Superior labral anterior posterior lesions of the shoulder.

Superior labrum anterior and posterior (SLAP) lesion is of fairly recent description and its understanding is rapidly evolving. Its incidence and need for surgical treatment has increased exponentially in line with the increase in shoulder arthroscopies. It is of particular importance in the elite over head athlete and the young. A range of arthroscopic techniques and devices have been described with good functional results. The ability to return to pre injury level of sports remains a concern.

Reverse shoulder arthroplasty - a literature review.

Professor Grammont revolutionised shoulder surgery with his reverse shoulder arthroplasty design. Patients who had poor results from a conventional shoulder replacement because of cuff deficiency can now be treated effectively. Although designed for cuff tear arthropathy, indications continue to evolve and broaden. The initial results look very promising and the implant has gained much popularity over the years. The article provides an extensive literature review of the indications, results and complications for reverse shoulder arthroplasty.

An overview of shoulder instability and its management.

The assessment and management of patients with instability of the shoulder joint can be challenging, due to the varying ways patients present, the array of different classification systems, the confusing terminology used and the differing potential management strategies. This review article aims to provide a clear explanation of the common concepts in shoulder instability and how they relate to the assessment and management of patients. There are sections covering the mechanisms of shoulder stability, the clinical assessment of patients and imaging techniques. Beyond that there is a discussion on the common classifications systems used and the typical management options. Some patients fall into reasonably well defined categories of classification and in these cases, the management plan is relatively easy to define. Unfortunately, other patients can elude simple classification and in these instances their management requires very careful consideration. Further research may help to facilitate a better understanding of management of the patients in this latter group.

Proximal humeral fractures: a review of current concepts.

The majority of proximal humerus fractures are sustained via low energy falls in the elderly population. These patients can attain an acceptable level of function via non-operative treatment. There is yet to be a clear consensus on treatment options suitable for those that fall outside of this majority group. Open reduction internal fixation, intra medullary nailing and arthroplasty surgery have all been used to varying effects. Good results are achievable if complications such as mal-union, non-union and avascular necrosis can be avoided. This review aims to clarify the options available to the current day trauma surgeon.

Tarsal joint fusion using memory compression staples--a study of 10 cases.

A prospective clinical study was undertaken to assess the effectiveness of Nickel-Titanium Memory compression staples for fusion of the intertarsal joints. Ten patients underwent procedures for fusion of various hindfoot and midfoot joints with the memory staples. The patients were evaluated regarding period of immobilization in cast and time to radiographic joint fusion. Arthrodesis was achieved in all patients. The average time to fusion was 7.8 weeks, with an average period of immobilization of 6.6 weeks. The early experience with the use of these staples in hindfoot and midfoot joint surgery is encouraging. We did not encounter any technical problems, and there is a suggestion that these implants may reduce the time to fusion.