Speciality
Spotlight

 



 

Orthopaedics

 

 


Injuries of Upper Limbs
     

  • SJ O’Brien, MJ Pagnani, S Fealy,
    et al (Hosp for Special Surgery, New York)
    The Active Compression Test: A
    New and Effective Test for Diagnosing Labral Tears and
    Acromioclavicular Joint Abnormality.
    Am  J Sports Med 
    26: 610-613, 1998.
       
    Superior labral tears are
    difficult to diagnose. A new test for detection
    of labral abnormality and acromioclavicular joint
    abnormality is presented which is both specific and
    sensitive.
        
    Technique :
    The physician stands behind the
    patient, who flexes the affected arm forward at 90o with the elbow at full
    extension, adducts the arm 10-15 medial to the
    sagittal plane and internally rotates it till the
    thumb points downward. The physician applies
    downward pressure on the arm.
    The maneuver is repeated with the palm fully
    supinated. The test is positive if
    there is pain with the first maneuver that is reduced
    or eliminated with the second maneuver. 
    Pain on the shoulder in the acromioclavicular
    joint is indicative or acromioclavicular joint
    abnormality, whereas pain or painful clicking is
    diagnosed as labral abnormality.
        
    Results : Of 56 patients who had
    positive active compression tests, 53 were found to
    have labral tears. The remaining 3 patients
    had a reverse Hills-Sach’s lesion, a hypermobile
    biceps tendon and multidirectional laxity and biceps
    tendinitis and anterior instability without a discrete
    labral tear. The specificity was 100%
    and the specificity 98.5%, the positive predictive
    value was 94.5% and the negative predictive value was
    100%.
            

  • Gartsman GM, Khan M, Hammerman
    SM  (Texas Orthopedic
    Hosp, Houston)
    Arthroscopic Repair of
    Full-Thickness Tears of the Rotator Cuff
    J Bone Joint Surg Am 80-A:
    832-840, 1998.
        
    This is a study of 73
    patients (mean age 60.7 years) who underwent
    arthroscopic repair of full thickness rotator cuff
    tears. 69 patients had an
    anatomical repair and 4 were repaired a mean 3mm
    medial to the insertion of the tendon.
    The scope could also detect that 63
    glenohumeral joints were normal and 10 had an
    intra-articular lesion. 90% rated the result as
    good to excellent.
        
    This technique should be used
    only by experienced surgeons.
    The open operation is relatively easy, but the
    advantage of arthroscopy includes smaller incision,
    access to the glenohumeral joints and treatment of
    intra-articular lesions, no need to detach the deltoid
    and less soft tissue desection.
           

 


 

         

Speciality Spotlight

 

 
Orthopaedics
 

 

Injuries of Upper Limbs
     

  • SJ O’Brien, MJ Pagnani, S Fealy, et al (Hosp for Special Surgery, New York)
    The Active Compression Test: A New and Effective Test for Diagnosing Labral Tears and Acromioclavicular Joint Abnormality.
    Am  J Sports Med  26: 610-613, 1998.
       
    Superior labral tears are difficult to diagnose. A new test for detection of labral abnormality and acromioclavicular joint abnormality is presented which is both specific and sensitive.
        
    Technique : The physician stands behind the patient, who flexes the affected arm forward at 90o with the elbow at full extension, adducts the arm 10-15 medial to the sagittal plane and internally rotates it till the thumb points downward. The physician applies downward pressure on the arm. The maneuver is repeated with the palm fully supinated. The test is positive if there is pain with the first maneuver that is reduced or eliminated with the second maneuver.  Pain on the shoulder in the acromioclavicular joint is indicative or acromioclavicular joint abnormality, whereas pain or painful clicking is diagnosed as labral abnormality.
        
    Results : Of 56 patients who had positive active compression tests, 53 were found to have labral tears. The remaining 3 patients had a reverse Hills-Sach’s lesion, a hypermobile biceps tendon and multidirectional laxity and biceps tendinitis and anterior instability without a discrete labral tear. The specificity was 100% and the specificity 98.5%, the positive predictive value was 94.5% and the negative predictive value was 100%.
            

  • Gartsman GM, Khan M, Hammerman SM  (Texas Orthopedic Hosp, Houston)
    Arthroscopic Repair of Full-Thickness Tears of the Rotator Cuff
    J Bone Joint Surg Am 80-A: 832-840, 1998.
        
    This is a study of 73 patients (mean age 60.7 years) who underwent arthroscopic repair of full thickness rotator cuff tears. 69 patients had an anatomical repair and 4 were repaired a mean 3mm medial to the insertion of the tendon. The scope could also detect that 63 glenohumeral joints were normal and 10 had an intra-articular lesion. 90% rated the result as good to excellent.
        
    This technique should be used only by experienced surgeons. The open operation is relatively easy, but the advantage of arthroscopy includes smaller incision, access to the glenohumeral joints and treatment of intra-articular lesions, no need to detach the deltoid and less soft tissue desection.
           

 

 

By |2022-07-20T16:44:12+00:00July 20, 2022|Uncategorized|Comments Off on Injuries of Upper Limbs

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