Humans ; Shoulder ; physiopathology ; Shoulder Impingement Syndrome ; physiopathology

Humans ; Musculoskeletal Manipulations ; Periarthritis ; physiopathology ; therapy ; Shoulder Joint ; physiopathology

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

OBJECTIVETo investigate a manipulating therapy for treatment of anterior shoulder dislocation in elderly.

METHODSFrom October 2011 to June 2012,27 elderly patients with anterior shoulder dislocation were treated by extorsion traction and pushing manipulation with fingers, including 7 males and 20 females aged from 65 to 86 years old with an average of 77. The course of disease ranged from 1 h to 1 d. The shoulder manifested square deformity, Dugus signs showed positive, and X-ray displayed anterior shoulder dislocation. Dugus fixation was applied for and removed external fixation at 3 weeks after operation and carried out shoulder functional exercise. Functional evaluation standard on shoulder joint injuries was used for evaluate clinical outcomes.

RESULTSAll patients were gained reduction for the first time, and followed up at 3 months after operation, no dislocation occurred. According to functional evaluation standard on shoulder joint injuries, 22 cases got an excellent result,2 cases good,and 1 case moderate.

CONCLUSIONExtorsion traction and pushing manipulating therapy for treatment of anterior shoulder dislocation in elderly, which has advantages of simple, convenient, less painful, and can avoid iatrogenic injury, is feasible to widespread.

Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Manipulation, Orthopedic ; Shoulder Dislocation ; physiopathology ; therapy ; Shoulder Joint ; physiopathology ; Traction ; Treatment Outcome

Shoulder surgeons need to be aware of the critical size of the glenoid or humeral osseous defects seen in patients with anterior shoulder instability, since the considerable size of osseous defect is reported to cause postoperative instability. Biomechanical studies have identified the size of the osseous defect which affects stability. Since engagement always occurs between a Hill-Sachs lesion and the glenoid rim, when considering the critical size of the Hill-Sachs lesion, we have to simultaneously consider the size of the glenoid osseous defect. With the newly developed concept of the glenoid track, we are able to evaluate whether a large Hill-Sachs lesion is an "on-track" or "off-track" lesion, and to consider both osseous defects together. In case of an off-track Hill-Sachs lesion, if the glenoid defect is less than 25%, no treatment is required. In this case, the Latarjet procedure or arthroscopic remplissage procedure can be a treatment option. However, if the glenoid defect is more than 25%, treatment such as bone grafting is required. This will convert an off-track lesion to an on-track lesion. After the bone graft or Latarjet procedure, if the Hill-Sachs lesion persists as off-track, then further treatment is necessitated. In case with an on-track Hill-Sachs lesion and a less than 25% glenoid defect, arthroscopic Bankart repair alone is enough.
Biomechanical Phenomena ; *Glenoid Cavity/injuries/pathology/physiopathology ; Humans ; *Humeral Head/injuries/pathology/physiopathology ; Shoulder Dislocation/physiopathology ; *Shoulder Joint/injuries/pathology/physiopathology

OBJECTIVETo evaluate the efficacy of abdominal acupuncture for adhesion-stage shoulder periarthritis.

METHODSOne hundred and fifty-seven cases of shoulder periarthritis were randomly divided into an abdominal acupuncture group (79 cases) and a body acupuncture group (78 cases). The abdominal acupuncture was applied at Zhongwan (CV 12), Shangqu (KI 17) and Huaroumen (ST 24) in the abdominal acupuncture group while conventional acupuncture was applied at Jianyu (LI 15), Jianliao (TE 14) and Jianzhen (SI 9) in the body acupuncture group. The treatment was given three times a week for both groups and ten times made an observation course. Before and after treatment, visual analogue scale (VAS) was adopted for pain assessment and functional activity score (Mallet score) was used for shoulder joint function assessment for all the patients. Also the efficacy of both groups was compared.

RESULTSThe total effective rate in the abdominal acupuncture group was 92.4% (73/79), which was superior to 71.8% (56/78) in the body acupuncture group. The score of VAS after the treatment was 2.58 +/- 1.64 in the abdominal acupuncture group while 3.12 +/- 1.93 in the body acupuncture group, which had no statistical significance between each other (P > 0.05). The functional activity score after the treatment was 8.34 +/- 3.02 in the abdominal acupuncture group while 7.49 +/- 3.36 in the body acupuncture group, which had no statistical significance between each other (P > 0.05).

