Introduction: Ultrasound is the imaging technique of choice for the study of rotator cuff lesions. However, in the case of shoulder trauma, it is rarely requested in our context. This study aimed to show ultrasound le...Introduction: Ultrasound is the imaging technique of choice for the study of rotator cuff lesions. However, in the case of shoulder trauma, it is rarely requested in our context. This study aimed to show ultrasound lesions of the rotator cuff in cases of non-fracture shoulder trauma at the CHUYO in Ouagadougou. Methodology: This was a prospective descriptive cross-sectional study running from August 1 to November 30, 2017, in the medical imaging department of CHUYO. The study population consisted of patients received in the department for ultrasound in the context of non-fracture shoulder trauma. Results: We collected 20 cases (66.67%) of rotator cuff lesions out of 30 non-fracture shoulder injuries. The mean age of the patients was 27.6 years. Road traffic accidents accounted for 60% of injuries, sports accidents for 30%, and domestic accidents for 10%. Ultrasound lesions were mainly tendon ruptures (36.67%) and tendinitis (23.33%). Ruptures were non-transfixing in 90.90% of cases. The supraspinatus was the most affected (81.81%). Conclusion: Ultrasound can help diagnose rotator cuff injuries, particularly in non-fractured shoulder trauma.展开更多
Rotator cuff repair(RCR) is one of the most commonly performed surgical procedures in orthopaedic surgery. The reported incidence of deep soft-tissue infections after RCR ranges between 0.3% and 1.9%. Deep shoulder in...Rotator cuff repair(RCR) is one of the most commonly performed surgical procedures in orthopaedic surgery. The reported incidence of deep soft-tissue infections after RCR ranges between 0.3% and 1.9%. Deep shoulder infection after RCR appears uncommon, but the actual incidence may be higher as many cases may go unreported. Clinical presentation may include increasing shoulder pain and stiffness, high temperature, local erythema, swelling, warmth, and fibrinous exudate. Generalized fatigue and signs of sepsis may be present in severe cases. Varying clinical presentation coupled with a low index of suspicion may result in delayed diagnosis. Laboratory findings include high erythrocyte sedimentation rate and C-reactive protein level, and, rarely, abnormal peripheral blood leucocyte count. Aspiration of glenohumeral joint synovial fluid with analysis of cell count, gram staining and culture should be performed in all patients suspected with deep shoulder infection after RCR. The most commonly isolated pathogens are Propionibacterium acnes, Staphylococcus epidermidis, and Staphylococcus aureus. Management of a deep soft-tissue infection of the shoulder after RCR involves surgical debridement with lavage and long-term intravenous antibiotic treatment based on the pathogen identified. Although deep shoulder infection after RCR is usually successfully treated, complications of this condition can be devastating. Prolonged course of intravenous antibiotic treatment, extensive soft-tissue destruction and adhesions may result in substantially diminished functional outcomes.展开更多
The most prevalent group of disorders of human shoulder is related to the muscles of the rotator cuff. In order to develop a mechanical method for rotator cuff muscles’ evaluation, we hypothesized that measurement of...The most prevalent group of disorders of human shoulder is related to the muscles of the rotator cuff. In order to develop a mechanical method for rotator cuff muscles’ evaluation, we hypothesized that measurement of the isometric force generated by the individual muscle of the rotator cuff might detect the variations, which are characteristic to the different disorders of rotator cuff muscles in adults. The isometric force of supraspinatus, infraspinatus and subscapularis muscles were measured in patients with rotator cuff tears, calcific tendinitis and subacromial impingement syndrome, 30 patients with each disorder, and compared to the normal values from our previous study. Torque of the force was calculated and normalized to lean body mass. The profiles of the mean torque-time curves of each group were compared statistically. We found the expected significantly lower profiles of the torque-time curves of all the tested rotator cuff muscles in comparison to the normal values. The best resolution between the curves of different study groups was found in the testing of the infraspinatus muscles. Therefore the previously unrecognized variations of rotator cuff muscles’ isometric strength build up patterns in the common disorders involving the rotator cuff muscles were revealed. The presented data might be a basis for the future development of a simple mechanical diagnostic method for identification of the abnormal patterns of muscle isometric strength in patients with rotator cuff muscles’ pathology.展开更多
