Abstract:
:Long thoracic nerve palsy can result from sudden or repetitive external biomechanical forces. This investigation describes a possible dynamic cause from internal forces. Six fresh cadaveric shoulders (3 female, 3 male, 4 left, 2 right) with full range of motion were systematically dissected to evaluate the anatomic course of the long thoracic nerve. In all specimens a tight fascial band of tissue arose from the inferior aspect of the brachial plexus, extended just superior to the middle scalene muscle insertion on the first rib, and presented a digitation that extended to the proximal aspect of the serratus anterior muscle. With progressive manual abduction and external rotation, the long thoracic nerve was found to "bow-string" across the fascial band. Medial and upward migration of the superior most aspect of the scapula was found to further compress the long thoracic nerve. Previous investigations have reported that nerves tolerate a 10% increase in their resting length before a stretch-induced neuropraxia develops. Previous studies postulated that long thoracic nerve palsy resulted from the tethering effect of the scalenus medius muscle as it actively or passively compressed the nerve; however, similar neuromuscular relationships occur in many other anatomic sites without ill effect. We propose that the cause of long thoracic nerve palsy may be this "bow-stringing" phenomenon of the nerve across this tight fascial band. This condition may be further exacerbated with medial and upward migration of the superior aspect of the scapula as is commonly seen with scapulothoracic dyskinesia and fatigue of the scapular stabilizers. Rehabilitation for long thoracic nerve palsy may therefore benefit from special attention to scapulothoracic muscle stabilization.
journal_name
J Shoulder Elbow Surgjournal_title
Journal of shoulder and elbow surgeryauthors
Hester P,Caborn DN,Nyland Jdoi
10.1016/s1058-2746(00)90007-7keywords:
subject
Has Abstractpub_date
2000-01-01 00:00:00pages
31-5issue
1eissn
1058-2746issn
1532-6500pii
S1058-2746(00)90007-7journal_volume
9pub_type
杂志文章abstract:BACKGROUND:Health care payers, including the federal government, increasingly base reimbursement on quality. Payers consider readmission rates after total joint arthroplasty an indicator of quality. The Patient Protection and Affordable Care Act contains provisions that preclude payment of hospital cost associated with...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2013.08.007
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:The pennation angle is an important architectural and functional feature of pennate muscles. The purpose of this study was to investigate the change in the pennation angle of the supraspinatus muscle after rotator cuff tear repair. MATERIALS AND METHODS:The study included 68 patients who underwent arthrosco...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.10.021
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Anterior shoulder dislocation in the young patient is a common problem, yet there is no universal agreement on its management. METHODS:In this study, we comprehensively surveyed all members of the British Elbow and Shoulder Society (BESS) to ascertain their preferred methods of treating young patients with ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2011.01.006
更新日期:2012-04-01 00:00:00
abstract::The purpose of this study was to assess the functional outcome of the terrible triad of the shoulder, a rare combination of anterior shoulder dislocation, massive rotator cuff tear, and neurologic injury. Six patients with this condition have been treated at our institution since 1990. The mean age was 57 years. All p...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/s1058-2746(03)00216-7
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND:The repetitive overhand throwing can potentially cause physiologic or pathologic changes in musculoskeletal and vascular structures. The purpose of this study was to investigate the effects of throwing on upper extremity arterial blood flow before and after a controlled pitching session. The hypothesis is th...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2010.09.007
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:Acute Hill-Sachs reduction represents a potential alternative method to remplissage for the treatment of an engaging Hill-Sachs lesion. This study biomechanically compared the stabilizing effects of an acute Hill-Sachs reduction technique and remplissage. METHODS:Six cadaveric shoulders were tested. For the...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.11.050
更新日期:2017-06-01 00:00:00
abstract::Six hundred one total shoulder arthroplasties and eighty-nine hemiarthroplasties were performed for primary osteoarthritis of the shoulder. Patients were evaluated with a physical examination, Constant score, and radiographic evaluation. The minimum follow-up was 2 years. At follow-up, the Constant score averaged 64 p...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/s1058-2746(02)86804-5
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:Decreased acromiohumeral distance (AHD) is commonly detected in patients with massive rotator cuff tears (mRCT). Most studies evaluating fixed humeral elevation have used pre- or postoperative standardized radiography and not stress radiography. This study aimed to evaluate the predictive role of preoperativ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.10.029
更新日期:2020-11-30 00:00:00
abstract::Most rotator cuff surgery is performed on chronic tears, but changes in the composition of chronically torn tendons remain poorly understood. In this study we surgically created supraspinatus tears in the rat and analyzed the composition of the tendon over time using immunohistochemistry. We found that collagen types ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2004.09.021
更新日期:2005-01-01 00:00:00
abstract::Periprosthetic humeral fractures are major complications of shoulder arthroplasty. Bone removal during surgical reaming is a risk factor for these fractures. Although it is recognized that the endosteal surface of the humerus is asymmetrical whereas the reamers are symmetrical, to our knowledge, the effect of cylindri...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2007.03.032
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:The Latarjet procedure is an effective procedure for the treatment of anterior glenohumeral joint instability; however, the complications are concerning. The purpose of this study was to review a single institution's experience with the Latarjet procedure for recurrent anterior glenohumeral instability speci...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.09.002
更新日期:2020-09-30 00:00:00
abstract:BACKGROUND:Although massive rotator cuff tears occasionally lead to severe impairment of shoulder function, the criteria for losing the ability to elevate the arm are unclear. This study aimed to analyze the features of both tear size and 3-dimensional (3D) shoulder kinematics that correspond to the loss of the ability...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.07.021
更新日期:2020-08-01 00:00:00
abstract:HYPOTHESIS:We hypothesized that the clavicle overrides the acromion during certain shoulder motions for individuals with acromioclavicular (AC) joint separation producing clinical symptoms. We measured 3-dimensional clavicular and scapular motions in AC joint separation models during humerothoracic motions, which shoul...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2013.01.004
