Description of the index

The SPADI was developed for use in an outpatient setting. It was designed to measure the impact of shoulder pathology in terms of pain and disability, for both current status and change in status over time. The initial version of die SPADI consisted of 20 items grouped into pain and disability subscales, items were selected and placed in either the pain or disability subscale by a panel that included three rheumatol-ogists and a physical therapist. The face validity of each subscale was...

SF36v1 Acute

This survey asks for your views about your health. This information will help keep track of how you feel and how welt you are able to do your usual activities. Thank you for completing this survey For each of the following questions, please mark an in the one box that best describes your answer. In general, would you say your health is Excellent Very good Good Fair Poor j 2. Compared to one week ago, how woutd you rate your health in general now 3, The following items are about activities you...

Intraarticular dislocation of the long biceps tendon combined with a complete tear of the subscapularis tendon

The biceps tendon is widened and flattened as a result of its contact with the lesser tuberosity. It is shown as a diversity of substance lesion, ranging from erosion to prerupture. The subscapularis tendon is torn from its attachment on the lesser tuberosity, and the long biceps tendon is interposed into the joint space and displaced infero-medially. On the articular side, the biceps tendon is apposed to the glenoid labrum. Entrapment of the tendon in the anterior joint space occurs with each...

Your Health and Weli Being

This survey asks for your views about your health. This information wilt help keep track of how you feel and how well you are able to do your usual activities. Thank you for completing this survey For each of the following questions, please mark an in the one box that best describes your answer. 1, In general, would you say your health is 2. Compared to one year ago, how would you rate your health in general now Much better Somewhat About the Somewhat Much worse now than one better now same as...

The Western Ontario shoulder instability index WOSI [70

The purpose of this study was to develop a valid, reliable, and responsive measurement tool for patients with shoulder instability. Since it is the patient's subjective impression of his or her function that is most important to the success of a treatment, it was decided that a disease-specific quality of life measurement tool was most appropriate. This in- The following questions concern the physical symptoms you have experienced due to your shoulder problem. In all cases, please enter the...

Classification of biceps tendon disorders according to Yamaguchi and Bindra [140

The various disorders of the long head of the biceps tendon were classified into inflammatory, unstable, or traumatic, on the basis of the original initiating event. It must be stressed that the distinction is not always clear the degenerated and inflamed tendon is more prone to trauma and, conversely, repeated trauma may result in changes in the tendon indistinguishable from those of inflammation. Nevertheless, this classification can help with the organization of the pathogenesis of these...

References

Fractures and ligamentous injuries of the clavicle and its articulation. J Bone Joint Surg Am, 49(4) 774-784, 1967 2. Amstutz, H.C., Sew Hoy, A. L., Clarke, I.C. UCLA anatomic total shoulder arthroplasty. Clin Orthop Relat Res, (155) 7-20, 1981 3. Antuna, S. A., Sperling, J. W., Cofield, R. H., Rowland, C. M. Glenoid revision surgery after total shoulder arthroplasty. J Shoulder Elbow Surg, 10(3) 217-224, 2001 4. Arlet, J., and Ficat, P. Diagnosis of primary femur head...

The rotator cuff qualityoflife measure RCQOL [59

Development of the disease-specific RC-QOL The RC-QOL was developed through a process of item generation, item reduction, pretesting, and test retest reliability analysis. Items were generated from a thorough review of the literature, discussions with clinicians experienced in the area of rotator cuff disease, and modifications of similar disease-specific quality-of-life outcome measures, as well as through direct input from a set of patients with a full spectrum of rotator cuff disease. These...

The Western Ontario rotator cuff index WORC [69

Walch Duplay Score

The purpose of the study was to develop a valid and reliable disease-specific quality-of-life measurement tool for patients with rotator cuff disease. Methodology for the development and evaluation of the tool included the following 1 identification of a specific patient population. 2 Generation of potential items, 3 item reduction, 4 protesting the prototype instrument, 5 determination of reliability, and 6 validation. The WORC consists of 21 items representing five domains pertinent to...

SF36v2 Acute

This survey asks for your views about your health. This information will help keep track of how you feel and how well you are able to do your usual activities. Thank you for completing this survey For each of the following questions, please mark an in the one boi that best describes your answer. 1. In general, would you say your health is 2, Compared to one week ago, how would you rate your health in general now Much better Somewhat About the Somewhat Much worse now than one better now same as...

