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H Graichen - One of the best experts on this subject based on the ideXlab platform.
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three dimensional analysis of Shoulder Girdle and supraspinatus motion patterns in patients with impingement syndrome
Journal of Orthopaedic Research, 2001Co-Authors: H Graichen, T Stammberger, H Bonel, E Wiedemann, Karlhans Englmeier, M Reiser, F EcksteinAbstract:Alterations of the Shoulder Girdle motion have been suggested to be associated with Shoulder disorders. The objective of this study was to perform a three-dimensional (3D) motion analysis of the supraspinatus muscle and Shoulder Girdle in patients with different stages of impingement syndrome. 20 patients with unilateral impingement and 14 normal controls were investigated at 30°, 90°, and 120° of abduction with and without abducting muscle activity. The spatial relationship between the Shoulder Girdle elements and the supraspinatus was quantified from open MRI data. No significant alterations in glenoid rotation were observed between the patients and asymptomatic volunteers. However, while in the healthy volunteers the values showed a normal distribution (28.5±3.6° at 90° abduction with muscle activity), the patients (30.5°±9.7°) contained a subset of five individuals with an obvious increase in glenoid rotation angle (>40°) compared with controls (>2.5 standard deviations higher than the mean) and with the healthy contralateral side. These five patients also displayed alterations in the scapulo-humeral rhythm and supraspinatus motion, but not in clavicular position. The study shows that only a specific subset of patients with impingement syndrome demonstrates complex changes in Shoulder Girdle and supraspinatus motion patterns, suggesting that this subset may benefit from an alternative type of treatment.
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three dimensional analysis of Shoulder Girdle and supraspinatus motion patterns in patients with impingement syndrome
Journal of Orthopaedic Research, 2001Co-Authors: H Graichen, T Stammberger, H Bonel, E Wiedemann, Karlhans Englmeier, M Reiser, F EcksteinAbstract:Alterations of the Shoulder Girdle motion have been suggested to be associated with Shoulder disorders. The objective of this study was to perform a three-dimensional (3D) motion analysis of the supraspinatus muscle and Shoulder Girdle in patients with different stages of impingement syndrome. 20 patients with unilateral impingement and 14 normal controls were investigated at 30 degrees, 90 degrees, and 120 degrees of abduction with and without abducting muscle activity. The spatial relationship between the Shoulder Girdle elements and the supraspinatus was quantified from open MRI data. No significant alterations in glenoid rotation were observed between the patients and asymptomatic volunteers. However, while in the healthy volunteers the values showed a normal distribution (28.5+/-3.6 degrees at 90 degrees abduction with muscle activity), the patients (30.5 degrees+/-9.7 degrees) contained a subset of five individuals with an obvious increase in glenoid rotation angle (>40 degrees) compared with controls (>2.5 standard deviations higher than the mean) and with the healthy contralateral side. These five patients also displayed alterations in the scapulo-humeral rhythm and supraspinatus motion, but not in clavicular position. The study shows that only a specific subset of patients with impingement syndrome demonstrates complex changes in Shoulder Girdle and supraspinatus motion patterns, suggesting that this subset may benefit from an alternative type of treatment.
F Eckstein - One of the best experts on this subject based on the ideXlab platform.
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three dimensional analysis of Shoulder Girdle and supraspinatus motion patterns in patients with impingement syndrome
Journal of Orthopaedic Research, 2001Co-Authors: H Graichen, T Stammberger, H Bonel, E Wiedemann, Karlhans Englmeier, M Reiser, F EcksteinAbstract:Alterations of the Shoulder Girdle motion have been suggested to be associated with Shoulder disorders. The objective of this study was to perform a three-dimensional (3D) motion analysis of the supraspinatus muscle and Shoulder Girdle in patients with different stages of impingement syndrome. 20 patients with unilateral impingement and 14 normal controls were investigated at 30°, 90°, and 120° of abduction with and without abducting muscle activity. The spatial relationship between the Shoulder Girdle elements and the supraspinatus was quantified from open MRI data. No significant alterations in glenoid rotation were observed between the patients and asymptomatic volunteers. However, while in the healthy volunteers the values showed a normal distribution (28.5±3.6° at 90° abduction with muscle activity), the patients (30.5°±9.7°) contained a subset of five individuals with an obvious increase in glenoid rotation angle (>40°) compared with controls (>2.5 standard deviations higher than the mean) and with the healthy contralateral side. These five patients also displayed alterations in the scapulo-humeral rhythm and supraspinatus motion, but not in clavicular position. The study shows that only a specific subset of patients with impingement syndrome demonstrates complex changes in Shoulder Girdle and supraspinatus motion patterns, suggesting that this subset may benefit from an alternative type of treatment.
