RESUMO
Anterior shoulder problems are extremely common in throwing athletes. Coracoid impingement syndrome, lesions of the long head of the biceps tendon, and rotator interval lesions are included in the extensive differential diagnosis which exists for anterior shoulder pain. In this article, we focus on the anatomy, pathophysiology, clinical presentation, diagnosis, and surgical treatment of these conditions.
Assuntos
Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/cirurgia , Instabilidade Articular/diagnóstico , Instabilidade Articular/cirurgia , Lesões do Manguito Rotador , Lesões do Ombro , Traumatismos dos Tendões , Traumatismos dos Tendões/diagnóstico , Traumatismos dos Tendões/cirurgia , Assistência ao Convalescente/métodos , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/fisiopatologia , Fenômenos Biomecânicos , Braquetes , Terapia por Exercício , Humanos , Instabilidade Articular/etiologia , Instabilidade Articular/fisiopatologia , Exame Físico , Cuidados Pós-Operatórios/métodos , Amplitude de Movimento Articular , Técnicas de Sutura , Síndrome , Traumatismos dos Tendões/etiologia , Traumatismos dos Tendões/fisiopatologia , Resultado do TratamentoRESUMO
Pelvic ring disruptions are the result of high energy blunt trauma and are associated with other significant injuries in greater than 50% of the cases. These injuries may involve neurovascular structures and other organ systems. Lower urinary tract injuries may occur in as much as 25% of patients with pelvic ring disruptions. Coordinated care between the orthopaedist and urologist is required for successful treatment of the urologic and pelvic injury. Of primary importance to the orthopaedist is the potential for infection after open stabilization of the anterior arch. When contaminated urine communicates with the anterior arch, the possibility of infection exists. Early repair of bladder disruptions with simultaneous anterior arch plating minimizes this risk. The treatment of urethral disruptions and the safest method for urinary drainage remain controversial, however.
Assuntos
Fraturas Fechadas/complicações , Ossos Pélvicos/lesões , Sistema Urinário/lesões , Fraturas Fechadas/fisiopatologia , Fraturas Fechadas/cirurgia , Humanos , Complicações Pós-Operatórias , Radiografia , Uretra/diagnóstico por imagem , Uretra/lesões , UrodinâmicaRESUMO
The purpose of this study was to observe the difference in healing of full-thickness articular cartilage defects treated with burr arthroplasty versus subchondral drilling. Cartilage was shaved off the medial femoral condyles of 39 rabbits without penetrating the subchondral plate. In left knees, two 2.0-mm holes were drilled into the condyle until bleeding was obtained. Right knees underwent a burr arthroplasty until punctate bleeding was observed. Animals were sacrificed at 6, 12, and 24 weeks postoperatively. Joint resurfacing and degenerative changes were evaluated grossly and histologically. Degenerative changes in the cartilage surface were observed with both treatments. Rabbits undergoing subchondral drilling had increased fibrocartilaginous healing with time, with a slight increase in degenerative changes. With burr arthroplasty, there was significant decrease in cartilaginous coverage of the exposed surface as well as progressive increase in degenerative changes. Although both techniques were suboptimal, histological evidence at 6 months suggests that subchondral drilling may result in a longer-lived repair than abrasion arthroplasty in the treatment of full-thickness lesions.
