Online ISSN: 2515-8260

Keywords : Shoulder


Role of PHILOS in Proximal Humerus Fractures

Kodidala Nagarjuna, Puppala Vinmaie, V. Nageswara Rao, N. Ramesh Kumar, R Shahnawaz Hussain .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 1896-1900

Background: Proximal humerus fractures are common and debilitating injuries and the incidence of them are increasing especially in the elderly. Treatment of unstable, displaced, and comminuted proximal humerus fractures remain challenging. Significant controversy continues regarding the best methods of treating displaced proximal humerus fractures. The treatment goal is to achieve a painless shoulder with a fully functional outcome. Regarding the treatment of proximal humerus fractures, controversies still exist about whether to do conservative or operative management. Various operative procedures are carried out like percutaneous pinning, tension band wiring, platting, and rush nailing. A recent method of internal fixation is with locking plates. PHILOS plates provide rigid fixation and more angular stability compared to other methods of operative treatment of proximal humerus fractures and help in early mobilization and physiotherapy which leads to achieving a painless shoulder with a good functional outcome.
Materials and Methods: Patients with fractures of the proximal humerus admitted to our centre between August 2020 to July 2021 will be taken up for study after obtaining consent. Clinical evaluation was done by the Constant Murley score. Fractures are classified using Neer s classification. A minimum of 24 cases are studied.
Results: In conclusion locking Compression plate is an advantageous implant in proximal humeral fractures due to angular stability, particularly in comminuted fractures and in Osteoporotic bones in elderly patients, thus allowing early mobilization.

Study of the acromion process of scapula and its clinical importance

Dr Mrs.Swapna.A.Shedge, Dr Sandeep.S.Mohite, Dr Manoj.P.Ambali

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 5466-5469

Aim: Study of the acromion process of scapula and its clinical importance.
Materials and methods: The present study used 180 dry adult scapulae (100 right, 80 left) of unknown age and sex at the anatomy department. Broken and wounded scapulae, as well as those with unique and complete features, were excluded from the study. Each scapula was morphologically examined, and the following acromion process parameters were measured and reported in millimetres using a Vernier calliper (mm).
Results: In the current research, the mean values of acromion length were 43.57±4.66 mm in total samples, 43.58±4.58 mm in right side, and 43.56±4.74 mm in left side. (Table 1) The mean values of acromion width were 27.66±3.51 mm in total samples, 27.78±3.58 mm in right side, and 27.54±3.44 mm in left side. (Table 2) The average distance from the tip of the acromion process to the tip of the coracoid process in the overall sample was 34.53± 2.91 mm, 34.17±2.96 mm on the right side, and 34.89±2.87 mm on the left side. (Table 3) The mean acromio-glenoid distance observed in the overall sample was 30.55±3.62, 30.11±3.69 mm on the right side, and 30.98±3.55 mm in the left side.
Conclusion: The acromion process is vital in shoulder joint development and provides stability. The morphometric study of the acromion may be utilised as an adjunct to encourage a better understanding of the illness that manifests itself in the shoulder area

A COMPARATIVE STUDY OF MANIPULATION UNDER ANAESTHESIA VERSUS ARTHROSCOPIC CAPSULAR RELEASE IN ADHESIVE CAPSULITIS OF SHOULDER

Dr, Debojyoti Mukherjee, Dr.Arshad Ahmed

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 1161-1174

Background: Adhesive capsulitis is not completely known, and recent studies have shown that it can lead to long-term disability over the course of several years13,17,27Long-term follow-up studies have shown that patients underestimate the amount of objective motion lost and that the duration of symptoms before medical care is sought may be correlated with recovery. Patients seeking care earlier usually recover more quickly.
Materials and Methods:
In Department Of Orthopaedics, R.G.Kar Medical College, Kolkata from november 2011 to september 2013 patients presenting to the outdoor patient department with clinical features of Adhesive Capsulitis of shoulder are evaluated with variables like  Age, Sex, Dominance of extremity, Diabetes, Duration of symptoms. A total of 44 patients satisfied the inclusion criteria. 4 patients were lost to follow up and thus 40 patients were available for follow up and evaluated.
Results: A total of 40 patients were evaluated. The MUA   group consisted of 23 patients and the ACR group consisted of 17 patients. The mean improvement in the MUA   group of patients at the final follow up of 6 months was 50.69 on the CMS score. The mean pre-operative CMS score was 22.0(+ 4.7)  and rose to  72.69 (+ 7.87) at 6 months. The mean pre-operative CMS score for ACR patients was 18.47(+4.47) and rose to 82.41 (+ 6.69) at 6 months follow up, with an improvement of 63.94 points.
Conclusion: Overall the results of ACR were encouraging over MUA across all stratifications. Abduction and internal rotation were in particular significantly better and pain reduction was earlier for ACR group of patients. This accounted for better functional scores in these patients.

