BOOK
Rockwood and Matsen's The Shoulder E-Book
Charles A. Rockwood | Michael A. Wirth | Edward V Fehringer | John W Sperling | Steven B. Lippitt | Frederick A. Matsen | John W Sperling | Steven B. Lippitt
(2016)
Additional Information
Book Details
Abstract
Fully updated with completely updated content, exciting new authors, and commentary by national and international experts in the field, Rockwood and Matsen’s The Shoulder, 5th Edition continues its tradition of excellence as the cornerstone reference for effective management of shoulder disorders. This masterwork provides how-to guidance on the full range of both tried-and-true and recent surgical techniques, including both current arthroscopic methods and the latest approaches in arthroplasty. An outstanding editorial team headed by Drs. Charles A. Rockwood, Jr. and Frederick A. Matsen III ensures that you have the tools you need to achieve optimal patient outcomes for any shoulder challenge you encounter. Throughout the book the authors focus on the value of the procedures to patients, showing ways that expense and risk can be minimized.
- Combines the ‘how to’ for ‘tried and true’ shoulder procedures along with the latest arthroscopic methods for managing shoulder disorders.
- Focuses on the most challenging open procedures, including those often overlooked in training programs, yet thoroughly reviews the rationale for using minimally invasive arthroscopic techniques whenever possible.
- Offers scientifically based coverage of shoulder function and dysfunction to aid in the decision-making process.
- Features new commentaries from international authorities – including dissenting and alternative viewpoints -- and final comments by our editorial experts.
- Covers new approaches, including reverse total shoulder, the latest rotator cuff repair methods, and the "ream and run" procedure, as well as emerging imaging methods.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| IFC_Expert Consult ad | IFC1 | ||
| Rockwood and Matsen's The Shoulder | i | ||
| Copyright Page | iv | ||
| Dedication | v | ||
| Preface | vii | ||
| Foreword to the Fifth Edition | ix | ||
| Foreword to the Fourth Edition | ei | ||
| Foreword to the Third Edition | eii | ||
| Foreword to the First Edition | xi | ||
| Contributors | xiii | ||
| Table Of Contents | xvii | ||
| Video Contents | xix | ||
| 1 Developmental Anatomy of the Shoulder and Anatomy of the Glenohumeral Joint | 1 | ||
| Comparative Anatomy | 1 | ||
| General Development | 1 | ||
| Development of Individual Regions | 2 | ||
| Scapula | 2 | ||
| Humerus | 3 | ||
| Clavicle | 4 | ||
| Scapulohumeral Muscles | 4 | ||
| Axioscapular Muscles | 4 | ||
| Axiohumeral Muscles | 4 | ||
| Muscles of the Upper Part of the Arm | 4 | ||
| Embryology | 4 | ||
| Prenatal Development | 4 | ||
| Embryonic Period | 5 | ||
| Fetal Period | 8 | ||
| Coracoacromial Arch Anatomy | 9 | ||
| Glenohumeral Capsule and Glenohumeral Ligaments | 10 | ||
| Biceps Tendon | 10 | ||
| Glenoid | 11 | ||
| Postnatal Development | 11 | ||
| Clavicle | 11 | ||
| Scapula | 11 | ||
| Proximal Humerus | 12 | ||
| Adult Glenohumeral Joint | 12 | ||
| Bony Anatomy | 12 | ||
| Shoulder Capsule | 14 | ||
| Glenohumeral Ligaments | 15 | ||
| Superior Glenohumeral Ligament | 15 | ||
| Middle Glenohumeral Ligament | 17 | ||
| Inferior Glenohumeral Ligament | 17 | ||
| Bicipital Tunnel | 23 | ||
| Bursae | 24 | ||
| Microvasculature | 26 | ||
| Rotator Cuff | 26 | ||
| Glenoid Labrum | 27 | ||
| Glenohumeral Capsule and Ligaments | 27 | ||
| Innervation | 28 | ||
| Editor Commentary | 29 | ||
| Senior Editor Commentary | 33 | ||
| References | 33.e1 | ||
| Bibliography | 33.e2 | ||
| 2 Gross Anatomy of the Shoulder | 35 | ||
| Bones and Joints | 35 | ||
| Sternoclavicular Joint | 36 | ||
| Clavicle | 38 | ||
| Acromioclavicular Joint | 39 | ||
| Scapula | 40 | ||
| Humerus | 43 | ||
| Muscles | 47 | ||
| Scapulothoracic Muscles | 47 | ||
| Trapezius | 47 | ||
| Rhomboids | 50 | ||
| Levator Scapulae and Serratus Anterior | 50 | ||
| Pectoralis Minor | 51 | ||
| Subclavius | 52 | ||
| Glenohumeral Muscles | 52 | ||
| Deltoid | 52 | ||
| Rotator Cuff | 53 | ||
| Supraspinatus | 54 | ||
| Infraspinatus | 56 | ||
| Teres Minor | 58 | ||
| Subscapularis | 58 | ||
| Teres Major | 58 | ||
| Coracobrachialis | 60 | ||
| Multiple Joint Muscles | 60 | ||
| Pectoralis Major | 61 | ||
| Latissimus Dorsi | 61 | ||
| Biceps Brachii | 62 | ||
| Triceps Brachii | 63 | ||
| Landmark Muscles | 63 | ||
| Sternocleidomastoid | 63 | ||
| Scalenus Anterior and Scalenus Medius | 63 | ||
| Omohyoid | 63 | ||
| Nerves | 63 | ||
| Nerve Function and Microanatomy | 64 | ||
| Brachial Plexus | 65 | ||
| Roots | 66 | ||
| Trunks, Divisions, and Cords | 67 | ||
| Terminal Branches | 67 | ||
| Specific Terminal Branches | 69 | ||
| Subscapular Nerves | 69 | ||
| Axillary Nerve | 69 | ||
| Musculocutaneous Nerve | 70 | ||
| Suprascapular Nerve | 71 | ||
| Autonomic Supply | 72 | ||
| Cranial Nerve XI | 72 | ||
| Intercostal Brachial Nerve | 72 | ||
| Supraclavicular Nerves | 72 | ||
| Blood Vessels | 73 | ||
| Arteries | 75 | ||
| Subclavian Artery | 75 | ||
| Axillary Artery | 76 | ||
| First Portion | 76 | ||
| Second Portion | 76 | ||
| Third Portion | 77 | ||
| Nonpathologic Anomalies | 77 | ||
| Collateral Circulation | 78 | ||
| Veins | 79 | ||
| Axillary | 79 | ||
| Cephalic | 79 | ||
| Lymphatic Drainage | 79 | ||
| Relationships | 80 | ||
| Bursae, Compartments, and Potential Spaces | 80 | ||
| Tumor Compartments | 80 | ||
| Infection | 80 | ||
| Compartment Syndromes | 81 | ||
| Regional Anesthesia Compartments | 81 | ||
| Fascial Spaces and Surgical Planes | 81 | ||
| Adipose Tissue | 82 | ||
| Bursae | 83 | ||
| Skin | 86 | ||
| Circulation | 86 | ||
| Sensation | 87 | ||
| Relaxed Skin Tension Lines | 89 | ||
| Editor Commentary | 90 | ||
| Senior Editor Commentary | 93 | ||
| References | 94.e1 | ||
| 3 Clinical Evaluation of Shoulder Problems | 95 | ||
| Patient History | 95 | ||
| Age | 96 | ||
| Sex | 96 | ||
| Presenting Complaint | 97 | ||
| Pain | 97 | ||
| Character of the Pain | 97 | ||
| Onset of the Pain | 98 | ||
| Location of Pain Perception | 98 | ||
| Aggravating Factors of Pain | 98 | ||
| Factors That Alleviate Pain | 99 | ||
| Response of Symptoms to Self-Prescribed Treatment | 99 | ||
| Instability | 100 | ||
| Paresthesia | 101 | ||
| Weakness | 101 | ||
| Crepitus | 101 | ||
| Physical Examination | 101 | ||
| Cervical Spine (Neck) | 101 | ||
| Shoulder | 103 | ||
| Inspection | 103 | ||
| Palpation | 104 | ||
| Joint Motion | 105 | ||
| Passive Shoulder Elevation | 105 | ||
| Active Elevation (Supine) | 105 | ||
| Active Elevation (Standing) | 105 | ||
| Passive External Rotation | 106 | ||
| Passive External Rotation in 90 Degrees of Abduction | 106 | ||
| Passive Internal Rotation in 90 Degrees of Abduction | 106 | ||
| Internal Rotation | 106 | ||
| Active Cross-Body Adduction | 107 | ||
| Functional Strength Testing | 107 | ||
| General Principles of Functional Strength Testing | 107 | ||
| Functional Strength Assessment | 108 | ||
| Stability Assessment | 108 | ||
| Generalized Laxity Assessment | 108 | ||
| Sulcus Test | 108 | ||
| Glenohumeral Translation (Load and Shift Test) | 109 | ||
| Anterior and Posterior Drawer Tests | 110 | ||
| Apprehension, Relocation, and Surprise Tests | 110 | ||
| Posterior Instability Testing | 111 | ||
| Rotator Cuff Examination | 112 | ||
| Subscapularis Muscle | 112 | ||
| Lift-Off Test | 112 | ||
| Belly-Press Test | 112 | ||
| Napoleon Test | 112 | ||
| Bear Hug Test | 113 | ||
| Supraspinatus Muscle | 113 | ||
| External Rotation | 114 | ||
