Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · May 2013
Randomized Controlled Trial Comparative StudyA double-blind randomized controlled trial comparing the effects of subacromial injection with corticosteroid versus NSAID in patients with shoulder impingement syndrome.
The objective of this study was to compare the efficacy of subacromial injection of triamcinolone compared to injection of ketorolac in the treatment of external shoulder impingement syndrome. ⋯ In this study, an injection of ketorolac resulted in greater improvements in the UCLA shoulder rating scale than an injection of triamcinolone at 4 weeks follow-up. While both triamcinolone and ketorolac are effective in the treatment of isolated subacromial impingement, ketorolac appears to have equivalent if not superior efficacy; all the while decreasing patient exposure to the potential side-effects of corticosteroids.
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J Shoulder Elbow Surg · May 2013
Glenohumeral range of motion in handball players with and without throwing-related shoulder pain.
Overhead athletes are subject to adaptations in the shoulder including glenohumeral internal rotation deficit (GIRD). It has been documented that this alteration is more evident in overhead athletes with pain. Our objective was to compare glenohumeral rotation motion between symptomatic and asymptomatic handball players. ⋯ Handball players showed specific adaptations in the throwing shoulder; in particular, handball players with pain have greater GIRD, ERG, and external rotation and lesser internal rotation of the throwing shoulder.
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J Shoulder Elbow Surg · May 2013
Accurate coracoid graft placement through use of a drill guide for the Latarjet procedure.
The Latarjet procedure has widely become the preferred treatment option for recurrent anterior glenohumeral instability in the presence of glenoid bone loss. The success of this procedure is largely dependent on accurate placement of the coracoid bone graft relative to the glenoid margin. With malpositioning of the coracoid graft, complications can arise, such as recurrent instability if placed too medially or impingement and subsequent early degenerative changes if positioned too laterally. To increase the accuracy and reproducibility of coracoid graft placement, we developed a simple and efficient drill guide that assists in accurate and safe positioning of the graft against the anterior glenoid to provide a congruent articular surface. ⋯ The use of a simple drill guide allows safe and accurate graft placement during an open Latarjet procedure.
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J Shoulder Elbow Surg · Apr 2013
Comparative StudyBiomechanical analysis of a novel locking plate with smooth pegs versus a conventional locking plate with threaded screws for proximal humerus fractures.
Repair of proximal humeral fractures with locking plates has greatly improved outcomes. However, an alarming rate of complications including screw cutout and impingement under the acromion has recently been reported. A novel locking plate with smooth pegs was developed to reduce these risks. The purpose of this study was to compare these 2 fixation methods with a cadaveric biomechanical study. ⋯ The SP group demonstrated superior biomechanical characteristics to the TS group in regards to cyclic bending.
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J Shoulder Elbow Surg · Apr 2013
Randomized Controlled TrialEfficacies of corticosteroid injection at different sites of the shoulder for the treatment of adhesive capsulitis.
A corticosteroid injection in the glenohumeral joint conducted blindly is technically demanding with a low rate of accuracy despite satisfactory clinical outcomes in the treatment for adhesive capsulitis. This study prospectively compared the clinical outcomes of patients with idiopathic adhesive capsulitis treated by a single corticosteroid injection in different locations of the shoulder. ⋯ The efficacy of a single corticosteroid injection was not found to be related to the site of injection. However, a single corticosteroid injection provided faster pain relief, a higher level of patient satisfaction, and an earlier improvement in shoulder motion and function than medication in patients with adhesive capsulitis.