of basic or clinical researches, several mechanisms of repetitive injuries have been suggested: subacromial (external) impingement, internal impingment, and scapular dyskinesia, which are believed to cause or, at least, contribute to the development of rotator cuff injuries, superior labrum anterior posterior lesions, and shoulder intabilities. It has been reported that the pain and disabilities of the shoulder injuries could be prevented or minimized by an appropriate rehabilitation program especially undertaken in the early phase of dysfunctions or injuries. The core components of the rehabilitation program include stretching of the posterior glenohumeral joint capsule, scapular stabilizing exercise, and strengthening the rotator cuff muscles. It is crucial to proceed onto the proper steps of the rehabilitation program as the functional recovery progresses. To gain a strong and sound biomechanics not only on the shoulder but also for the whole body kinetic chain would be the most important factor for the injured athlete to regain his or her previous athletic activities.
Athletes ; Athletic Injuries ; Biomechanics ; Dyskinesias ; Humans ; Muscles ; Rotator Cuff ; Shoulder ; Shoulder Joint ; Sports

variety of sports activities can result in shoulder injuries either by an accidental strong trauma or by repetitive but cumulative stress for a long period. Based on the huge amount of basic or clinical researches, several mechanisms of repetitive injuries have been suggested: subacromial (external) impingement, internal impingment, and scapular dyskinesia, which are believed to cause or, at least, contribute to the development of rotator cuff injuries, superior labrum anterior posterior lesions, and shoulder intabilities. It has been reported that the pain and disabilities of the shoulder injuries could be prevented or minimized by an appropriate rehabilitation program especially undertaken in the early phase of dysfunctions or injuries. The core components of the rehabilitation program include stretching of the posterior glenohumeral joint capsule, scapular stabilizing exercise, and strengthening the rotator cuff muscles. It is crucial to proceed onto the proper steps of the rehabilitation program as the functional recovery progresses. To gain a strong and sound biomechanics not only on the shoulder but also for the whole body kinetic chain would be the most important factor for the injured athlete to regain his or her previous athletic activities.
Athletes ; Athletic Injuries ; Biomechanics ; Dyskinesias ; Humans ; Muscles ; Rotator Cuff ; Shoulder ; Shoulder Joint ; Sports

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Musculoskeletal Manipulations ; Shoulder Dislocation ; physiopathology ; therapy ; Shoulder Joint ; injuries