| External Rotation Lag Sign | 114 | ||
| Hornblower’s Sign | 115 | ||
| Special Tests | 115 | ||
| Rotator Cuff Tests | 115 | ||
| Neer Impingement Sign | 115 | ||
| Neer Impingement Test | 116 | ||
| Hawkins-Kennedy Impingement Test | 116 | ||
| Jobe-Yocum Test | 117 | ||
| Painful Arc Test | 117 | ||
| Combining Tests for Rotator Cuff Pathology | 118 | ||
| Internal Impingement | 118 | ||
| Modified Relocation Test | 118 | ||
| Internal Rotation Resistance Stress Test | 119 | ||
| Acromioclavicular Joint Tests | 119 | ||
| Biceps Tendon Tests | 120 | ||
| Yergason’s Test | 120 | ||
| Speed’s Test | 120 | ||
| Ludington’s Test | 120 | ||
| Upper Cut Test | 120 | ||
| Superior Labrum Anterior Posterior Tests | 121 | ||
| O’Brien Test (Active Compression Test) | 121 | ||
| SLAPprehension Test | 122 | ||
| Biceps Tension Test | 122 | ||
| Anterior Slide Test | 122 | ||
| Crank Test | 122 | ||
| Pain Provocation Test | 122 | ||
| Biceps Load Test I | 122 | ||
| Biceps Load Test II | 123 | ||
| Dynamic Labral Shear Test | 123 | ||
| Modified Dynamic Labral Shear Test | 124 | ||
| Posteroinferior Labral Pathology | 124 | ||
| Subcoracoid Impingement Test | 125 | ||
| Scapular Dyskinesis Tests | 125 | ||
| Resting Scapular Positional Measurements | 125 | ||
| Observed Repetitive Forward Elevation | 125 | ||
| Push-up Test | 125 | ||
| Resisted Forward Elevation | 126 | ||
| Scapular Stabilization Test | 126 | ||
| Scapular Assistance Test | 126 | ||
| Glenohumeral Internal Rotation Deficit | 127 | ||
| Crepitus Testing | 127 | ||
| Neurologic Testing | 128 | ||
| Isolated Muscle Strength Testing | 128 | ||
| Deltoid | 128 | ||
| Biceps | 128 | ||
| Brachialis | 128 | ||
| Triceps | 129 | ||
| Superior Trapezius and Levator Scapulae | 129 | ||
| Middle Trapezius and Rhomboids | 129 | ||
| Subscapularis, Supraspinatus, Infraspinatus and Teres Minor Strength Testing | 129 | ||
| Reflex Testing | 129 | ||
| Clavicular Reflex | 129 | ||
| Scapular Reflex | 129 | ||
| Pectoralis Reflex | 129 | ||
| Biceps Reflex | 130 | ||
| Triceps Reflex | 130 | ||
| Brachioradialis Reflex | 130 | ||
| Horner Syndrome | 130 | ||
| Sensory Testing | 130 | ||
| Vascular Examination | 130 | ||
| Thoracic Outlet Syndrome | 130 | ||
| Adson’s Maneuver and Modified Adson’s Maneuver | 130 | ||
| Wright’s Maneuver | 131 | ||
| Overhead Exercise Test/Roos Test | 131 | ||
| Costoclavicular Maneuver | 132 | ||
| Editor Commentary | 132 | ||
| Senior Editor Commentary | 132 | ||
| References | 133.e1 | ||
| 4 Radiographic Evaluation of Shoulder Problems | 135 | ||
| Fractures of the Glenohumeral Joint | 135 | ||
| Recommended Views | 135 | ||
| Techniques for Taking the Trauma Series | 135 | ||
| True Anteroposterior Views | 135 | ||
| Axillary Lateral View | 136 | ||
| Technique for the Scapulolateral Radiograph | 136 | ||
| Techniques for the Modified Axillary Views | 139 | ||
| Velpeau Axillary Lateral View | 139 | ||
| Apical Oblique View | 140 | ||
| Stripp Axial Lateral View | 140 | ||
| Trauma Axillary Lateral View | 140 | ||
| Computed Tomography Scan | 140 | ||
| Magnetic Resonance Imaging | 140 | ||
| Anterior Instability | 141 | ||
| Recommended Views | 141 | ||
| West Point Axillary Lateral View | 142 | ||
| Apical Oblique View | 142 | ||
| Recurrent Anterior Glenohumeral Instability | 143 | ||
| Posterior Humeral Head Compression Fractures Associated with Anterior Dislocation: the Hill-Sachs Lesion | 143 | ||
| Recommended Views | 143 | ||
| Stryker Notch View | 143 | ||
| Anteroposterior View in Internal Rotation | 143 | ||
| Posterior Instability | 144 | ||
| Recommended Views | 144 | ||
| Techniques to Evaluate Posterior Instability | 144 | ||
| Soft Tissue Evaluation of Shoulder Instability | 144 | ||
| Glenohumeral Arthritis | 150 | ||
| Recommended Views | 150 | ||
| Glenohumeral Arthroplasty | 151 | ||
| Recommended Views | 151 | ||
| Evaluation | 152 | ||
| Clavicle | 153 | ||
| Acromioclavicular Joint and Distal Clavicle | 153 | ||
| Recommended Views | 153 | ||
| Evaluation Techniques | 153 | ||
| Reduced Voltage | 153 | ||
| Zanca View | 153 | ||
| Anteroposterior Views | 153 | ||
| Anteroposterior Stress View | 153 | ||
| Axillary Lateral View | 155 | ||
| Alexander View | 155 | ||
| Tomogram or Computed Tomography Scan | 156 | ||
| Bone Scan | 156 | ||
| Magnetic Resonance Imaging | 156 | ||
| Sternoclavicular Joint and Medial Clavicle | 156 | ||
| Recommended Views | 156 | ||
| Evaluation Techniques | 156 | ||
| Serendipity View (40-Degree Cephalic Tilt View) | 156 | ||
| Tomogram | 157 | ||
| Computed Tomography | 157 | ||
| Magnetic Resonance Imaging | 158 | ||
| Bone Scan | 158 | ||
| Rotator Cuff | 158 | ||
| Recommended Views | 158 | ||
| Techniques to Evaluate Rotator Cuff Tendinitis | 159 | ||
| Anteroposterior View | 159 | ||
| Axillary Lateral View | 159 | ||
| Thirty-Degree Caudal Tilt View | 159 | ||
| Scapular Outlet View | 159 | ||
| Techniques to Evaluate Rotator Cuff Integrity | 160 | ||
| Arthrography, Arthrotomography, and Computed Tomography Arthrography | 160 | ||
| Subacromial Bursography | 161 | ||
| Ultrasonography | 161 | ||
| Magnetic Resonance Imaging | 161 | ||
| Scapula | 163 | ||
| Recommended Views | 163 | ||
| Calcific Tendinitis | 163 | ||
| Biceps Tendon | 163 | ||
| Acknowledgments | 167 | ||
| Editor Commentary | 167 | ||
| Senior Editor Commentary | 167 | ||
| References | 168.e1 | ||
| Bibliography | 168.e3 | ||
| 5 Effectiveness Evaluation of the Shoulder | 169 | ||
| History | 169 | ||
| Development of Outcome Measures and Tools | 170 | ||
| Assessing an Outcome Measure | 170 | ||
| Validity | 170 | ||
| Reliability | 171 | ||
| Responsiveness | 171 | ||
| Application of Outcome Measures | 171 | ||
| Clinician Versus Patient Reported Outcomes | 171 | ||
| Response Methodology | 172 | ||
| Scoring an Outcome Measure: Categoric Rankings Versus Aggregate Scores | 172 | ||
| Computer Adaptive Testing | 172 | ||
| Types of Outcome Measures | 172 | ||
| Generic Health-Related Quality of Life Instruments | 173 | ||
| Short Form 36 and Short Form 12 | 173 | ||
| EuroQol 5 Dimensions Questionnaire | 173 | ||
| Limb-Specific Outcome Instruments | 174 | ||
| DASH and QuickDASH Questionnaires | 174 | ||
| Shoulder-Specific Outcome Instruments | 174 | ||
| Constant-Murley Score | 174 | ||
| American Shoulder and Elbow Society Score | 175 | ||
| Simple Shoulder Test | 175 | ||
| Single Assessment Numerical Evaluation Test | 175 | ||
| University of California–Los Angeles End-Result Score | 176 | ||
| Other Shoulder Specific Tests | 176 | ||
| Disease-Specific Outcome Instruments of the Shoulder | 176 | ||
| Western Ontario Shoulder Instability Index | 176 | ||
| Western Ontario Rotator Cuff Index and Western Ontario Osteoarthritis Shoulder Index | 176 | ||
| Rotator Cuff Quality of Life Questionnaire | 176 | ||
| Outcome Measures That Assess Pain | 177 | ||
| Putting It All Together: Choosing the Right Outcome Measure | 177 | ||
| Future Developments | 177 | ||
| Senior Author’s Current Practice | 178 | ||
| Conclusion | 178 | ||
| International Expert Commentary | 180 | ||
| Editor Commentary | 181 | ||
| References | 181.e1 | ||
| 6 Fractures of the Proximal Humerus | 183 | ||
| Anatomy | 183 | ||
| Mechanism of Injury | 186 | ||
| Clinical Evaluation | 186 | ||
| Imaging | 186 | ||
| Classification | 187 | ||
| Methods of Treatment | 189 | ||
| Treatment Considerations According to Fracture Subtype | 189 | ||
| Greater Tuberosity Fractures | 189 | ||
| Epidemiology | 189 | ||
| Nature of the Injury | 189 | ||
| Evaluation | 190 | ||
| Treatment | 190 | ||
| Nonoperative Management | 190 | ||