Although the relationship between the material properties of the coracoacromial ligament and rotator cuff tears has been clarified, it is difficult to evaluate these properties in the clinical setting. The purpose of ...Although the relationship between the material properties of the coracoacromial ligament and rotator cuff tears has been clarified, it is difficult to evaluate these properties in the clinical setting. The purpose of this study was to clarify the relationship between rotator cuff tears and the length and thickness of the coracoacromial ligament in living shoulders, in order to assess the potential use of these parameters as clinical indicators of the possible risk or progression of rotator cuff tears. Thirty-five volunteers (46 shoulders, mean age: 52 years) were enrolled. The presence or absence of rotator cuff tears and the length and thickness of the coracoacromial ligament were evaluated by ultrasonography. Longitudinal images of the coracoacromial ligaments with the acromion and coracoid process as landmarks were obtained, and the lengths of the ligaments were measured using acoustic shadows as the index. On the same screens, the thicknesses at the center of the ligaments were measured. Ligaments in shoulders with a rotator cuff tear were significantly shorter than ligaments in shoulders without a rotator cuff tear (25.9 ± 2.5 mm vs. 28.6 ± 1.7 mm, respectively;P < 0.0001). There was no significant difference in the thicknesses of the ligaments. The length and thickness of the coracoacromial ligament of living shoulders were easily evaluated with ultrasonography in the present study, and the coracoacromial ligament was found to be significantly shorter in shoulders with a rotator cuff tear. The risk and progression of rotator cuff tears can be evaluated clinically by measuring the length of the coracoacromial ligament.展开更多
目的探讨糖尿病对关节镜下肩袖修复术后病人肩关节功能恢复的影响。方法回顾性分析我科自2019年5月至2022年5月接受关节镜下肩袖修复术的62例肩袖损伤病人的临床资料和随访结果,其中糖尿病组30例,男18例,女12例,年龄为(62.10±11.87...目的探讨糖尿病对关节镜下肩袖修复术后病人肩关节功能恢复的影响。方法回顾性分析我科自2019年5月至2022年5月接受关节镜下肩袖修复术的62例肩袖损伤病人的临床资料和随访结果,其中糖尿病组30例,男18例,女12例,年龄为(62.10±11.87)岁;对照组32例,男18例,女14例,年龄为(63.78±12.98)岁。手术方式均为关节镜下缝线桥技术缝合肩袖。分别记录两组病人术前1周、术后3个月、6个月和12个月各时间点肩关节最大外展角度值,以及肩关节功能评分,包括疼痛视觉模拟量表(visual analogue scale,VAS)评分、美国肩肘外科协会(American Shoulder Elbow Surgeon,ASES)评分、加州大学洛杉矶分校(University of California at Los Angeles,UCLA)肩关节评分以及Constant⁃Murley评分。据此对手术效果进行评估。结果62例病人均未出现伤口感染、术后僵硬、术后再撕裂等并发症。两组病人的肩关节最大外展角度值、VAS评分、ASES评分、UCLA评分以及Constant⁃Murley评分均在术后3个月、6个月和1年得到显著改善(P<0.05)。糖尿病组的肩关节最大外展角度值及各肩关节功能评分在术前1周、术后3个月及6个月时均劣于对照组(P<0.05),但在术后12个月时,糖尿病组与对照组比较,差异无统计学意义(P>0.05)。结论糖尿病对关节镜下肩袖修复术后的病人短期恢复会存在影响,但长期临床结果没有显著差异。围手术期血糖控制良好的糖尿病病人在关节镜下肩袖修复术后表现出与非糖尿病病人相当的临床和结构恢复。展开更多
文摘Introduction: Ultrasound is the imaging technique of choice for the study of rotator cuff lesions. However, in the case of shoulder trauma, it is rarely requested in our context. This study aimed to show ultrasound lesions of the rotator cuff in cases of non-fracture shoulder trauma at the CHUYO in Ouagadougou. Methodology: This was a prospective descriptive cross-sectional study running from August 1 to November 30, 2017, in the medical imaging department of CHUYO. The study population consisted of patients received in the department for ultrasound in the context of non-fracture shoulder trauma. Results: We collected 20 cases (66.67%) of rotator cuff lesions out of 30 non-fracture shoulder injuries. The mean age of the patients was 27.6 years. Road traffic accidents accounted for 60% of injuries, sports accidents for 30%, and domestic accidents for 10%. Ultrasound lesions were mainly tendon ruptures (36.67%) and tendinitis (23.33%). Ruptures were non-transfixing in 90.90% of cases. The supraspinatus was the most affected (81.81%). Conclusion: Ultrasound can help diagnose rotator cuff injuries, particularly in non-fractured shoulder trauma.
文摘Rotator cuff repair(RCR) is one of the most commonly performed surgical procedures in orthopaedic surgery. The reported incidence of deep soft-tissue infections after RCR ranges between 0.3% and 1.9%. Deep shoulder infection after RCR appears uncommon, but the actual incidence may be higher as many cases may go unreported. Clinical presentation may include increasing shoulder pain and stiffness, high temperature, local erythema, swelling, warmth, and fibrinous exudate. Generalized fatigue and signs of sepsis may be present in severe cases. Varying clinical presentation coupled with a low index of suspicion may result in delayed diagnosis. Laboratory findings include high erythrocyte sedimentation rate and C-reactive protein level, and, rarely, abnormal peripheral blood leucocyte count. Aspiration of glenohumeral joint synovial fluid with analysis of cell count, gram staining and culture should be performed in all patients suspected with deep shoulder infection after RCR. The most commonly isolated pathogens are Propionibacterium acnes, Staphylococcus epidermidis, and Staphylococcus aureus. Management of a deep soft-tissue infection of the shoulder after RCR involves surgical debridement with lavage and long-term intravenous antibiotic treatment based on the pathogen identified. Although deep shoulder infection after RCR is usually successfully treated, complications of this condition can be devastating. Prolonged course of intravenous antibiotic treatment, extensive soft-tissue destruction and adhesions may result in substantially diminished functional outcomes.
