RESUMEN
Acute distal biceps injuries clinically present with sudden pain and acute loss of flexion and supination strength. The main injury mechanism occurs during the eccentric load of the biceps. The hook test is the most significant examination test, presenting the highest sensibility and specificity for this lesion. Magnetic resonance imaging, the gold standard imaging test, can provide information regarding integrity and identify partial and/or complete tears. The surgical treatment uses an anterior or double approach and several reattachment techniques. Although there is no clinical evidence to recommend one fixation method over the other, biomechanical studies show that the cortical button resists better to failure. Although surgical treatment led to an 89% rate of return to work in 14 weeks, the recovery of high sports performance occurred in 1 year, with unsustainable outcomes.
RESUMEN
Complex proximal humeral fractures, especially in elderly patients, often require arthroplastic surgical treatment. Traditionally, shoulder hemiarthroplasty (HA) is the method of choice, resulting in long implant survival and a painless shoulder; however, shoulder HA has heterogeneous clinical outcomes related to the correct position of the implant, both in terms of height and version, and the anatomical consolidation of tuberosities. Today, reverse shoulder arthroplasties are increasingly used to treat such fractures. These techniques result in better functional outcomes compared to HAs, especially regarding anterior flexion, but implant longevity has not been established. The development of specific prosthetic humeral components for the treatment of fractures, which were recently introduced in the clinical practice, led to better clinical outcomes.
RESUMEN
Objective: Describe the outcomes of patients with adhesive capsulitis treated with arthroscopic surgical procedure. Methods: Between January and September of 2009, 9 patients (10 cases) underwent arthroscopic surgical release. There were 4 male (one bilateral) and 5 female patients. Their mean age was 51 years (27-63). The time from onset of symptoms to the surgical procedure averaged 23.4 months (6-38). Preoperative assessment was based on the UCLA and Constant score. ROM was evaluated with one week and six months of surgery. Results: According to UCLA shoulder score (p < 0.01) it increased from preoperatively (6-14) to 31.6 postoperatively (26-35) and the Constant (p < 0.01) from 20 (13-27) to 79.2 (66-91). ROM improved significantly, with mean passive elevation changing from 89° (80-100°) preoperatively to 150° postoperatively with one week and 153° with six months, mean passive external rotation changing from 12.5° (0-30°) preoperatively to 46° (one week) and 56° (six months) postoperatively, and passive internal rotation from L5 (T12-gluteus) to T11 (one week) and T9 (six months). There was not statistical significance of the duration of the disease and the postoperative result. Conclusion: This study shows that the surgical treatment of adhesive capsulitis with arthroscopic capsular release and manipulation appears to be a safe procedure that results in pain relief and functional gain.