| Operative Management | 190 | ||
| Postoperative Care | 195 | ||
| Outcomes | 195 | ||
| Lesser Tuberosity Fractures | 195 | ||
| Surgical Neck Fractures | 197 | ||
| Epidemiology | 197 | ||
| Evaluation | 198 | ||
| Treatment | 199 | ||
| Three-Part Fractures | 200 | ||
| Four-Part Fractures | 201 | ||
| Proximal Humerus Fracture-Dislocations | 201 | ||
| Operative Techniques: General Considerations | 204 | ||
| Percutaneous Treatment of Proximal Humerus Fractures | 204 | ||
| Surgical Technique | 205 | ||
| Two-Part Fracture | 206 | ||
| Three-Part and Four-Part Fractures | 207 | ||
| Postoperative Care | 207 | ||
| Outcomes | 208 | ||
| Open Reduction and Internal Fixation | 208 | ||
| Nonlocking and Locking Plate Fixation | 208 | ||
| Intramedullary Nail Fixation | 208 | ||
| Locking Plate Versus Intramedullary Fixation | 209 | ||
| Arthroplasty | 210 | ||
| Hemiarthroplasty | 210 | ||
| Reverse Total Shoulder Arthroplasty | 211 | ||
| Authors’ Preferred Method of Treatment | 212 | ||
| Methods of Treatment | 212 | ||
| Nondisplaced or Minimally Displaced PHFs | 212 | ||
| Open Reduction and Internal Fixation of PHFs | 212 | ||
| Surgical Approach | 212 | ||
| Nonlocking and Locking Plate Surgical Technique | 213 | ||
| Postoperative Care | 216 | ||
| Intramedullary Fixation Surgical Technique | 216 | ||
| Postoperative Care | 217 | ||
| Hemiarthroplasty for Fracture | 217 | ||
| Patient Selection | 217 | ||
| Surgical Technique | 217 | ||
| Postoperative Care | 222 | ||
| Reverse Shoulder Arthroplasty for Primary and Secondary Management of Proximal Humerus Fractures | 222 | ||
| Patient Selection | 222 | ||
| Surgical Technique | 224 | ||
| Postoperative Care | 226 | ||
| Reverse Arthroplasty for Revision of Failed Hemiarthroplasty or Internal Fixation for Proximal Humerus Fractures | 226 | ||
| Complications Associated with Treatment of Proximal Humerus Fractures | 229 | ||
| Shoulder Stiffness | 230 | ||
| Osteonecrosis | 230 | ||
| Malunion | 231 | ||
| Nonunion | 232 | ||
| Heterotopic Bone Formation | 234 | ||
| Complications Specific to Treatment Type | 234 | ||
| Percutaneous Fixation | 234 | ||
| Open Reduction and Internal Fixation | 234 | ||
| Intramedullary Nail Fixation | 234 | ||
| Arthroplasty | 234 | ||
| International Expert Commentary | 238 | ||
| Senior Editor Commentary | 239 | ||
| Editor Commentary | 241 | ||
| References | 242.e1 | ||
| 7 Fractures of the Scapula | 243 | ||
| Anatomy | 243 | ||
| Location of Fractures of the Scapula | 245 | ||
| New Classification Scheme | 245 | ||
| Clinical Features | 245 | ||
| Associated Injuries and Complications | 245 | ||
| Radiographic Evaluation | 246 | ||
| Types of Fractures and Methods of Treatment | 249 | ||
| Glenoid Neck (Extra-articular) Fractures | 249 | ||
| Glenoid Cavity (Intra-articular) Fractures | 253 | ||
| Type I | 255 | ||
| Type II | 255 | ||
| Type III | 258 | ||
| Type IV | 258 | ||
| Type V | 260 | ||
| Type VI | 260 | ||
| Fractures of the Scapular Body and Spine | 262 | ||
| Isolated Acromial Fractures | 265 | ||
| Isolated Coracoid Fractures | 266 | ||
| Double Disruptions of the Superior Shoulder Suspensory Complex | 268 | ||
| Floating Shoulder (Ipsilateral Fractures of the Midshaft Clavicle and the Glenoid Neck) | 270 | ||
| Fracture of the Glenoid Neck and Other Non–Midshaft-Clavicle Disruptions of the Superior Shoulder Suspensory Complex | 272 | ||
| Fracture of the Coracoid Process and a Grade III Disruption of the Acromioclavicular Joint | 272 | ||
| Fractures of the Ipsilateral Coracoid and Acromial Processes | 272 | ||
| Fracture of the Coracoid Process and a Type I Fracture of the Distal Third of the Clavicle (as Well as Type II and V Distal Clavicle Fractures) | 273 | ||
| Acromial Fracture with Grade III Disruption of the Acromioclavicular Joint | 273 | ||
| Segmental Fracture of the Acromion | 274 | ||
| Other Combinations | 274 | ||
| Avulsion Fractures of the Scapula | 274 | ||
| Diagnosis and Treatment | 275 | ||
| Nonoperative Treatment | 275 | ||
| Operative Treatment | 275 | ||
| Other Disorders | 276 | ||
| Lateral Dislocation of the Scapula (Scapulothoracic Dissociation) | 276 | ||
| Intrathoracic Dislocation of the Scapula | 278 | ||
| Scapulothoracic Crepitus | 279 | ||
| Etiology | 279 | ||
| Diagnosis | 280 | ||
| Treatment | 280 | ||
| Authors’ Preferred Methods of Treatment | 280 | ||
| Scapular Body (and Spine) Fractures | 280 | ||
| Isolated Coracoid Process Fractures111 | 280 | ||
| Isolated Acromial Process Fractures | 281 | ||
| Double Disruptions of the Superior Shoulder Suspensory Complex | 281 | ||
| Avulsion Fractures of the Scapula | 282 | ||
| Glenoid Process Fractures (General Considerations) | 282 | ||
| Principles of Surgery | 282 | ||
| Postoperative Management | 284 | ||
| Glenoid Cavity Fractures | 286 | ||
| Glenoid Neck Fractures | 287 | ||
| Scapulothoracic Dissociation | 288 | ||
| Intrathoracic Dislocation | 288 | ||
| Scapulothoracic Crepitus | 288 | ||
| Authors’ Final Note | 288 | ||
| International Expert Commentary | 289 | ||
| Editor Commentary | 290 | ||
| References | 290.e1 | ||
| 8 Fractures of the Clavicle | 291 | ||
| Historical Review | 291 | ||
| Anatomy | 292 | ||
| Development | 292 | ||
| Morphology and Function | 292 | ||
| Surgical Anatomy | 294 | ||
| Above the Clavicle | 294 | ||
| Below the Clavicle | 295 | ||
| Behind the Clavicle | 295 | ||
| On Top of the Clavicle | 295 | ||
| Function | 295 | ||
| Power and Stability of the Arm | 296 | ||
| Motion of the Shoulder Girdle | 296 | ||
| Muscle Attachments | 297 | ||
| Protection of Neurovascular Structures | 298 | ||
| Respiratory Function | 298 | ||
| Cosmesis | 298 | ||
| Classification of Clavicle Fractures | 299 | ||
| Craig’s Classification | 299 | ||
| Group I Fractures | 299 | ||
| Group II Fractures | 299 | ||
| Group III Fractures | 301 | ||
| Rockwood’s Classification | 301 | ||
| Robinson’s Classification | 302 | ||
| Mechanism of Injury | 304 | ||
| Trauma in Children | 304 | ||
| Birth Fractures | 304 | ||
| Injuries in Infancy and Childhood | 304 | ||
| Trauma in Adults and Adolescents | 304 | ||
| Stress Fractures | 305 | ||
| Nontraumatic Fractures | 305 | ||
| Clinical Findings | 307 | ||
| Birth Fractures | 307 | ||
| Fractures in Children | 307 | ||
| Fractures in Adults | 308 | ||
| Associated Injuries | 309 | ||
| Radiographic Evaluation | 311 | ||
| Fractures of the Shaft | 311 | ||
| Fractures of the Distal Third | 313 | ||
| Fractures of the Medial Third | 314 | ||
| Differential Diagnosis | 314 | ||
| Congenital Pseudarthrosis | 315 | ||
| Cleidocranial Dysostosis | 316 | ||
| Sternoclavicular Dislocation | 316 | ||
| Acromioclavicular Separation | 316 | ||
| Complications | 316 | ||
| Nonunion | 316 | ||
| Predisposing Factors | 317 | ||
| Inadequate Immobilization | 317 | ||
| Severity of Trauma | 317 | ||
| Refracture | 317 | ||
| Location of Fracture | 317 | ||
| Degree of Displacement | 318 | ||
| Primary Open Reduction | 318 | ||
| Diagnosis | 318 | ||
| Radiographic Evaluation | 318 | ||
| Symptoms | 319 | ||
| Physical Examination | 319 | ||
| Malunion | 319 | ||
| Neurovascular Sequelae | 320 | ||
| Vascular Compression Syndromes | 321 | ||
| Neurologic Syndromes | 321 | ||
| Diagnosis | 322 | ||
| Posttraumatic Arthritis | 322 | ||
| Treatment | 322 | ||
| Children | 322 | ||
| Adults | 323 | ||
| Support | 323 | ||
| Reduction | 323 | ||
| Reduction With Fixation | 324 | ||
| Reduction With External Fixation | 324 | ||
| Nonunion | 324 | ||
| Rehabilitation After Clavicle Fracture | 326 | ||
| Return-to-Play Criteria in Athletes | 326 | ||
| Neurovascular Complications | 326 | ||