Role of ultrasound and MRI in patients with shoulder pathologies: A correlation study

Dr.Paramjit Singh, Dr.Amanpreet Kaur, Dr.Suman Bhagat, Dr. Gurinder Bir Singh, Dr. Nikhil Gupta

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 2890-2899

Introduction: The rotator cuff disorders constitute the most common cause of shoulder
pathologies. Ultrasonography and MRI are widely used in evaluating various shoulder
pathologies. USG of shoulder is simple, cheap, fast and non-invasive imaging technology
for detection of rotator cuff and non- rotator cuff abnormalities. In this study we have
assessed the usefulness of USG in diagnosing the shoulder pathologies and have correlated
with the MRI.
Aim: Evaluation of a patient with shoulder pathology with ultrasonography as the initial
line of imaging technique as compared to MRI, assessing the accuracy of ultrasonography
in diagnosing shoulder joint pathologies, especially rotator cuff abnormalities, using MRI
as a reference standard and correlating findings wherever possible.
Materials and Methods: Hundred patients were studied prospectively over a period of two
years. Study subjects included both men and women in all age groups with suspected
shoulder pathology, suspected to have musculo-tendinous origin. All patients underwent
USG evaluation of the shoulder joint followed by MRI of the affected shoulder.
Results: USG showed a sensitivity of 85%, specificity of 100%, PPV of 100% and NPV of
97% in diagnosing full thickness tear of rotator cuff using MRI as reference. For partial
thickness tears, it showed a sensitivity of 71%, specificity of 69%, PPV of 82% and NPV of
54%. Overall accuracy of USG in detection of any tear of rotator cuff with MRI as
reference was 82%. The strength of agreement between USG and MRI for the diagnosis of
any tear of rotator cuff is considered to be ‘substantial’ in our study (Kappa=0.635).
Conclusion: USG showed comparable results to MRI in assessment of rotator cuff
abnormality and should be used as first line of investigation in patients presenting with
shoulder pathologies. It proved to have high sensitivity and specificity for full thickness
tears with relatively less sensitivity and specificity in detection of partial thickness tear.

PREVALENCE OF ASYMPTOMATIC ROTATOR CUFF TEARS IN INDIVIDUALS WITH CONTRA LATERAL SYMPTOMATIC ROTATOR CUFF TEAR DIAGNOSED BY ULTRASONOGRAPHY IN A HOSPITAL. ORIGINAL RESEARCH ARTICLE

Dr. Ashish. S. Babhulkar, Dr. Dhananjay. D. Deshmukh, Dr. Ajinkya. N. Deshpande

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 4792-4801

Shoulder disorders are the most common complaint in general population and have an unfavorable outcome in many patients. Shoulder pain is the third most common cause of musculoskeletal consultation in primary care. Degenerative rotator cuff tear is the characteristic cause of shoulder pain and most often involves the supraspinatus tendon (SSP tendon). These tears can cause the significant impact on patient’s life, marking the functional impairment of shoulder joints. Plain radiography, ultrasonography, MRI, are the imaging modalities used for the assessment of rotator cuff-related pathologies. Ultrasonography of shoulder is accepted as the investigation of choice for rotator cuff abnormality mainly because it is non-invasive, cost effective, time consuming and well tolerated imaging modality that uses high frequency transducers to diagnose rotator cuff tears.This research deals with the study of prevalence of asymptomatic rotator cuff tears and their correlation with respect to age, sex, hand dominance and diabetes mellitus.

RESULTS OF TREATMENT OF SPRENGEL DISEASE IN CHILDREN.

F.Sh. Alimukhamedova; A.M. Dzhuraev .

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 4396-4406

Summary. In the department of pediatric orthopedics of the RSSPMCTO over the past 15 years 82 children with a congenital high scapula at the age from 3 to 14 years have been treated. The osteoarticular and neuromuscular systems, X-ray, MSCT and electroneuromyographic studies were performed to assess the general condition of the patient. Surgical treatment was carried out in 34 children without reconstruction and in 40 with reconstruction of the shape of the scapula. Of all 74 patients examined in the long-term period after treatment, we obtained good results in 75.7% of cases, satisfactory in 21.6%, and unsatisfactory anatomical and cosmetic treatment results in 2.7%.