Impingement and instability in the overhand or throwing athlete according to Kvitne et al [73 and Jobe et al [66

Based on the information obtained through a detailed history, physical examination, and preliminary diagnostic arthroscopy, most throwing athletes with refractory anterior shoulder pain can be classified into one of four groups. - Primary instability because of chronic labral and capsular microtrauma - Primary instability because of generalized ligamentous hyperelasticity These overhand or throwing athletes are usually older and have shoulder pain associated with pure primary impingement, but...

Constant Murley score [23

In the Constant and Murley method of functional assessment, a hundredpoint score is based on the assessment of a number of individual subjective and objective parameters in an entirely clinical setting Table 9 . The authors consider a hundred-point scoring system, combined with the ability to assess individual parameters with numerical values, to be the best method of functional assessment of the shoulder. The parameters are chosen for their functional relevance. The first subjective parameter...

Acquired

Soft tissue deficiency Bony deficiency Scapulothoracic dysfunction Acute posterior dislocations are rare, accounting for approximately 5 of all dislocations. Direct trauma to the front of the shoulder, a posteriorly directed force on an adducted arm, and indirect muscle forces seizure or electrical shock, all can cause posterior dislocation. Volitional recurrent posterior subluxation Voluntary recurrent posterior subluxation describes a group of patients with an underlying conscious or...

Classification of hidden rotator interval lesions according to Bennett [8

Abnormal Biceps

Various lesions of the rotator interval are illustrated in Fig. 20. These include subscapularis tear or intraarticular subscapularis IASS without involvement of the SGHL MCHL complex, Fig. 20 a tears of the SGHL MCHL complex without subscapularis IASS involvement, Fig. 20b and subscapularis IASS tears with involvement of the SGHL MCHL com- Fig. 20. Arthroscopic classification of hidden rotator interval lesions. The various lesions found in rotator interval. Arrows indicate potential direction...

Classifications of rotator cuff tears according to Patte [107

Snyder Cuff Tear Classification

1 Extent of the tear see Sect. 5.6 2 Topography of the tear in the sagittal plane 3 Topography of the tear in the frontal plane 4 Trophic quality of the muscle of the torn tendon 5 State of the long head of the biceps Topography of rotator cuff tear in sagittal plane according to Patte 107 Fig. 7 Segment 1 subscapularis tear Segment 2 coracohumeral ligament tear Segment 3 isolated supraspinatus tear Segment 4 tear of entire supraspinatus and one-half of infraspinatus Segment 5 tear of...

State of ACjoint space and SCjoint space according to De Palma [31

Outer Third Clavicle

Of significance was the observation that the lateral one third of the clavicles exhibits varying degrees of anterior torsion. This is readily noted if the clavicle is observed with the sternoclavicular and the acromioclavicular joints intact and if the sternum is placed in a vertical position Fig. 33a . Sixty-six such specimens obtained from cadavers were studies the clavicles fell into one of three types, each of which exhibited specific features Fig. 33b Type 1 in this group the clavicles...

Classifications of proximal humeral fractures

Proximal Humerus Fracture

11.1 Classification of proximal humeral fractures according to Neer 93 The classification adopted is based, neither on the level of the fracture nor on the mechanism of injury, but on the presence or absence of displacement of one or more of the four major segments. Since all minimally displaced fractures pose analogous problems in treatment and prognosis, it seems logical that they be grouped together, regardless of the number of fracture lines. Displaced fractures require more accurate...

Classification of fractures of the clavicle according to Neer [95101106

Coracoclavicular Avulsion

Neer classified the clavicular fractures in three groups 1. Midclavicular fracture middle third 80 Fig. 37 f 2. Fracture of the distal clavicle or interligamentous fracture 15 3. Fracture of the inner clavicle inner third 5 Distal fractures comprise 10 of clavicular injuries and can be classified into two types, depending upon the status of the ligaments Fig. 37 a . Type I resents no problem and requires little or no treatment. It occurs more frequently in ratio of 3 1. The full extent of the...