| Newborns and Infants | 327 | ||
| Children | 327 | ||
| Ages 2 to 12 Years | 327 | ||
| Ages 12 to 16 Years | 328 | ||
| Medial and Distal Fractures in Children | 328 | ||
| Adults | 328 | ||
| Medial-Third Fractures | 328 | ||
| Middle-Third Fractures | 329 | ||
| Indications for Primary Open Fixation | 330 | ||
| Treatment Alternatives | 330 | ||
| Plate and Screw Fixation | 331 | ||
| Pertinent Anatomy | 332 | ||
| Choice of Plate | 333 | ||
| Placement of the Plate | 334 | ||
| Surgical Technique for Plate and Screw Fixation | 334 | ||
| Intramedullary Fixation | 335 | ||
| Types of Intramedullary Fixation | 336 | ||
| Pertinent Anatomy | 336 | ||
| Choice of Intramedullary Fixation | 337 | ||
| Surgical Technique for Intramedullary Fixation | 338 | ||
| Rockwood Clavicle Pin | 338 | ||
| Sonoma CRx Clavicle Pin | 338 | ||
| Patient Positioning | 341 | ||
| Incision | 342 | ||
| Medial Fragment Preparation | 343 | ||
| Lateral Fragment Preparation | 344 | ||
| Fracture Reduction | 345 | ||
| Final Fixation | 346 | ||
| Management of Butterfly Fragments | 346 | ||
| Final Closure | 347 | ||
| Postoperative Care | 348 | ||
| Implant Removal | 349 | ||
| Postremoval Care | 349 | ||
| Medial Approach | 349 | ||
| Middle-Third Malunion and Nonunion | 349 | ||
| Surgical Technique | 349 | ||
| Postoperative Care | 351 | ||
| Distal Clavicle Fractures | 352 | ||
| Treatment Options | 353 | ||
| Coracoclavicular Screw Technique | 355 | ||
| Postoperative Care | 357 | ||
| What Is the Best Fixation for Fractures of the Clavicle? | 359 | ||
| International Expert Commentary | 359 | ||
| Editor Commentary | 363 | ||
| References | 363.e1 | ||
| 9 Disorders of the Acromioclavicular Joint | 365 | ||
| Developmental Anatomy | 365 | ||
| Clavicle | 365 | ||
| Acromion and Coracoid Processes | 365 | ||
| Anatomy and Function | 365 | ||
| Overview | 365 | ||
| Skin | 365 | ||
| Muscle Attachments | 366 | ||
| Pertinent Osteology | 366 | ||
| Distal Clavicle | 366 | ||
| Coracoid Process | 367 | ||
| Acromion Process | 367 | ||
| Acromioclavicular Joint Architecture | 367 | ||
| Intra-Articular Disk | 367 | ||
| Ligaments | 368 | ||
| Coracoclavicular Articulation | 370 | ||
| Neurovascular Structures | 371 | ||
| Excision of the Distal Clavicle | 371 | ||
| Complete Excision | 371 | ||
| Partial Excision | 372 | ||
| Results of Excision | 372 | ||
| Open | 372 | ||
| Arthroscopic | 373 | ||
| Complications of Excision | 374 | ||
| Open | 374 | ||
| Arthroscopic | 374 | ||
| Management of Failed Distal Clavicle Excisions | 374 | ||
| Author’s Preferred Method | 375 | ||
| Technical Pearls and Pitfalls | 376 | ||
| Summary | 377 | ||
| Biomechanics of Acromioclavicular Motion | 377 | ||
| Spectrum of Disorders | 378 | ||
| Characteristics of the Painful Acromioclavicular Joint Evaluation | 378 | ||
| History | 378 | ||
| Physical Examination | 379 | ||
| Provocative Testing | 379 | ||
| Imaging | 382 | ||
| Plain Radiographs | 382 | ||
| Anteroposterior View | 382 | ||
| Lateral Views | 383 | ||
| Other Views | 383 | ||
| Stress Views | 383 | ||
| Anteroposterior Stress Views | 383 | ||
| Lateral Stress Views | 384 | ||
| Computed Tomography | 384 | ||
| Nuclear Medicine | 384 | ||
| Magnetic Resonance Imaging | 386 | ||
| Ultrasonography | 387 | ||
| Traumatic Disorders | 388 | ||
| Overview | 388 | ||
| Associated Injuries | 388 | ||
| Classification | 388 | ||
| Treatment Analysis | 392 | ||
| General | 392 | ||
| Results | 392 | ||
| Mechanism of Injury | 392 | ||
| Direct | 392 | ||
| Indirect | 392 | ||
| Acute Lesions | 393 | ||
| Type I | 393 | ||
| Signs and Symptoms | 393 | ||
| Imaging | 393 | ||
| Pathoanatomy | 393 | ||
| Treatment | 393 | ||
| Methods | 393 | ||
| Results | 394 | ||
| Complications | 394 | ||
| Author’s Preferred Method | 394 | ||
| Type II | 394 | ||
| Signs and Symptoms | 394 | ||
| Imaging | 395 | ||
| Pathoanatomy | 395 | ||
| Treatment | 395 | ||
| Methods | 395 | ||
| Results | 395 | ||
| Complications | 396 | ||
| Author’s Preferred Method | 396 | ||
| Type III | 396 | ||
| Signs and Symptoms | 396 | ||
| Imaging | 396 | ||
| Pathoanatomy | 397 | ||
| Treatment | 397 | ||
| Nonoperative Treatment | 398 | ||
| Methods | 398 | ||
| Results | 398 | ||
| Complications | 399 | ||
| Author’s Preferred Method | 399 | ||
| Operative Treatment | 399 | ||
| Indications | 400 | ||
| Contraindications | 400 | ||
| Methods | 400 | ||
| Experimental Investigations. | 405 | ||
| Results | 408 | ||
| Complications | 411 | ||
| Salvage of Failed Coracoclavicular Stabilization. | 416 | ||
| Author’s Preferred Method | 416 | ||
| Type III Variants | 418 | ||
| Pseudodislocation and Physeal Injuries | 418 | ||
| Signs and Symptoms | 418 | ||
| Imaging | 420 | ||
| Pathoanatomy | 420 | ||
| Treatment | 420 | ||
| Results | 421 | ||
| Fracture of the Coracoid Process | 421 | ||
| Signs and Symptoms | 421 | ||
| Imaging | 421 | ||
| Pathoanatomy | 421 | ||
| Treatment | 422 | ||
| Type IV | 422 | ||
| Signs and Symptoms | 422 | ||
| Imaging | 422 | ||
| Pathoanatomy | 422 | ||
| Nonoperative Treatment | 422 | ||
| Operative Treatment | 422 | ||
| Indications and Contraindications | 422 | ||
| Methods | 426 | ||
| Results | 426 | ||
| Complications | 426 | ||
| Author’s Preferred Method | 426 | ||
| Type V | 426 | ||
| Signs and Symptoms | 426 | ||
| Imaging | 427 | ||
| Pathoanatomy | 427 | ||
| Operative Treatment | 427 | ||
| Methods | 427 | ||
| Results | 427 | ||
| Experimental Treatment | 428 | ||
| Complications | 428 | ||
| Author’s Preferred Method | 429 | ||
| Type VI | 429 | ||
| Signs and Symptoms | 429 | ||
| Imaging | 429 | ||
| Pathoanatomy | 429 | ||
| Operative Treatment | 430 | ||
| Contraindications | 430 | ||
| 10 Disorders of the Sternoclavicular Joint | 453 | ||
| Surgical Anatomy | 453 | ||
| Ligaments of the Sternoclavicular Joint | 453 | ||
| Intra-Articular Disk Ligament | 453 | ||
| Costoclavicular Ligament | 455 | ||
| Interclavicular Ligament | 455 | ||
| Capsular Ligament | 455 | ||
| Subclavius Muscle | 456 | ||
| Applied Surgical Anatomy | 456 | ||
| Range of Motion of the Sternoclavicular Joint | 458 | ||
| Epiphysis of the Medial Clavicle | 460 | ||
| Classification of Sternoclavicular Joint Disorders | 460 | ||
| Classification Based on Etiology | 460 | ||
| Traumatic Injury | 460 | ||
| Mechanism of Injury | 461 | ||
| Most Common Cause of Injury to the Sternoclavicular Joint | 461 | ||
| Traumatic Injury Subtypes | 462 | ||
| Sprain or Subluxation | 462 | ||
| Acute and Recurrent Dislocation | 462 | ||
| Injuries in the Skeletally Immature | 462 | ||
| Incidence of Injury to the Sternoclavicular Joint | 462 | ||
| Orthopedic Injuries Associated With the Sternoclavicular Joint | 462 | ||
| Bilateral Dislocations | 462 | ||
| Dislocations of Both Ends of the Clavicle | 463 | ||
| Combined Sternoclavicular Joint Injury and Fractures of the Clavicle | 463 | ||
| Combined Sternoclavicular Joint Dislocation and Scapulothoracic Dissociation | 463 | ||
| Signs and Symptoms of Injuries to the Sternoclavicular Joint | 463 | ||
| Traumatic Subluxation | 463 | ||
| Signs Common to Anterior and Posterior Dislocations | 464 | ||
| Signs and Symptoms of Anterior Dislocations | 464 | ||
| Signs and Symptoms of Posterior Dislocations | 464 | ||
| Radiographic Findings of Injury to the Sternoclavicular Joint | 464 | ||
| Anteroposterior Views | 464 | ||
| Heinig View | 464 | ||
| Hobbs View | 464 | ||
| Serendipity View | 465 | ||
| Computed Tomography Scans | 465 | ||
| Magnetic Resonance Imaging | 465 | ||
| Ultrasound | 467 | ||
| Atraumatic Disorders of the Sternoclavicular Joint | 467 | ||