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three dimensional analysis of Shoulder Girdle and supraspinatus motion patterns in patients with impingement syndrome
Journal of Orthopaedic Research, 2001Co-Authors: H Graichen, T Stammberger, H Bonel, E Wiedemann, Karlhans Englmeier, M Reiser, F EcksteinAbstract:Alterations of the Shoulder Girdle motion have been suggested to be associated with Shoulder disorders. The objective of this study was to perform a three-dimensional (3D) motion analysis of the supraspinatus muscle and Shoulder Girdle in patients with different stages of impingement syndrome. 20 patients with unilateral impingement and 14 normal controls were investigated at 30 degrees, 90 degrees, and 120 degrees of abduction with and without abducting muscle activity. The spatial relationship between the Shoulder Girdle elements and the supraspinatus was quantified from open MRI data. No significant alterations in glenoid rotation were observed between the patients and asymptomatic volunteers. However, while in the healthy volunteers the values showed a normal distribution (28.5+/-3.6 degrees at 90 degrees abduction with muscle activity), the patients (30.5 degrees+/-9.7 degrees) contained a subset of five individuals with an obvious increase in glenoid rotation angle (>40 degrees) compared with controls (>2.5 standard deviations higher than the mean) and with the healthy contralateral side. These five patients also displayed alterations in the scapulo-humeral rhythm and supraspinatus motion, but not in clavicular position. The study shows that only a specific subset of patients with impingement syndrome demonstrates complex changes in Shoulder Girdle and supraspinatus motion patterns, suggesting that this subset may benefit from an alternative type of treatment.
Roger M. Tillman - One of the best experts on this subject based on the ideXlab platform.
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FOREQUARTER AMPUTATION FOR HIGH-GRADE MALIGNANT TUMOURS OF THE Shoulder Girdle
2016Co-Authors: S. M. Bhagia, Roger M. Tillman, Orthopaedic Registrar, Consultant Orthopaedic Surgeon, Robert J. GrimerAbstract:We reviewed 20 patients after forequarter amputation performed for high-grade malignant tumours of the Shoulder Girdle (Enneking grades IIB to III). The operations were classified as palliative or curative according to the resection margins and the presence of disseminated disease at the time of the surgery. There were five palliative and 15 curative procedures. Two patients died from unrelated causes, septicaemia and suicide. Eight died in the first two years, four of whom had had a palliative operation. Four died between two and five years after surgery, one after a palliative operation. Five patients are alive, at a mean of 89.4 months after surgery, four of whom are free from disease. The median survival after a palliative amputation was 20.6 months. Our overall five-year survival (palliative and curative cases) was 21.2%, for curative cases it was 30.2%. None of the patients use an artificial prosthesis. Despite the disfigurement which results from this operation, it still has a useful role to play in the management of high-grade malignant tumours of the upper limb. J Bone Joint Surg [Br] 1997;79-B:924-6
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Forequarter amputation for high-grade malignant tumours of the Shoulder Girdle
The Journal of bone and joint surgery. British volume, 1997Co-Authors: S. M. Bhagia, E. M. Elek, Robert J. Grimer, Simon R. Carter, Roger M. TillmanAbstract:We reviewed 20 patients after forequarter amputation performed for high-grade malignant tumours of the Shoulder Girdle (Enneking grades IIB to III). The operations were classified as palliative or curative according to the resection margins and the presence of disseminated disease at the time of the surgery. There were five palliative and 15 curative procedures. Two patients died from unrelated causes, septicaemia and suicide. Eight died in the first two years, four of whom had had a palliative operation. Four died between two and five years after surgery, one after a palliative operation. Five patients are alive, at a mean of 89.4 months after surgery, four of whom are free from disease. The median survival after a palliative amputation was 20.6 months. Our overall five-year survival (palliative and curative cases) was 21.2%, for curative cases it was 30.2%. None of the patients use an artificial prosthesis. Despite the disfigurement which results from this operation, it still has a useful role to play in the management of high-grade malignant tumours of the upper limb.