Classification of fractures of the clavicle according to Jager and Breitner [62

Lateral Third Clavicle Classification

In consideration of the treatment, Jager and Breitner expanded Neer's classification of lateral clavicular fractures Fig. 38 . Type I represents the lateral fracture without ligamentous injury with or without involvement of the AC-joint stable . The interligamenteous fractures were distinguished into Type lia with avulsion of the pars conoidea from the proximal fragment unstable Type lib with isolated avulsion of the pars trapezoidea from the lateral fragment moderate unstable Type ill...

Extraarticular dislocation combined with a partial tear of the subscapularis tendon

In this type the long biceps tendon is completely dislocated to a point over the lesser tuberosity. The deeper portions of the subscapu-laris tendon still insert into the lesser tuberosity, separating the biceps tendon from the joint space. Invariably there is a rupture of the common attachment of the superior glenohumeral ligament and cor-acohumeral ligament. The biceps tendon, then, is displaced over the anterior wall of the groove and slips or glides medially over the torn fibres of the...

Classifications of scapular fractures

Scapula Inferior Fracture Malunion

12.1 Classification of scapula fractures according to Euler and Ruedi 37 Basically scapular fractures can be classified into intracapsular and extracapsular fractures. This classification is to be geared to anatomical structures and represents an ascending order of the injury severity. The aim is to give a prognosis to the expected loss of function Fig. 47 . Scapula blade, isolated or comminuted B Fractures of the processes C Fractures of the scapular neck C1 Anatomical neck C2 Surgical neck C3...

Classification of shoulder instability according to Gerber et al [44 45 118

Hyperlaxity can be combined with instability, however it is not a primarily disease, but it characterises an individual constitution. Therefore multidirectional instability should be distinguished from multidirectional hyperlaxity and should be considered into a classification of shoulder instability. This differentiation of laxity and instability lead to the following classification 2 Unidirectional instability without hyperlaxity 3 Unidirectional instability with hyperlaxity 4...

Classification of clavicular fractures according to Craig [24

Classifica Craig Clavicula

On the base of Allman's classification Craig introduced in 1990 a more detailed classification of clavicular fractures that was based on the variable fracture patterns seen within the three broad groups of Allman's clavicle fracture classification Group I fracture of the middle third Group II fracture of the distal third - Type I minimal displacement interligamentous - Type II displaced secondary to a fracture medial to the coracocla-vicular ligaments A. Conoid and trapezoid attached B. Conoid...

Rotator Cuff Fracture

Fracture Type

Fig. 44 f The AO classification of proximal humeral fractures Proximal and distal segments In the proximal and distal segments the fractures are either extraarticular type A or articular. The articular fractures are either partial articular type B or complete articular type C . The three exceptions are the proximal humerus A extraarticular unifocal, B extraarticular bifocal, and C articular , the proximal fe mur A trochanteric area, B neck, C head , and the malleolar segment A infrasyndesmotic,...

Classification of fractures of the clavicle in adult according to Robinson [114

Clavicle Fracture Rockwood

A new classification was developed based on radiological review of the anatomical site and the extent of displacement, comminution and articular extension out of 1000 patients. There were satisfactory levels of inter- and intraobserver variation for reliability and reproducibility. Fractures of the medial fifth type 1 , undisplaced diaphyseal fractures type 2 A and fractures or the outer firth type 3 A usually had a benign prognosis. The incidence of complications of union was higher in...

Peithes line

Sion Perthes

- Classic Perthes lesion complete detachment of the labrum together with the inferior glenohumeral ligament from the glenoid rim, in which the inferior glenohumeral ligament is detached subperioste-al from the scapular neck periosteal pouch . - ALPSA lesion 104 deperiostation of the labrum and the inferior glenohumeral ligament from the anterior scapular neck with the development of a scar formation at the base of the periosteal pouch. Non-Bankart Capsular substance Quattro lesion HAGL lesion...

Classification of significant Hill Sachs lesions according to Burkhart and De Beer [18

Hill Sach Lesion Engaging

Dynamic arthroscopic examination of the shoulder as it went into abduction and external rotation revealed the geometric etiology of the symptoms there was an articular-arc deficit on the humeral side with an engaging Hill-Sachs lesion Fig. 30 a . That is, with the arm in abduction of 90 , if the shoulder was externally rotated more than 30 , the Hill-Sachs lesion would engage the anterior corner of the glenoid, and the patient would sense that engagement as a popping or catching sensation. The...

