What's New in Shoulder and Elbow Surgery

The Leni and Peter W. May Department of Orthopaedic Surgery, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA.
The Journal of Bone and Joint Surgery (Impact Factor: 5.28). 07/2012; 94(14):1338-42. DOI: 10.2106/JBJS.L.00469
Source: PubMed
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Available from: Matthew L. Ramsey, Aug 07, 2014
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    ABSTRACT: Die Arthroskopie des Ellenbogengelenkes gewinnt zunehmend an Bedeutung. Eine umfassende Untersuchung und präoperative Diagnostik sind für eine korrekte Indikationsstellung entscheidend. Neben den häufigen Eingriffen an Gelenkhaut und Knorpel können bei zunehmender Expertise auch Instabilitäten sowie Bewegungseinschränkungen arthroskopisch therapiert werden. Eine Ausweitung der Indikationsstellung auf die Frakturversorgung des Ellenbogengelenkes stellt aktuell noch eine Ausnahme dar.
    Trauma und Berufskrankheit 12/2011; 13(4). DOI:10.1007/s10039-011-1810-4
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    ABSTRACT: Die arthroskopische Therapie von Weichteillsionen der Schulter hat in vielen Bereichen die offene Chirurgie weitgehend abgelst. So werden an vielen Kliniken heute komplexe Pathologien am Kapsel-Labrum-Apparat und an der Rotatorenmanschette zunehmend in arthroskopischer Technik versorgt. Auf Basis dieser rapiden technischen Evolution hat sich auf der anderen Seite eine groes Spektrum an mglichen Komplikationen entwickelt. Dieses betrifft sowohl den technischen Umgang mit den neuen Instrumentarien und Ankersystemen als auch die Analyse der jeweils vorliegenden Weichteillsion mit darauf aufbauender Therapie.Diese Arbeit soll eine bersicht ber die verschiedenen Komplikationen bei rekonstruktiven arthroskopischen Schulteroperationen geben und mgliche Vermeidungs- bzw. Lsungsstrategien erlutern.Arthroscopic surgery of the shoulder has taken the place of open surgery in many cases of soft tissue lesions. A lot of surgeons now use an arthroscopic technique for the management of even complex forms of shoulder instability and rotator cuff tears. On the other hand, due to this rapid development a large scale of possible complications has developed comprising both the technical aspects of instruments and implants as well as the analysis and the subsequent treatment of the particular pathologies found.This paper is an overview of different complications in reconstructive arthroscopic shoulder surgery and explains some possible strategies for avoiding and managing these problems.
    Arthroskopie 01/2006; 19(2):157-171. DOI:10.1007/s00142-006-0346-2
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    ABSTRACT: IntroductionWe report a case of an iatrogenic neck of humerus fracture sustained during MUA, following arthroscopic capsular release, for a diagnosis of frozen shoulder. The patient was subsequently diagnosed as having shoulder girdle metastatic disease. Case historyA 70years old lady presented with a 4month history of severe progressive pain in the right shoulder. The patient had had breast cancer treated 18years with subsequent local recurrence 10years after her original diagnosis. Examination of her right shoulder revealed bony tenderness and decreased range of motion in all directions. Shoulder X-ray showed osteopaenia. Conservative treatment for a diagnosis of frozen shoulder failed to alleviate her pain and she was offered arthroscopic capsular release and MUA. During the manipulation she sustained iatrogenic neck of humerus fracture. A bone scan showed diffuse osteoblastic activity due to the acute fracture. Conservative management of the fracture was initiated with close clinical follow-up with serial shoulder X-rays. A lytic lesion was noted in the humeral head 3months after the operation. MRI was performed at this stage, showing a large metastatic deposit with extensive extra osseous soft tissue spread. She underwent excision of the proximal humerus with the overlying deltoid muscle and insertion of a spacer. ConclusionWe would recommend having a low threshold for extensive imaging if there is a strong suspicion of metastatic disease. Shoulder MRI scan and biopsy in addition to bone scan and plain film should be performed to rule out malignancy before proceeding to any surgical intervention. KeywordsFrozen shoulder–Adhesive capsulitis–Pathological fracture–Manipulation under anaesthesia
    European Journal of Orthopaedic Surgery & Traumatology 05/2011; 21(4):289-292. DOI:10.1007/s00590-010-0702-9 · 0.18 Impact Factor
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