Arthroscopic Treatment for Snapping Scapula: A Prospective Case Series.

Arthroscopic treatment for snapping scapula: a prospective case series.

Filed under: Rehab Centers

Eur J Orthop Surg Traumatol. 2013 Jan 5;
Blønd L, Rechter S

PURPOSE: Painful snapping scapula can be a disabling condition. The object of this prospective study was to assess the efficiency of arthroscopic bone resection of the medial superior corner of scapula, in patients suffering from continuously painful snapping scapula. METHODS: Twenty patients with painful snapping scapula underwent arthroscopic scapulothoracic bursectomi and resection of the hook formation at the medial superior margin of the scapular. Preoperatively, all patients reported temporary relief via a local anesthetic injection and had completed a 3-month rehabilitation program. The Western Ontario Rotator Cuff index (WORC) was used for the assessment of pain and function levels both pre- and postoperatively. RESULTS: Twenty patients (13 women and 7 men) were included. The mean follow-up was 2.9 years (range 2-5 years). The mean age was 40 years (range 19-68 years). The mean duration of symptoms was 4 years (range 4 months-20 years). Seven previously had arthroscopic operations in the affected shoulder with acromioplasty, with or without acromioclavicular joint resection. The median preoperative WORC score was 35.0 (range 18-74) and significantly increased to 86.4 (range 33-100) postoperatively. Out of 20 patients, 18 improved and 19 indicated that they would undergo the surgery again. CONCLUSION: In this study, it was found that, among patients troubled by painful snapping scapula and without relief by exercise-based rehabilitation, arthroscopic resection of the medial superior hook formation in combination with partial bursectomy provides a serious gain in respect to the WORC score and is believed to be an effective treatment in most cases. One patient had a serious complication.
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The olecranon osteotomy provides better outcome than the triceps-lifting approach for the treatment of distal humerus fractures.

Filed under: Rehab Centers

Eur J Orthop Surg Traumatol. 2012 Dec 21;
Elmadag M, Erdil M, Bilsel K, Acar MA, Tuncer N, Tuncay I

INTRODUCTION: Intra-articular distal humeral fractures can be approached in a variety of ways. The purpose of this study is to evaluate and compare the functional outcomes of two approaches: approach with olecranon osteotomy and triceps-lifting approach for the treatment of intra-articular distal humeral fractures. METHODS: This study shows a consecutive series of 54 intra-articular distal humeral fractures of 54 patients who were treated with open reduction and internal fixation with anatomic plating. Lateral plating was performed in 10 (45.5 %) patients, and medial and lateral parallel plating was performed in 12 (54.5 %) patients in olecranon osteotomy group, while lateral plating was performed in 8 (25 %) patients, and medial and lateral parallel plating was performed in 24 (75 %) patients in triceps-lifting group. RESULTS: Mean follow-up was 38.3 months for olecranon osteotomy group and 41.4 months for triceps-lifting group. Functional outcomes according to MAYO elbow score and extension-flexion motion arc values were significantly better in olecranon osteotomy group (p < 0.05). CONCLUSION: Approach with olecranon osteotomy provided better functional outcomes than triceps-lifting approach. Additionally, intra-articular distal humerus fractures can be safely treated with olecranon osteotomy which provides more control over the elbow joint and better visualisation and allows early postoperative rehabilitation. LEVEL OF EVIDENCE: IV. HubMed – rehab


Anterior cruciate ligament (ACL) autograft reconstruction with hamstring tendons: clinical research among three rehabilitation procedures.

Filed under: Rehab Centers

Eur J Orthop Surg Traumatol. 2012 Nov 16;
Zhu W, Wang D, Han Y, Zhang N, Zeng Y

OBJECTIVE: To compare the effects of the three rehabilitation procedures following anterior cruciate ligament (ACL) autograft reconstruction with hamstring tendons. DESIGN: An observational and retrospective case-controlled series. SETTING: The Department of Sports Medicine, Shenzhen Second People Hospital, Shenzhen, PR China. PATIENTS OR PARTICIPANTS: Forty-five patients who were made to undergo ACL reconstructions by using quadrupled semitendinosus and gracilis tendons were divided into three groups: accelerated rehabilitation procedures group, aggressive rehabilitation procedures group, and self-made rehabilitation procedures group. MAIN OUTCOME MEASURES: The knee range of motion, thigh perimeter, IKDC score, and bone tunnel diameter in 3D-CT films were evaluated 3 and 6 months and 1 year later. RESULTS: The knee range of motion and thigh perimeter of group A were higher than those of group B and group C at 3, 6, and 12 months. IKDC scores of group C were better than those of groups A and B. The bone tunnel widening with group B was larger than that with groups A and C, and the differences were statistically significant (P < 0.05). CONCLUSION: Early rehabilitation is beneficial for restoration of knee function after ACL reconstruction. Moderate procedure is better than accelerated procedure. HubMed – rehab


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