| Spontaneous Subluxation and Dislocation | 467 | ||
| Arthritis | 467 | ||
| Osteoarthritis | 467 | ||
| Rheumatoid Arthritis | 468 | ||
| Seronegative Spondyloarthropathies | 469 | ||
| Crystal Arthropathy | 469 | ||
| Less Common Forms of Arthritis | 470 | ||
| Infection | 470 | ||
| Disorders Specific to the Sternoclavicular Joint | 471 | ||
| Condensing Osteitis of the Medial Clavicle | 471 | ||
| Friedrich Disease | 472 | ||
| Synovitis Acne Pustulosis Hyperostosis Osteitis (SAPHO) Syndrome | 472 | ||
| Other Conditions | 473 | ||
| Tietze Syndrome | 473 | ||
| Treatment | 473 | ||
| Traumatic Injuries: Anterior | 473 | ||
| Sprain/Subluxation | 473 | ||
| Acute Dislocation | 473 | ||
| Chronic Dislocation | 475 | ||
| Injuries in the Skeletally Immature | 475 | ||
| Anterior Physeal Injuries of the Medial Clavicle | 475 | ||
| Anterior Dislocation | 475 | ||
| Traumatic Injuries: Posterior | 476 | ||
| Nonoperative Treatment | 476 | ||
| Sprain/Subluxation | 476 | ||
| Acute Dislocation | 476 | ||
| Methods of Closed Reduction | 476 | ||
| Abduction Traction Technique | 476 | ||
| Adduction Traction Technique (Buckerfield and Castle Technique) | 477 | ||
| Operative Treatment | 477 | ||
| General Considerations | 477 | ||
| Reconstruction Techniques of the Sternoclavicular Joint | 478 | ||
| Local Tendon Transfers (Subclavius Tendon or Sternocleidomastoid Tendon) | 478 | ||
| Ligament Reconstruction (Autograft and Allograft Tissue) | 478 | ||
| Reconstruction Techniques Using Synthetic Materials | 478 | ||
| Open Reduction and Internal Fixation | 479 | ||
| Interpositional Arthroplasty | 479 | ||
| Combined Osteotomy of the Medial Clavicle and Ligament Repair | 479 | ||
| Resection of the Medial Clavicle (With and Without Costoclavicular Ligament Reconstruction) | 479 | ||
| Arthrodesis | 479 | ||
| Injuries in the Skeletally Immature | 479 | ||
| Acute Posterior Physeal Injuries of the Medial Clavicle | 479 | ||
| Chronic Posterior Physeal Injuries of the Medial Clavicle | 480 | ||
| Posterior Dislocation (Acute and Chronic) | 480 | ||
| Atraumatic Disorders | 480 | ||
| Spontaneous Subluxation or Dislocation (Anterior and Posterior) | 480 | ||
| Arthritis | 480 | ||
| Infection | 480 | ||
| Disorders Specific to the Sternoclavicular Joint | 481 | ||
| Authors’ Preferred Method of Treatment | 481 | ||
| Anterior Sternoclavicular Joint Injuries | 481 | ||
| 11 Sepsis of the Shoulder | 493 | ||
| History | 493 | ||
| Septic Anatomy of the Shoulder | 494 | ||
| Microanatomy and Cell Biology | 495 | ||
| Classification | 496 | ||
| Pathogenic Mechanisms of Septic Arthritis and Osteomyelitis | 497 | ||
| Surfaces as Substrata for Bacterial Colonization | 497 | ||
| Intra-articular Sepsis | 498 | ||
| Osteomyelitis | 498 | ||
| Microbial Adhesion and Intra-Articular Sepsis | 499 | ||
| Bacterial Pathogens | 501 | ||
| Clinical Presentation | 502 | ||
| Symptoms and Signs | 502 | ||
| Total Shoulder Replacement | 503 | ||
| Rheumatoid Arthritis | 503 | ||
| Differential Diagnosis | 503 | ||
| Laboratory Evaluation | 503 | ||
| Synovial Fluid Analysis | 503 | ||
| Imaging Studies | 504 | ||
| Complications | 506 | ||
| Treatment | 506 | ||
| Outcome | 508 | ||
| Prevention | 511 | ||
| Authors’ Preferred Method of Treatment | 511 | ||
| Summary | 512 | ||
| International Expert Commentary | 512 | ||
| Editor Commentary | 512 | ||
| References | 514.e1 | ||
| 12 Fractures, Dislocations, and Acquired Problems of the Shoulder in Children | 515 | ||
| Fractures of the Proximal Humerus | 515 | ||
| Anatomy | 515 | ||
| Embryology and Development | 515 | ||
| Relevant Anatomy | 515 | ||
| Fracture Incidence | 516 | ||
| Mechanism of Injury | 516 | ||
| Classification | 517 | ||
| History and Physical Examination | 517 | ||
| Radiographic Evaluation | 518 | ||
| Treatment | 519 | ||
| Reduction | 520 | ||
| Operative Treatment | 521 | ||
| Tuberosity Fracture Treatment | 522 | ||
| Glenohumeral Instability Treatment | 522 | ||
| Authors’ Preferred Treatment | 523 | ||
| Nonoperative | 523 | ||
| Operative | 523 | ||
| Postfracture Care and Rehabilitation | 523 | ||
| Complications | 523 | ||
| Fractures of the Clavicle | 524 | ||
| Anatomy | 524 | ||
| Embryology and Development | 524 | ||
| Relevant Anatomy | 525 | ||
| Fracture Incidence | 525 | ||
| Mechanism of Injury | 526 | ||
| Signs and Symptoms | 526 | ||
| Associated Injuries | 526 | ||
| Radiographic Evaluation | 526 | ||
| Differential Diagnosis | 528 | ||
| Classification | 528 | ||
| Lateral Clavicle Injuries | 528 | ||
| Medial Clavicle Injuries | 530 | ||
| Treatment | 530 | ||
| Fractures of the Clavicle Shaft | 530 | ||
| Lateral Clavicle Injuries | 531 | ||
| Medial Clavicle Injuries | 532 | ||
| Complications | 532 | ||
| Malunions | 532 | ||
| Nonunions | 532 | ||
| Neurovascular Injuries | 533 | ||
| Fractures of the Scapula | 533 | ||
| Anatomy | 533 | ||
| Embryology and Development | 533 | ||
| Relevant Anatomy | 533 | ||
| Fracture Incidence | 535 | ||
| Mechanism of Injury | 535 | ||
| Signs and Symptoms | 535 | ||
| Associated Injuries | 535 | ||
| Radiographic Evaluation | 535 | ||
| Differential Diagnosis | 536 | ||
| Classification | 536 | ||
| Treatment | 537 | ||
| Complications | 540 | ||
| Editor Commentary | 541 | ||
| Senior Editor Commentary | 541 | ||
| References | 541.e1 | ||
| 13 Glenohumeral Instability | 543 | ||
| Historical Review | 543 | ||
| Early Descriptions | 543 | ||
| Humeral Head Defect | 543 | ||
| Anterior Capsule and Muscle Defects | 545 | ||
| Rotator Cuff Injuries | 545 | ||
| Treatment of Acute Traumatic Dislocations | 546 | ||
| Operative Reconstructions for Anterior Instability | 547 | ||
| Posterior Glenohumeral Instability | 547 | ||
| Relevant Anatomy | 548 | ||
| Skin | 548 | ||
| First Muscle Layer | 548 | ||
| Coracoacromial Arch and Clavipectoral Fascia | 549 | ||
| Rotator Cuff | 551 | ||
| Scapulohumeral Ligaments | 551 | ||
| Glenoid Concavity and Labrum | 554 | ||
| Capsular Deformation | 556 | ||
| Mechanics of Glenohumeral Stability | 556 | ||
| Stability at Rest | 558 | ||
| Net Humeral Joint Reaction Force | 559 | ||
| Balance Stability Angle and the Stability Ratio | 560 | ||
| Glenoidogram | 561 | ||
| Glenoid Version | 561 | ||
| Scapular Positioning | 564 | ||
| Ligaments | 564 | ||
| Adhesion and Cohesion | 566 | ||
| Glenohumeral Suction Cup | 566 | ||
| Limited Joint Volume | 568 | ||
| Types of Glenohumeral Instability | 569 | ||
| Circumstances of Instability | 569 | ||
| Degree of Instability | 570 | ||
| Traumatic Instability | 571 | ||
| Direction of Instability | 572 | ||
| Anterior Dislocations | 572 | ||
| Posterior Dislocations | 572 | ||
| Inferior Dislocations | 574 | ||
| Superior Dislocations | 574 | ||
| Bilateral Dislocations | 576 | ||
| Dislocation | 578 | ||
| Clinical Findings | 578 | ||
| History | 578 | ||
| Physical Examination | 578 | ||
| Anterior Dislocation | 578 | ||
| Posterior Dislocation | 578 | ||
| Radiographic Evaluation | 579 | ||
| Injuries Associated With Anterior Dislocations | 585 | ||
| Ligaments and Capsule | 585 | ||
| Fractures | 586 | ||
| Cuff Tears | 586 | ||
| Vascular Injuries | 589 | ||
| Anatomy | 589 | ||
| Mechanism of Injury | 590 | ||
| Injury at the Time of Dislocation | 590 | ||
| Injury at the Time of Reduction | 590 | ||
| Signs and Symptoms | 590 | ||
| Treatment and Prognosis | 590 | ||
| Nerve Injuries | 590 | ||
| Anatomy | 590 | ||
| Mechanism of Injury | 591 | ||
| Incidence | 591 | ||
| Diagnosis | 591 | ||
| Treatment and Prognosis | 591 | ||
| Recurrence of Instability After Anterior Dislocations | 591 | ||
| Effect of Age | 591 | ||