文摘The most prevalent group of disorders of human shoulder is related to the muscles of the rotator cuff. In order to develop a mechanical method for rotator cuff muscles’ evaluation, we hypothesized that measurement of the isometric force generated by the individual muscle of the rotator cuff might detect the variations, which are characteristic to the different disorders of rotator cuff muscles in adults. The isometric force of supraspinatus, infraspinatus and subscapularis muscles were measured in patients with rotator cuff tears, calcific tendinitis and subacromial impingement syndrome, 30 patients with each disorder, and compared to the normal values from our previous study. Torque of the force was calculated and normalized to lean body mass. The profiles of the mean torque-time curves of each group were compared statistically. We found the expected significantly lower profiles of the torque-time curves of all the tested rotator cuff muscles in comparison to the normal values. The best resolution between the curves of different study groups was found in the testing of the infraspinatus muscles. Therefore the previously unrecognized variations of rotator cuff muscles’ isometric strength build up patterns in the common disorders involving the rotator cuff muscles were revealed. The presented data might be a basis for the future development of a simple mechanical diagnostic method for identification of the abnormal patterns of muscle isometric strength in patients with rotator cuff muscles’ pathology.
文摘Although the relationship between the material properties of the coracoacromial ligament and rotator cuff tears has been clarified, it is difficult to evaluate these properties in the clinical setting. The purpose of this study was to clarify the relationship between rotator cuff tears and the length and thickness of the coracoacromial ligament in living shoulders, in order to assess the potential use of these parameters as clinical indicators of the possible risk or progression of rotator cuff tears. Thirty-five volunteers (46 shoulders, mean age: 52 years) were enrolled. The presence or absence of rotator cuff tears and the length and thickness of the coracoacromial ligament were evaluated by ultrasonography. Longitudinal images of the coracoacromial ligaments with the acromion and coracoid process as landmarks were obtained, and the lengths of the ligaments were measured using acoustic shadows as the index. On the same screens, the thicknesses at the center of the ligaments were measured. Ligaments in shoulders with a rotator cuff tear were significantly shorter than ligaments in shoulders without a rotator cuff tear (25.9 ± 2.5 mm vs. 28.6 ± 1.7 mm, respectively;P < 0.0001). There was no significant difference in the thicknesses of the ligaments. The length and thickness of the coracoacromial ligament of living shoulders were easily evaluated with ultrasonography in the present study, and the coracoacromial ligament was found to be significantly shorter in shoulders with a rotator cuff tear. The risk and progression of rotator cuff tears can be evaluated clinically by measuring the length of the coracoacromial ligament.
文摘目的探讨糖尿病对关节镜下肩袖修复术后病人肩关节功能恢复的影响。方法回顾性分析我科自2019年5月至2022年5月接受关节镜下肩袖修复术的62例肩袖损伤病人的临床资料和随访结果,其中糖尿病组30例,男18例,女12例,年龄为(62.10±11.87)岁;对照组32例,男18例,女14例,年龄为(63.78±12.98)岁。手术方式均为关节镜下缝线桥技术缝合肩袖。分别记录两组病人术前1周、术后3个月、6个月和12个月各时间点肩关节最大外展角度值,以及肩关节功能评分,包括疼痛视觉模拟量表(visual analogue scale,VAS)评分、美国肩肘外科协会(American Shoulder Elbow Surgeon,ASES)评分、加州大学洛杉矶分校(University of California at Los Angeles,UCLA)肩关节评分以及Constant⁃Murley评分。据此对手术效果进行评估。结果62例病人均未出现伤口感染、术后僵硬、术后再撕裂等并发症。两组病人的肩关节最大外展角度值、VAS评分、ASES评分、UCLA评分以及Constant⁃Murley评分均在术后3个月、6个月和1年得到显著改善(P<0.05)。糖尿病组的肩关节最大外展角度值及各肩关节功能评分在术前1周、术后3个月及6个月时均劣于对照组(P<0.05),但在术后12个月时,糖尿病组与对照组比较,差异无统计学意义(P>0.05)。结论糖尿病对关节镜下肩袖修复术后的病人短期恢复会存在影响,但长期临床结果没有显著差异。围手术期血糖控制良好的糖尿病病人在关节镜下肩袖修复术后表现出与非糖尿病病人相当的临床和结构恢复。
