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  • SOG
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    Original URL path: http://sog.sg/component/mailto/?tmpl=component&link=aHR0cDovL3NvZy5zZy9vdXItc2VydmljZXMvc2hvdWxkZXI%3D (2014-05-06)
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  • Treatment of the Unstable Shoulder
    1957 324 young patient with ant dislocations 94 had recurrence if 20 years old 62 had recurrence if 30 years old 14 had recurrence if 40 years old Natural History Non operative treatment of shoulder dislocation in young athletes Arciera J Arthroscopy 1995 De Beardino J South Orthopaedic Ass 1996 Haelen J Arch Orthopaedic Trauma Surgery 1990 Hovelius J Orthopaedic Science 1999 Wheeler J Arthroscopy 1998 Kirkby J Arthroscopy 1999

    Original URL path: http://sog.sg/treatment-of-the-unstable-shoulder (2014-05-06)
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  • Arthroscopic Treatment of Shoulder Dislocation
    or fall squared off appearance of shoulder Palpable gap below the acromion Humeral head palpable antero inferiiorly to glenoid Must examine distal pulses and axillary nerve Conservative Treatment Rowe JBJS 1957 324 young patient with ant dislocations 94 had recurrence if 20 years old 62 had recurrence if 30 years old 14 had recurrence if 40 years old Natural History Non operative treatment of shoulder dislocation in young athletes Arciera

    Original URL path: http://sog.sg/arthroscopic-treatment-of-shoulder-dislocation (2014-05-06)
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  • Arthroscopic Repair of Rotator Cuff Tear with Double Row
    teres minor and subcapularis Provide rotation elevate the arm and give stability to the shoulder joint Supraspinatus is most frequently torn in degenerative tears of the rotator cuff More than one tendon can be involved Rotator Cuff Tears Pain loss of motion and weakness may occur when one of the rotator cuff tendons tears The tendons generally tear off at their insertion attachment onto the humeral head What Happens in

    Original URL path: http://sog.sg/arthroscopic-repair-of-rotator-cuff-tear-with-double-row (2014-05-06)
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  • Shoulder Impingement Syndrome
    the teres minor These muscles cover the ball of the shoulder head of the humerus The muscles work together to lift and rotate the shoulder Shoulder Impingement The acromion is the front edge of the shoulder blade It sits over and in front of the humeral head As the arm is lifted the acromion rubs or impinges on the surface of the rotator cuff This causes pain and limits movement

    Original URL path: http://sog.sg/shoulder-impingement-syndrome (2014-05-06)
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  • Acromio-clavicular Joint Dislocation
    of Injury The athlete who sustains an acromio clavicular injury commonly reports either one of two mechanisms of injury direct or indirect Direct force This is when the athlete falls on to the point of the shoulder with the arm usually at the side and adducted The force drives the acromion downwards and medially 70 of acromio clavicular joint injuries are the result of a direct injury Indirect force This is when the athlete falls onto an outstretched arm The force is transmitted through the humeral head to the acromion therefore the acromio clavicular ligament is disrupted and the coraco clavicular ligament is stretched Treatment Type I II and some III injuries can generally be managed without surgery However these injuries may result in persistent shoulder pain dysfunction or both in the future Type I and II separations may progress to develop symptomatic degenerative disease Type III separations may result in impingement symptoms and muscle fatigue discomfort Late surgical management may be required Treatment of Type III Injuries An area of controversy Many surgeons believe that this degree of displacement leads to muscle fatigue discomfort and difficulty manipulating heavy loads As a result operative intervention should be considered in heavy

    Original URL path: http://sog.sg/acromio-clavicular-joint-dislocation (2014-05-06)
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  • Treatment of Shoulder Pain
    painful lateral aspect of upper arm worse at night can not lie on affected arm Commonly caused by repeated overhead movements which cause pinching of the tendon Outlet impingement In older athletes Tendinopathy followed by acromial changes and compression of the cuff under the arch In younger athletes Subtle glenohumeral laxity leading to muscle imbalance and subacromial space impingement Supraspinatus Outlet Space between the anterior acromion coracoacromial ligament and acromioclavicular joint Supraspinatus muscle tendon Narrowing causes impingement Neer s Impingement Sign Patient seated Forcibly flex arm to overhead position Pain humerus impinges against CA arch Hawkin s Impingement Sign Throwing position Flex forward 30 deg Forcibly int rotate Pain impingement of supraspinatous against CA ligament Athletic Impingement In younger athletes the impingement may be related to eccentric overload and microtrauma to the cuff or to subtle glenohumeral instability This may lead to secondary CA ligament impingement Pathology of Outlet Impingement Neer Stage I Edema and Hemorrhage Stage II Fibrosis and Tendonitis Stage III Bone Spurs and Tendon Rupture Stages of Rotator Cuff Impingement Stage I Younger patients 25 y o can occur at any age Clinical features Edema Hemorrhage Pain worse with 90 degrees abd Reversible lesion Stage II Middle age patients 25 40 y o Pain with ADL s Night pain Fibrotic changes of Supraspinatus tendon Biceps tendon Subacromial bursa Irreversible because of long term repeated stress Treatment Treatment is rest in the younger patient modification of activity i e not playing golf racket sports In chronic cases physiotherapy analgesics and sometimes steroid and local anaesthetic injections become necessary Surgery Treatment of calcifying tendinitis Non operative rest NSAIDS stretching PROM steroid injection Extracorporeal Shock Wave treatment Needle aspiration lavage Harmon 79 good DePalma 61 Operative Arthroscopic lavage debridement Rupture of the Rotator Cuff Stage III Impingement End stage result

    Original URL path: http://sog.sg/treatment-of-shoulder-pain (2014-05-06)
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  • SOG
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    Original URL path: http://sog.sg/component/mailto/?tmpl=component&link=aHR0cDovL3NvZy5zZy9vdXItc2VydmljZXMvZWxib3c%3D (2014-05-06)
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