| Effect of Trauma, Sports, Sex, and Dominance | 592 | ||
| Effect of Postdislocation Treatment | 592 | ||
| Effect of Fractures | 592 | ||
| Injuries Associated With Posterior Dislocations | 592 | ||
| Fractures | 592 | ||
| Other Associated Injuries | 593 | ||
| Recurrence of Instability After Posterior Dislocations | 593 | ||
| Treatment | 593 | ||
| Anterior Dislocations | 593 | ||
| Acute Traumatic Anterior Dislocations | 593 | ||
| Timing of Reduction and Analgesia | 593 | ||
| Methods of Reduction | 593 | ||
| Authors’ Preferred Method of Anterior Reduction | 594 | ||
| Chronic Anterior Traumatic Dislocations | 595 | ||
| Reduction and Analgesia | 595 | ||
| Open Reduction | 595 | ||
| Results of Treatment of Chronic Dislocations | 596 | ||
| Management After Reduction of an Anterior Dislocation | 596 | ||
| Evaluation | 596 | ||
| Protection | 596 | ||
| Strengthening | 596 | ||
| Early Surgery in Anterior Dislocations | 597 | ||
| Soft Tissue Interposition | 597 | ||
| Displaced Fracture of the Greater Tuberosity | 597 | ||
| Glenoid Rim Fracture | 597 | ||
| Posterior Dislocations | 597 | ||
| Reduction | 597 | ||
| Surgery | 598 | ||
| Authors’ Preferred Method of Treatment | 598 | ||
| Recurrent Dislocation | 599 | ||
| Evaluation | 599 | ||
| History | 599 | ||
| Physical Examination | 600 | ||
| Demonstration of Instability | 600 | ||
| Laxity Tests | 600 | ||
| Provocative Stability Tests | 602 | ||
| Radiographs and Other Tests | 604 | ||
| Humeral Head Changes | 605 | ||
| Stryker Notch View | 606 | ||
| Apical Oblique View | 606 | ||
| Glenoid Changes | 608 | ||
| Special Radiographic Techniques | 608 | ||
| Rotator Cuff Imaging | 609 | ||
| Electromyography | 609 | ||
| Arthroscopy | 609 | ||
| Treatment | 611 | ||
| Nonoperative Management | 611 | ||
| Surgical Management of Traumatic Anterior Instability | 613 | ||
| Examination Under Anesthesia | 615 | ||
| Operative Management | 615 | ||
| Capsulolabral Reconstruction | 616 | ||
| Open Bankart Repair With Open Capsular Shift | 616 | ||
| Other Anterior Repairs | 619 | ||
| Staple Capsulorrhaphy | 619 | ||
| Capsular Reconstruction | 619 | ||
| Subscapularis Muscle Procedures | 620 | ||
| Putti-Platt Procedure | 620 | ||
| Magnuson-Stack Procedure | 621 | ||
| Bone Block Procedures | 621 | ||
| Eden-Hybbinette Procedure | 622 | ||
| Oudard Procedure | 622 | ||
| Fresh Osteochondral Allograft From the Distal Tibia | 622 | ||
| Coracoid Transfer | 622 | ||
| Trillat Procedure | 623 | ||
| Bristow-Helfet Procedure | 623 | ||
| Latarjet Procedure | 624 | ||
| Other Open Repairs | 624 | ||
| Gallie Procedure | 624 | ||
| Nicola Procedure | 624 | ||
| Saha Procedure | 625 | ||
| Boytchev Procedure | 625 | ||
| Osteotomy of the Proximal Humerus | 625 | ||
| Osteotomy of the Neck of the Glenoid | 625 | ||
| Complications of Anterior Repairs | 625 | ||
| Arthroscopic Bankart Repair | 630 | ||
| Arthroscopic Remplissage With Arthroscopic Bankart Repair | 632 | ||
| Authors’ Preferred Method of Management of Anterior Shoulder Instability | 633 | ||
| Flatow’s Preferred Method for Open Management of Traumatic Shoulder Instability | 633 | ||
| Surgical Incision | 633 | ||
| Identification and Protection of the Axillary Nerve | 635 | ||
| Division of the Subscapular Tendon | 635 | ||
| Division of the Capsule | 635 | ||
| Capsular Shift and Bankart Repair | 635 | ||
| Wound Closure | 637 | ||
| Postoperative Management | 637 | ||
| Results | 638 | ||
| Parsons’ Preferred Technique for the Latarjet Procedure | 638 | ||
| Procedure | 638 | ||
| Surgical Incision | 638 | ||
| Coracoid Autograft Harvest | 638 | ||
| Preparation of the Coracoid Autograft | 638 | ||
| Subscapularis Split and Capsulotomy | 640 | ||
| Fixation of the Coracoid Autograft | 640 | ||
| Wound Closure | 641 | ||
| Postoperative Management | 641 | ||
| Operative Management of Posterior Instability | 641 | ||
| Considerations in the Decision for Surgery | 641 | ||
| Arthroscopic Posterior Instability Repair | 641 | ||
| Open Posterior Surgical Approaches | 641 | ||
| Open Posterior Soft Tissue Repairs | 642 | ||
| Rotation Osteotomy of the Humerus | 642 | ||
| Glenoid Osteotomy | 642 | ||
| Posterior Glenoid Bone Blocks | 643 | ||
| Complications of Posterior Repairs | 643 | ||
| Authors’ Preferred Method for Open Repair of Recurrent Posterior Glenohumeral Instability | 643 | ||
| Preoperative Considerations | 643 | ||
| Procedure | 643 | ||
| Surgical Incision | 643 | ||
| Identification and Elevation of the Infraspinatus Tendon | 645 | ||
| Division of the Capsule | 645 | ||
| Capsular Shift | 645 | ||
| Wound Closure | 645 | ||
| Postoperative Management | 645 | ||
| Results | 645 | ||
| Multidirectional Instability | 646 | ||
| Nonoperative Treatment of Multidirectional Instability | 646 | ||
| Operative Treatment of Atraumatic Instability | 646 | ||
| Presurgical Considerations | 646 | ||
| Open Capsular Shift for Multidirectional Instability | 646 | ||
| Arthroscopic Stabilization for Multidirectional Instability | 647 | ||
| Authors’ Preferred Technique for Open Treatment of Multidirectional Glenohumeral Instability | 647 | ||
| Procedure | 647 | ||
| Postoperative Management | 647 | ||
| Results | 647 | ||
| International Expert Commentary | 648 | ||
| Editor Commentary | 649 | ||
| References | 649.e1 | ||
| 14 The Rotator Cuff | 651 | ||
| Historical Review | 651 | ||
| Relevant Shoulder Anatomy | 652 | ||
| Deltoid Muscle | 652 | ||
| Rotator Cuff | 652 | ||
| Coracoid and Coracoacromial Ligament | 654 | ||
| Scapular and Acromial Anatomy | 654 | ||
| Humeroscapular Motion Interface | 657 | ||
| Acromioclavicular Joint | 659 | ||
| Vascular Anatomy | 659 | ||
| Biomechanics of the Rotator Cuff | 659 | ||
| Basic Science of Cuff Tendon and Healing | 663 | ||
| Tendon Composition and Structure | 664 | ||
| Biomechanical Properties | 665 | ||
| Tendon Healing | 666 | ||
| Classification of Rotator Cuff Pathology | 666 | ||
| Partial-Thickness Tears | 667 | ||
| Full-Thickness Tears | 667 | ||
| Tear Size/Number of Tendons Torn | 667 | ||
| Tear Shape | 668 | ||
| Patte Classification | 668 | ||
| Muscle Atrophy and Fatty Infiltration | 668 | ||
| Subscapularis Tears | 669 | ||
| Clinical Evaluation and Physical Examination | 669 | ||
| Physical Examination | 671 | ||
| Differential Diagnosis | 676 | ||
| Imaging of the Rotator Cuff | 678 | ||
| MRI | 678 | ||
| Ultrasonography | 679 | ||
| Natural History of Rotator Cuff Pathology and Implications on Surgical Indications | 680 | ||
| Natural History of Asymptomatic Rotator Cuff Tears | 680 | ||
| Natural History of Symptomatic Rotator Cuff Tears | 682 | ||
| Indications for Rotator Cuff Repair | 682 | ||
| Group I: Early Operative Repair—Acute Tear | 683 | ||
| Group II: Trial of Nonoperative Treatment—Nonacute Tear | 683 | ||
| Group III: Maximize Conservative Care—Irreparable Tear | 683 | ||
| Nonoperative Management of Rotator Cuff Tears | 684 | ||
| Phase I: Pain Control | 684 | ||
| Phase II: Stretching | 684 | ||
| Phase III: Strengthening Program | 684 | ||
| Phase IV: Maintenance and Prevention | 690 | ||
| Arthroscopic Rotator Cuff Repair | 691 | ||
| Surgical Technique | 692 | ||
| Subscapularis Repair | 693 | ||
| Partial-Thickness Repair | 694 | ||
| Full-Thickness Repair | 694 | ||
| Mini-Open Rotator Cuff Repair | 696 | ||
| Results of Rotator Cuff Repair Surgery | 704 | ||
| Surgical Options for Irreparable Cuff Tears | 704 | ||
| Partial Repair | 704 | ||
| Nonrepair Strategies | 705 | ||
| Smooth and Move Procedure | 705 | ||
| Postoperative Program | 707 | ||
| Tendon Transfers | 709 | ||
| Interposition Grafts and Capsular Reconstruction | 710 | ||