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Sensory innervation to the shoulder provided by the distal suprascapular nerve (dSSN) remains the subject of debate. The purpose of this study was to establish consensus with respect to the anatomic features of the sensory branches of the dSSN. The relevant hypothesis was that the dSSN would give off 3 senso...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.02.016
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Results of shoulder arthroplasty have been reported to be inferior with posterior glenoid wear and accompanying subluxation of the humeral head. The purpose of this study was to examine the effect of posterior glenoid wear on posterior subluxation of the humeral head. MATERIAL AND METHODS:A custom loading d...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2010.04.010
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Deep prosthetic infection is a potentially devastating complication after total elbow arthroplasty, with an incidence of up to 12%. This study examined the demographics, microbiologic profile, and outcomes of infected total elbow arthroplasty treated with 2-stage revision in a tertiary referral unit. METHOD...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2017.12.033
更新日期:2018-05-01 00:00:00
abstract:HYPOTHESIS:Arthroscopic osteocapsular arthroplasty for stage III osteoarthritis (advanced stage) shows worse clinical and radiologic outcomes compared with stage I or II according to computed tomography (CT)-based classification. METHODS:Clinical and radiologic outcomes in 65 patients treated with arthroscopic osteoca...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.09.036
更新日期:2020-05-01 00:00:00
abstract::The purpose of this study was to assess the efficacy of pulsed radiofrequency (PRF) applied to the suprascapular nerve for pain relief in medically unfit patients with painful cuff tear arthropathy. Twelve patients with chronic shoulder pain due to cuff tear arthropathy were recruited. The mean age was 68 years (range...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2007.10.007
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:Significant controversy surrounds optimal treatment of displaced 4-part proximal humeral fractures. Reverse total shoulder arthroplasty (RTSA) has recently been proposed as an alternative to hemiarthroplasty (HA) and open reduction-internal fixation (ORIF). Several authors have questioned the additional impl...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2013.07.044
更新日期:2014-02-01 00:00:00
abstract:INTRODUCTION:Patients may experience a loss of internal rotation (IR) and external rotation (ER) after reverse total shoulder arthroplasty (RTSA). We hypothesized that alterations in the glenosphere position will affect the amount of impingement-free IR and ER. MATERIALS AND METHODS:Computed tomography (CT) scans of t...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2012.07.013
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:In throwing athletes, cubital tunnel syndrome and insufficiency of the ulnar collateral ligament (UCL) are common pathologic processes of the elbow. The objective of this study was to investigate the effect of UCL tears on ulnar nerve elongation in the simulated throwing position. METHODS:Eight fresh frozen...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.02.009
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:This study assessed whether treating medial end clavicular fractures using an inverted distal clavicle locking plate, twisted through 90° around its axis, would allow for a less invasive surgical approach and improve screw trajectory insertion. MATERIALS AND METHODS:We searched the databases of the 2 senior...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.08.047
更新日期:2019-04-01 00:00:00
abstract::An understanding of the morphology of the glenoid is important from the viewpoint of implant design and selection. This study describes the endosteal dimensions and shape of the glenoid and correlates these results with age, gender, and the presence of osteoarthritis. This study used 72 scapulae. Data were obtained fr...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2006.03.008
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:Proximal humerus fractures are one of the most common fractures among elderly patients. We performed a systematic review to detail the demographics, outcomes, and complications of patients who undergo reverse shoulder arthroplasty for complex proximal humerus fractures. METHODS:A systematic review of the li...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jse.2013.09.012
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:There is an increasing trend toward the use of reverse total shoulder arthroplasty (RTSA) over stemmed hemiarthroplasty (HA) for the management of proximal humeral fractures. There are limited data available comparing the revision rates for RTSA and HA in the setting of a fracture. The aim of this study was ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.04.005
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Hyaluronic acid (HA) is an analgesic and chondroprotective agent often used for the nonoperative treatment of osteoarthritis (OA). The effects of HA injections are well studied in the treatment of knee OA, but the effects in glenohumeral OA remain unclear. This study evaluated the efficacy of HA to reduce pa...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,meta分析
doi:10.1016/j.jse.2018.09.011
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to increase our understanding of the pathoanatomy of the ulnar collateral ligament (UCL) by performing a descriptive analysis of the surgical inspection of the anterior bundle in patients undergoing reconstruction. METHODS:A single-surgeon series of 163 patients who underwent U...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.01.017
更新日期:2019-08-01 00:00:00
abstract::The purpose of this study was to document the diagnosis, surgical treatment, and functional outcome in patients with subscapularis ruptures after shoulder arthroplasty. Prospective objective and subjective data were collected on 7 patients with symptomatic rupture of the subscapularis tendon after shoulder arthroplast...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2005.02.013
更新日期:2005-09-01 00:00:00
abstract::Studies show that the radial head is a significant stabilizer to valgus and varus stresses and external rotatory stability. We review the outcomes of patients who had radial head replacement in our institution. Six patients with Mason-Johnston type III or IV radial head fractures underwent radial head replacement and ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2007.07.020
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Posterior humeral decentering presents a challenge in glenohumeral arthroplasty. Soft tissue releases and osteophyte resection can lead to intraoperative decentering not evident preoperatively. Inferior outcomes result if decentering is not addressed as a part of the arthroplasty. When there is >50% posterio...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.02.027
更新日期:2016-12-01 00:00:00