Martin M. Malawer - One of the best experts on this subject based on the ideXlab platform.
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limb sparing resections of the Shoulder Girdle
Journal of The American College of Surgeons, 2002Co-Authors: Jacob Bickels, James C. Wittig, Yehuda Kollender, Isaac Meller, Kristen L Kellargraney, Martin M. MalawerAbstract:Abstract BACKGROUND: Limb-sparing surgeries around the Shoulder Girdle pose a surgical difficulty, because tumors arising in this location are frequently large at presentation, are juxtaposed to the neurovascular bundle, require en bloc resection of proportionally large amounts of bone and soft tissues, and necessitate complex resection and reconstruction. STUDY DESIGN: Between 1980 and 1997, we treated 134 patients who presented with 110 primary malignant, 12 metastatic, and 12 benign aggressive bone and soft tissue tumors of the Shoulder Girdle and subsequently underwent a limb-sparing resection. Reconstruction of the bone defect included 92 proximal humerus and 9 scapular prostheses. All patients were followed up for a minimum of 2 years. We summarize the principles of limb-sparing resections of the Shoulder Girdle, with emphasis on the surgical anatomy of the Shoulder Girdle, principles of resection and reconstruction, and functional outcomes. RESULTS: Function was estimated to be good or excellent in 101 patients (75.4%), moderate in 23 patients (17.1%), and poor in 10 patients (7.5%). Complications included 13 transient nerve palsies, 2 deep wound infections, and 1 prosthetic loosening. Local tumor recurrence occurred in 5 of 103 (4.9%) patients with primary sarcomas of the Shoulder Girdle. CONCLUSIONS: Detailed preoperative evaluation and surgical planning are essential for performing a limb-sparing resection around the Shoulder Girdle. Local tumor control, associated with good functional outcomes, is achieved in the majority of patients.
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Palliative forequarter amputation for metastatic carcinoma to the Shoulder Girdle region: Indications, preoperative evaluation, surgical technique, and results
Journal of surgical oncology, 2001Co-Authors: James C. Wittig, Jacob Bickels, Yehuda Kollender, Kristen L. Kellar-graney, Isaac Meller, Martin M. MalawerAbstract:Background and Objectives Uncontrolled metastatic carcinoma of the Shoulder Girdle is a difficult oncologic problem. This study reviews our experience with palliative forequarter amputation with emphasis on patient selection criteria, preoperative radiologic assessment, surgical technique, epineural postoperative analgesia, and clinical outcome. Methods Eight patients who underwent palliative forequarter amputation for metastatic carcinoma between 1980 and 1999 were analyzed retrospectively. Diagnoses included breast carcinoma (n = 3), squamous cell carcinoma (n = 2), hypernephroma (n = 2), and carcinoma of unknown origin (n = 1). All patients presented with severe, intractable pain and a useless extremity. Venography demonstrated obliteration of the axillary vein in each of the patients in whom this procedure was performed. Exploration of the brachial plexus confirmed tumor encasement and unresectability in all patients. Epineural catheters for bupivacaine infusion were placed for postoperative pain control. Results All patients experienced dramatic pain relief and improved mobility and overall function. Life-threatening hemorrhage and sepsis were alleviated. There were no instances of phantom limb pain or adverse psychological reactions, and no complications related to epineural analgesia. Conclusions Palliative forequarter amputation is relatively safe and reliable and provides effective pain relief for selected patients with unresectable metastatic carcinoma to the axilla and bony Shoulder Girdle in whom radiotherapy and/or chemotherapy has not been effective. The triad of pain, motor loss, and an obliterated axillary vein is indicative of brachial plexus infiltration and unresectability. J. Surg. Oncol. 2001; 77:105–113. © 2001 Wiley-Liss, Inc.