| Approach to Failed Cuff Surgery | 710 | ||
| Management | 712 | ||
| Rehabilitation After Rotator Cuff Repair | 713 | ||
| Basic Science Evidence | 713 | ||
| Clinical Evidence | 713 | ||
| International Expert Commentary | 714 | ||
| Editor Commentary | 719 | ||
| References | 719.e1 | ||
| 15 Shoulder Arthroscopy | 721 | ||
| Contributors | 721 | ||
| General Principles | 721 | ||
| Anesthesia and Monitoring | 722 | ||
| Equipment | 722 | ||
| Positioning | 724 | ||
| Examination Under Anesthesia | 725 | ||
| Portals and Diagnostic Arthroscopy | 726 | ||
| Standard Portals | 726 | ||
| Accessory Portals | 727 | ||
| Diagnostic Arthroscopy | 727 | ||
| Fluid Management and Hemostasis | 728 | ||
| Arthroscopic Treatment of Shoulder Instability | 730 | ||
| Pathoanatomy | 730 | ||
| Diagnosis and Diagnostic Arthroscopy in Shoulder Instability | 731 | ||
| Arthroscopic Management of Posttraumatic Anterior Instability | 732 | ||
| Overview | 732 | ||
| Results of Arthroscopic Treatment of Anterior Shoulder Instability | 732 | ||
| Arthroscopic Versus Open Anterior Stabilization | 733 | ||
| Contraindications | 733 | ||
| Traumatic Humeral Avulsion of the Glenohumeral Ligaments | 734 | ||
| Treatment of the First-Time Dislocator | 734 | ||
| Summary of Indications | 734 | ||
| Authors’ Preferred Technique | 735 | ||
| Single-Row Repair | 736 | ||
| Double-Row Repair | 737 | ||
| Arthroscopic Anterior Stabilization Guidelines for High-Risk Athletes | 738 | ||
| Arthroscopic Management of Posterior Instability | 738 | ||
| Authors’ Preferred Technique | 739 | ||
| Arthroscopic Management of Multidirectional Instability | 740 | ||
| Results of Open Inferior Capsular Shift | 741 | ||
| Arthroscopic Capsular Plication | 741 | ||
| Arthroscopic Thermal Capsulorrhaphy | 741 | ||
| Rotator Interval Closure | 741 | ||
| Authors’ Preferred Technique | 742 | ||
| Summary of Indications | 742 | ||
| Postoperative Management and Return to Play | 743 | ||
| Complications of Stabilization Surgery | 743 | ||
| Conclusions | 743 | ||
| Arthroscopic Management of Rotator Cuff Disease | 744 | ||
| Evolution of Arthroscopic Rotator Cuff Repair | 744 | ||
| Tear Recognition | 744 | ||
| Approach | 744 | ||
| Diagnostic Arthroscopy and Tear Recognition | 744 | ||
| Rotator Cuff Tear Classification | 745 | ||
| Tear Shape | 745 | ||
| Crescent Tears | 745 | ||
| U-Shaped Tears | 745 | ||
| L-Shaped Tears | 745 | ||
| Massive, Contracted, Immobile Tears | 746 | ||
| Tear Size | 746 | ||
| Tear Retraction | 746 | ||
| Rotator Cuff Muscle Quality | 747 | ||
| Repair Techniques | 747 | ||
| Authors’ Preferred Method | 749 | ||
| Advanced Arthroscopic Repairs | 751 | ||
| Massive Rotator Cuff Tears | 751 | ||
| Mobilization | 751 | ||
| Interval Slides | 751 | ||
| Patches/Tissue Augmentation | 752 | ||
| Authors’ Preferred Method | 752 | ||
| Partial Rotator Cuff Tears | 752 | ||
| Classification | 752 | ||
| Treatment Options | 752 | ||
| Operative Management | 753 | ||
| Authors’ Preferred Method | 753 | ||
| Subscapularis Tears | 753 | ||
| Diagnosis | 753 | ||
| Operative Indications | 754 | ||
| Arthroscopic Repair Outcomes | 755 | ||
| Biceps Tendon | 755 | ||
| Authors’ Preferred Method | 755 | ||
| Outcomes of Arthroscopic Rotator Cuff Repairs | 756 | ||
| Biomechanical Repair Strategies | 756 | ||
| Summary | 757 | ||
| Arthroscopic Treatment of Acromioclavicular Joint Osteolysis, Arthritis, and Instability | 757 | ||
| Anatomy | 757 | ||
| Distal Clavicle Osteolysis | 758 | ||
| Indications | 758 | ||
| Technique: Distal Clavicular Resection | 758 | ||
| Outcome | 759 | ||
| Acromiclavicular Arthritis | 759 | ||
| Indication | 759 | ||
| Technique: Acromioclavicular Joint Resection | 759 | ||
| Outcome | 760 | ||
| Acromioclavicular and Coracoclavicular Instability | 761 | ||
| Indication | 761 | ||
| Benefits and Disadvantages of Arthroscopic Versus Open Surgical Approaches | 762 | ||
| Technique: Arthroscopic Coracoclavicular Reconstruction | 762 | ||
| Glenohumeral Approach for Arthroscopic Coracoclavicular Reconstruction | 762 | ||
| Lateral Subacromial Approach for Acromioclavicular Joint Reconstruction | 763 | ||
| Coracoid Drilling | 763 | ||
| Coracoid and Clavicle Button | 763 | ||
| Graft Passage | 763 | ||
| Surgical Technique for Anatomic Coracoclavicular Reconstruction | 764 | ||
| Patient Positioning and Preparation | 764 | ||
| Exposure of the AC Joint | 764 | ||
| Clavicular Tunnel Placement | 764 | ||
| Preparation, Passage, and Fixation of the Graft | 765 | ||
| Acromioclavicular Joint Capsule Repair and Wound Closure | 765 | ||
| Rehabilitation Protocol | 765 | ||
| Outcome | 765 | ||
| Arthroscopic Treatment of Shoulder Stiffness and Rotator Cuff Calcific Tendinitis | 766 | ||
| Primary Adhesive Capsulitis | 766 | ||
| Overview | 766 | ||
| Management | 767 | ||
| Nonoperative Management | 767 | ||
| Closed Manipulation | 767 | ||
| Arthroscopic Treatment | 768 | ||
| Outcomes | 770 | ||
| Secondary Adhesive Capsulitis | 770 | ||
| Secondary Shoulder Stiffness | 770 | ||
| Overview | 770 | ||
| Stiffness After Instability Procedures | 771 | ||
| Stiffness After Fracture | 771 | ||
| Stiffness and Rotator Cuff Disease | 771 | ||
| Calcific Tendinitis | 771 | ||
| Overview | 771 | ||
| Nonoperative Treatment | 772 | ||
| Arthroscopic Treatment | 772 | ||
| Arthroscopic Management of Prearthritic and Arthritic Conditions of the Shoulder and the Postarthroplasty Shoulder | 774 | ||
| Indications for Arthroscopic Treatment | 774 | ||
| Technique and Outcomes | 774 | ||
| Standard Setup and Overview | 774 | ||
| Debridement | 775 | ||
| Capsular Release | 777 | ||
| Microfracture | 778 | ||
| Glenoidplasty | 779 | ||
| Resurfacing | 779 | ||
| Subacromial Decompression and Distal Clavicle Excision | 780 | ||
| Inflammatory Synovitis and Arthritis | 780 | ||
| Renal Arthropathy | 781 | ||
| Osteonecrosis | 781 | ||
| Arthroscopy After Shoulder Arthroplasty | 781 | ||
| Summary | 782 | ||
| Arthroscopic Surgery for Biceps-Labral Complex Disease | 783 | ||
| Introduction | 783 | ||
| Redefining the Anatomy of the Biceps-Labral Complex | 784 | ||
| Inside | 784 | ||
| Normal Anatomy | 785 | ||
| Pathological Lesions | 785 | ||
| Junction | 788 | ||
| Normal Anatomy | 788 | ||
| Pathological Lesions | 790 | ||
| Bicipital Tunnel | 791 | ||
| Normal Anatomy | 791 | ||
| Pathological Lesions (Bicipital Tunnel Syndrome) | 793 | ||
| Surgical Options | 794 | ||
| Labral Procedures | 794 | ||
| Biceps Procedures | 796 | ||
| Bicipital Tunnel Decompressing Techniques | 796 | ||
| Bicipital Tunnel Nondecompressing Techniques | 799 | ||
| Reproducing Length-Tension Relationship | 799 | ||
| Selecting the Optimal Surgical Technique | 801 | ||
| Preoperative Evaluation | 801 | ||
| Authors’ Preferred Algorithm | 802 | ||
| Summary | 803 | ||
| Arthroscopic Management of the Thrower’s Shoulder | 804 | ||
| Introduction | 804 | ||
| Rotator Cuff Tears | 805 | ||
| Surgical Findings | 805 | ||
| Surgical Technique | 807 | ||
| Outcomes | 808 | ||
| SLAP Tears | 810 | ||
| Surgical Findings | 810 | ||
| Surgical Technique | 811 | ||
| Outcomes | 812 | ||
| GIRD/Motion Loss | 814 | ||
| Treatment | 814 | ||
| Instability | 814 | ||
| Biceps Tunnel Disease | 815 | ||
| Subacromial Impingement | 816 | ||
| Posterior Ossification of the Shoulder | 817 | ||
| Conclusion | 818 | ||
| Complications of Shoulder Arthroscopy | 818 | ||
| Introduction | 818 | ||
| Preoperative Complications | 818 | ||
| Anesthesia | 818 | ||
| Regional Anesthesia | 818 | ||
| Peripheral Nerve Injury | 819 | ||
| Positioning | 819 | ||
| Traction | 819 | ||