Classification of frozen shoulder according to Lundberg [81

Primary frozen shoulders were defined as follows a The total elevation in the shoulder joint restricted to 135 or less. b The restriction of motion localized to the humero-scapular joint. c No findings in the case history or in the clinical or radiological examination which could explain the decrease of the range of motion by the latter criterion cases with post-traumatic conditions, rheumatoid arthritis, osteoarthritis, hemiplegia and other more obvious changes, were excluded. The range of...

Superior labrum anterior to posterior lesion according to Snyder [122 123

Slap Snyder

A SLAP lesion is defined as an injury of the superior labrum from anterior to posterior in relation to the biceps tendon anchor. Type 1 fraying and fragmentation of the free edge of the superior labrum. - This is often a relatively minor problem that is commonly encountered during routine arthroscopy in middle-aged and older patients Fig. 17 a . Type 2 the biceps anchor is significantly detached from the superior - Usually associated with fraying of the edge of the labrum. - The middle...

Classification of supraspinatus muscle atrophy in MRI according to Zanetti [142

Infraspinatus Muscle Pictures

Magnetic resonance imaging was performed on a 1.0-Tesla scanner. A sequence of parasagittal T1-weighted turbo spin-echo MRI images repetition time TR echo time TE 700 12 ms parallel to the glenohu-meral joint space was obtained. For quantitative assessment, areas and SIs of the rotator cuff muscle and the area of the fossa supraspinata were measured at the most lateral image on which the scapular spine is in contact with the rest of the scapula Fig. 14 a . Tangent Sign Qualitative assessment of...

Arthroscopic stages of adhesive capsulitis according to Neviaser [103

Adhesive capsulitis is a specific entity consisting of four identifiable In stage 1, patients usually present with signs and symptoms of the impingement syndrome. Their motion usually is restricted very little if at all, and that restriction fools the physician into believing this loss of motion and increased pain are due to a rotator cuff tendinitis the impingement sign . The usual treatment for the impingement syndrome fails, often to the point that decompression of the acromial arch is...

Classification of SLAP lesion according to Maffet et al [82

Slap Maffet

The authors performed a diagnostic arthroscopy in 63 patients. Of these, 62 had lesions that fit within the classifications system of Snyder 122, 123 . Thirty-eight percent in this study had significant biceps tendon-superior labrum injury that did not fit into the classification system proposed by Snyder 122, 123 . The authors defined three additional types of SLAP lesions Type I-IV are equivalent to Snyder's classification Type V an anterior-inferior Bankart lesion continues superiorly to...

Triangular defect

Rotator Cuff Infraspinatus Mobilization

Reverse L Supraspinatus tear extends medially through rotator cuff interval in line with long head of biceps tendon Fig. 10 b A moderate-sized triangular defect is most commonly produced when a supraspinatus tear extends medially along its anterior border in a line with the long head of the biceps tendon. This limb of the tear is located through the relatively thin fibrocapsular area between the subscapularis and supraspinatus tendon. The long head of the biceps tendon travels below the...

Arthroscopic classification of partialthickness rotator cuff tears according to Ellman [32

Partial Thickness Tear Rotator

The author stated that any tear, whether partial or complete, should be classified as Stage III impingement according to Neer 97 . The following subclassification of Stage III is proposed to include both partialand full-thickness rotator cuff tears Table 1 . The classification of partial-thickness tears Fig. 9 34 indicates which surface is involved and grades the severity of the tear according to depth. The normal cuff is considered to be 10-12-mm thick. A Grade 1 partial tear less than 3-mm...

Classification of supraspinatus muscle atrophy in MRI according to Thomazeau [128

Grading Supraspinatus Atrophy

All MRI images were obtained with a 1 Tesla unit. The quantitative analysis was then performed on the spin-echo Tl-weighted oblique-sagittal images TR 480 ms, TE 12 ms, FOV 250X250, matrix 380X512 . To evaluate the atrophy of the supraspinatus muscle, the occupation ratio R of the supraspinatus fossa by the muscle belly is calculated. This analysis was based on the ratio between the surface of the muscle S1 and the surface delineated by the limits of the fossa S2 Fig. 12 . The selected...