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a new surgical classification system for Shoulder Girdle resections analysis of 38 patients
Clinical Orthopaedics and Related Research, 1991Co-Authors: Martin M. Malawer, Isaac Meller, William K DunhamAbstract:A new, six-stage surgical classification system is described for Shoulder-Girdle resections for patients being treated by limb-sparing procedures for bone and soft-tissue tumors. The classification is based upon current concepts of oncological surgery, the structures removed, the type of resection performed, and the relationship of the resection to the glenohumeral joint, and it indicates the increasing surgical magnitude of the procedure. Data from 38 patients with an average follow-up period of 4.6 years (range, two to 8.4 years) were analyzed. Thirty-two tumors were in bone and six in soft tissue. Eighty-seven percent (33 of the 38 tumors) were malignant. Twenty-four lesions were located in the proximal humerus and 14 in the scapula. The system permitted classification of all Shoulder Girdle resections done in this study's institutions. The classification is proposed as a means of establishing a uniform terminology in the comparison of such data.
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tumors of the Shoulder Girdle technique of resection and description of a surgical classification
Orthopedic Clinics of North America, 1991Co-Authors: Martin M. MalawerAbstract:Limb-sparing surgery is safe and reliable for most bone and soft-tissue tumors of the Shoulder Girdle. Eighty to ninety percent of patients with high-grade sarcomas of the Shoulder can be safely treated by the various surgical techniques described. Attention must be paid to appropriate patient selection, preoperative staging, and planning. In addition, careful skeletal and muscular reconstruction of the surgical defect is necessary for a successful outcome. A new, universal, classification schemata (types I-VI) of Shoulder Girdle resections has been developed. This classification system is based on the bones resected, the status of the abductor mechanism, and the relationship to the glenohumeral joint. This system permits easy description and comparison of the various limb-sparing procedures performed.
Ryan M Carney - One of the best experts on this subject based on the ideXlab platform.
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alligator mississippiensis sternal and Shoulder Girdle mobility increase stride length during high walks
The Journal of Experimental Biology, 2018Co-Authors: David B Baier, Brigid M Garrity, Sabine Moritz, Ryan M CarneyAbstract:ABSTRACT Crocodilians have played a significant role in evolutionary studies of archosaurs. Given that several major shifts in forelimb function occur within Archosauria, forelimb morphologies of living crocodilians are of particular importance in assessing locomotor evolutionary scenarios. A previous X-ray investigation of walking alligators revealed substantial movement of the Shoulder Girdle, but as the sternal cartilages do not show up in X-ray, the source of the mobility could not be conclusively determined. Scapulocoracoid movement was interpreted to indicate independent sliding of each coracoid at the sternocoracoid joint; however, rotations of the sternum could also produce similar displacement of the scapulocoracoids. Here, we present new data employing marker-based XROMM (X-ray reconstruction of moving morphology), wherein simultaneous biplanar X-ray video and surgically implanted radio-opaque markers permit precise measurement of the vertebral axis, sternum and coracoid in walking alligators. We found that movements of the sternum and sternocoracoid joint both contribute to Shoulder Girdle mobility and stride length, and that the sternocoracoid contribution was less than previously estimated. On average, the joint contributions to stride length (measured with reference to a point on the distal radius, thus excluding wrist motion) are as follows: thoracic vertebral rotation 6.2±3.7%, sternal rotation 11.1±2.5%, sternocoracoid joint 10.1±5.2%, glenohumeral joint 40.1±7.8% and elbow 31.1±4.2%. To our knowledge, this is the first evidence of sternal movement relative to the vertebral column (presumably via rib joints) contributing to stride length in tetrapods.