CONCLUSIONThe abdominal acupuncture is an ideal treatment for adhesion-stage shoulder periarthritis, which has better total efficacy than conventional acupuncture. It achieves the same effect in relieving pain and improving functional activity as conventional acupuncture, but also has an advantage at fast selection of acupoint and less discomfort of needling sensation.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Periarthritis ; physiopathology ; therapy ; Shoulder ; physiopathology

Inferior glenohumeral dislocation is the least common type of glenohumeral dislocations. It may be associated with fractures of the adjacent bones and neurovascular compromise. It should be treated immediately by close reduction. The associated neuropraxia usually recovers with time. Traction-counter traction method is commonly used for reduction followed by immobilization of the shoulder for three weeks. Here, we report a case of inferior glenohumeral joint dislocation with greater tuberosity fracture with transient neurovascular compromise and present a brief review of the literature.
Adult ; Fractures, Bone ; physiopathology ; therapy ; Humans ; Male ; Shoulder Dislocation ; complications ; physiopathology ; therapy

OBJECTIVETo assess the clinical efficacy and the safety for periarthritis of shoulder treated with deep puncture by elongated needle combined with spike-hooked needle and cupping.

METHODSA multicentral randomized controlled study was adopted. One hundred and twenty cases were divided into an observation group and a control group, 60 cases in each one. In observation group, elongated needle, spike-hooked needle and cupping were used to stimulate Jianyu (LI 15), Naoshu (SI 10), Naohui (TE 13) and Jianqian (Extra). In control group, a conventional needling and cupping were applied to the same points as observation group. Visual Analogue Scale (VAS) and Melle evaluation for the function activity of shoulder joint were adopted to assess and compare the efficacy on analgesia and the effect on shoulder joint range of motion before and after treatment in two groups.

RESULTSIn observation group, the cured and markedly effective rate of analgesia was 91.7% (55/60), which was obviously better than 20.4% (12/59) in control group (P < 0.001). Concerning to the improvements of the range of motion in shoulder joint, the cured and markedly effective rate in observation group was 91.7% (55/60), which was better than 18. 6% (11/59) in control group (P < 0.001). VAS score and Melle score after treatment were apparently improved as compared with those before treatment in two groups (all P < 0.001). The improvements in observation group were superior to those in control group (both P < 0.001). There was no adverse event reported during the treatment in two groups.

CONCLUSIONThe deep puncture by elongated needle combined with spike-hooked needle and cupping achieves a significant clinical efficacy on periarthritis of shoulder and has no adverse reaction reported.

Acupuncture Therapy ; instrumentation ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Periarthritis ; physiopathology ; therapy ; Range of Motion, Articular ; Shoulder Joint ; physiopathology ; Shoulder Pain ; physiopathology ; therapy

OBJECTIVETo evaluate the posterior and superior compression test (PSCT) and weight-bearing on elbow test (WBE) on the diagnosis of superior labrum anterior to posterior (SLAP) lesion.

METHODSFrom July 2000 to March 2007, 4 clinical tests including O'Brien test, Crank test, PSCT and WBE were randomly performed on 207 patients (209 shoulders). Among the patients, 125 were males and 82 were females with the mean age of 39 years. All the patients underwent arthroscopic treatment by the same doctor. The arthroscopic diagnosis was considered as the golden standard. For each test, the parameters on clinical epidemiology were calculated, and the differences of detection rate between the physical tests and the arthroscopic examination were compared.

RESULTSThe parameters on clinical epidemiology of O'Brien test, Crank test, PSCT and WBE were comparable. The difference of detection rate between the physical tests and the arthroscopic examination was not statistically significant (P > 0.05). The detection rates of PSCT and WEB in the group of injury of posterior and superior labrum were statistically higher than the group of injury of anterior and superior labrum. The detection rate of PSCT in the group of simple SLAP lesion was relatively higher.

CONCLUSIONSCompared with O'Brien test and Crank test, the new PSCT and WBE have not only comparable clinical value in the diagnosis of SLAP lesion, but also the advantage in predicting the location of SLAP lesion. The detection rate of PSCT in the group of simple SLAP lesion is relatively higher, but the mechanism is to be determined.

Adolescent ; Adult ; Aged ; Arthroscopy ; Elbow Joint ; injuries ; physiopathology ; Exercise Test ; methods ; Female ; Humans ; Male ; Middle Aged ; Shoulder Dislocation ; diagnosis ; physiopathology ; Shoulder Joint ; injuries ; physiopathology ; Weight-Bearing

Total shoulder arthroplasty and shoulder hemiarthroplasty have been the traditional method for treating a variety of shoulder conditions, including arthritis, cuff tear arthropathy, and some fracture types. However, these procedures did not provide consistently good results for patients with torn rotator cuffs. The development of the reverse prosthesis by Grammont in the late 20th century revolutionized the treatment of the rotator-cuff-deficient shoulder with arthritis. The main indication for the reverse prosthesis remains the patient with cuff tear arthropathy who has pain and loss of motion. Because the reverse total shoulder arthroplasty produced such good results in these patients, the indications for the reverse prosthesis have expanded to include other shoulder conditions that have previously been difficult to treat successfully and predictably. This review discusses and critically reviews these newer indications for the reverse total shoulder arthroplasty.
*Arthroplasty, Replacement ; Humans ; Range of Motion, Articular ; Rotator Cuff/*surgery ; Shoulder Fractures/diagnosis/physiopathology/*surgery ; Shoulder Joint/*surgery