| Intraoperative Complications | 820 | ||
| Neurovascular Injury and Portal Placement | 820 | ||
| Air Embolism | 821 | ||
| Fluid Extravasation and Airway Compromise | 821 | ||
| Hemodynamics | 821 | ||
| Tendon and Osseous Injuries | 821 | ||
| Postoperative | 822 | ||
| Infection | 822 | ||
| Thromboembolism | 822 | ||
| Editor Commentary | 823 | ||
| Senior Editor Commentary | 824 | ||
| References | 829.e1 | ||
| 16 Glenohumeral Arthritis and Its Management | 831 | ||
| Overview | 831 | ||
| Clinical Evaluation | 833 | ||
| History | 834 | ||
| Chief Complaint | 834 | ||
| Medical History | 835 | ||
| Physical Examination | 835 | ||
| Radiographic Evaluation | 842 | ||
| Laboratory Evaluation | 853 | ||
| Disease Characteristics | 853 | ||
| Degenerative Joint Disease | 853 | ||
| Secondary Degenerative Joint Disease | 856 | ||
| Capsulorrhaphy Arthropathy | 857 | ||
| Rheumatoid and Other Types of Inflammatory Arthritis | 857 | ||
| Cuff Tear Arthropathy | 867 | ||
| Avascular Necrosis | 873 | ||
| Glenohumeral Chondrolysis | 876 | ||
| Other Types of Arthritis | 878 | ||
| Neurotropic (Charcot) Arthropathy | 878 | ||
| Radiation Arthropathy | 878 | ||
| Septic Arthritis | 880 | ||
| Neoplastic Joint Destruction | 880 | ||
| Miscellaneous Arthropathies | 880 | ||
| Treatment | 881 | ||
| Communication | 881 | ||
| Nonoperative Treatment | 882 | ||
| Activity Modification and Fitness | 882 | ||
| Exercises | 882 | ||
| Medication | 888 | ||
| Injections | 888 | ||
| Surgical Treatment | 888 | ||
| Arthroscopic | 888 | ||
| Considerations | 888 | ||
| Open | 890 | ||
| Debridement and Capsular Release | 890 | ||
| Synovectomy | 891 | ||
| Resection | 891 | ||
| Arthrodesis | 892 | ||
| Considerations | 892 | ||
| Technique | 895 | ||
| Arthroplasty | 899 | ||
| Considerations | 899 | ||
| Types of Arthroplasty | 900 | ||
| Mechanics of Anatomic Arthroplasty | 902 | ||
| Mobility | 903 | ||
| Capsular Laxity. | 903 | ||
| Humeral Articular Surface. | 906 | ||
| Glenoid Articular Surface. | 907 | ||
| Concentricity of the Coracoacromial and Glenohumeral Spheres. | 907 | ||
| Absence of Unwanted Bone Contact. | 907 | ||
| Unrestricted Humeroscapular Motion Interface. | 907 | ||
| Stability | 907 | ||
| Humeral Articular Surface Area. | 917 | ||
| Stabilizing the Glenoid Concavity. | 920 | ||
| Control of the Net Humeral Joint Reaction Force. | 931 | ||
| Strength | 940 | ||
| Smoothness | 941 | ||
| Distributed Load Transfer. | 941 | ||
| Smooth Joint Surfaces. | 942 | ||
| Techniques for Anatomic Arthroplasty | 942 | ||
| Prosthesis Selection for Anatomic Arthroplasty | 942 | ||
| Humeral Component. | 942 | ||
| Humeral Articular Surface. | 942 | ||
| Fixation of the Head Component to the Humeral Bone. | 945 | ||
| Glenoid Component. | 957 | ||
| Surgical Technique for Anatomic Arthroplasty | 967 | ||
| Preparation of the Patient. | 967 | ||
| Initial Preparation of the Humerus. | 974 | ||
| Glenoid Arthroplasty. | 979 | ||
| Ream and Run Arthroplasty. | 979 | ||
| Total Shoulder Arthroplasty. | 981 | ||
| Humeral Arthroplasty. | 987 | ||
| Special Considerations | 991 | ||
| Degenerative Joint Disease. | 991 | ||
| Rheumatoid Arthritis. | 991 | ||
| Secondary Degenerative Joint Disease. | 992 | ||
| Capsulorrhaphy Arthropathy. | 992 | ||
| Cuff Tear Arthropathy. | 992 | ||
| Postoperative Rehabilitation | 994 | ||
| Results | 998 | ||
| Modes of Failure | 1000 | ||
| Stiffness. | 1001 | ||
| Infection. | 1001 | ||
| Glenoid Failure. | 1007 | ||
| Humeral Component Failure. | 1010 | ||
| Instability. | 1011 | ||
| Rotator Cuff Failure. | 1017 | ||
| Fractures. | 1018 | ||
| Nerve Injuries. | 1020 | ||
| Arthroplasty for the Cuff-Deficient Shoulder | 1020 | ||
| Considerations | 1020 | ||
| Prosthesis Selection | 1022 | ||
| Surgical Technique | 1026 | ||
| Cuff Tear Arthropathy Prosthesis. | 1026 | ||
| Reverse Total Shoulder Arthroplasty. | 1027 | ||
| Results | 1031 | ||
| Cuff Tear Arthropathy Prosthesis. | 1031 | ||
| Reverse Total Shoulder Arthroplasty. | 1031 | ||
| International Expert Commentary | 1041 | ||
| Editor Commentary | 1042 | ||
| References | 1042.e1 | ||
| 17 The Biceps Tendon | 1043 | ||
| Historical Review | 1043 | ||
| Anatomy | 1046 | ||
| Soft Tissue Restraint | 1048 | ||
| Rotator Interval | 1048 | ||
| The Groove | 1049 | ||
| Osseous Anatomy | 1050 | ||
| Comparative Anatomy | 1050 | ||
| Developmental Anatomy | 1051 | ||
| Pathologic Anatomy | 1051 | ||
| Osseous Pathoanatomy | 1053 | ||
| Function of the Biceps Tendon (and the Biceps-Labral Complex) | 1056 | ||
| Direct Observation | 1056 | ||
| Electromyographic Evaluation | 1058 | ||
| Summary | 1059 | ||
| Classification of Bicipital and Labral Lesions | 1059 | ||
| Slatis and Aalto Classification | 1060 | ||
| Type A: Impingement Tendinitis | 1060 | ||
| Type B: Subluxation of the Biceps Tendon | 1061 | ||
| Type C: Attrition Tendinitis | 1061 | ||
| Habermeyer and Walch Classification | 1061 | ||
| Origin Lesions | 1062 | ||
| Interval Lesions | 1062 | ||
| Biceps Tendinitis | 1062 | ||
| Subluxation of the Long Head of the Biceps Tendon | 1062 | ||
| Superior Subluxation (Type I) | 1062 | ||
| Subluxation in the Groove (Type II) | 1062 | ||
| Malunion and Nonunion of the Lesser Tuberosity (Type III) | 1062 | ||
| Isolated Rupture of the Biceps Tendon Occurring in the Rotator Interval | 1062 | ||
| Biceps Tendinitis Associated With Rotator Cuff Tears | 1062 | ||
| Dislocation Associated With Rotator Cuff Tears | 1062 | ||
| Extra-Articular Dislocation Associated With Subscapularis Lesions (Type IA) | 1062 | ||
| Extra-Articular Dislocation of the Long Head of the Biceps Tendon Associated With an Intact Subscapularis (Type IB) | 1062 | ||
| Intra-Articular Dislocation of the Long Head of the Biceps Tendon (Type II) | 1063 | ||
| Ruptures of the Biceps Associated With Rotator Cuff Tears | 1063 | ||
| TLC Classification | 1063 | ||
| Incidence | 1063 | ||
| Etiology | 1064 | ||
| Prevention | 1064 | ||
| Clinical Features of Bicipital Lesions | 1065 | ||
| Physical Examination | 1065 | ||
| Associated Conditions | 1068 | ||
| Diagnostic Tests | 1068 | ||
| Plain Film Radiology | 1068 | ||
| Fisk Method | 1068 | ||
| Bicipital Groove View | 1068 | ||
| Arthrography | 1069 | ||
| Ultrasonography | 1070 | ||
| Magnetic Resonance Imaging | 1070 | ||
| Arthroscopy | 1072 | ||
| Complications | 1073 | ||
| Differential Diagnosis | 1073 | ||
| Impingement Syndrome | 1073 | ||
| Shoulder Instability | 1074 | ||
| Glenoid Labrum Tears Without Instability | 1074 | ||
| Adhesive Capsulitis | 1074 | ||
| Glenohumeral Arthritis | 1075 | ||
| Coracoid Impingement Syndrome | 1075 | ||
| Treatment | 1075 | ||
| Nonoperative Treatment | 1075 | ||
| History | 1075 | ||
| Results | 1075 | ||
| Operative Treatment: Open | 1076 | ||
| Review | 1076 | ||
| Operative Treatment: Arthroscopic | 1079 | ||
| Review | 1079 | ||
| Techniques | 1081 | ||
| Operative Treatment: Current Controversies | 1085 | ||
| Authors’ Preferred Methods | 1085 | ||
| Superior Labral Tears | 1085 | ||
| Impingement Tendinitis | 1085 | ||
| Biceps Instability | 1086 | ||
| Isolated Biceps Lesions | 1087 | ||
| Isolated Biceps Rupture in Patients Younger Than 50 Years | 1087 | ||
| Acute Biceps Rupture in Patients Older Than 50 Years | 1087 | ||
| Postoperative Care | 1087 | ||
| Failed Biceps Tenodesis or Tenotomy | 1088 | ||
| Summary | 1088 | ||
| Acknowledgements | 1089 | ||
| International Expert Commentary | 1089 | ||
| Editor Commentary | 1091 | ||
| References | 1091.e1 | ||
| Bibliography | 1091.e5 | ||
| 18 Nerve Problems Related to the Shoulder | 1093 | ||
| Clinical Evaluation | 1093 | ||
| Musculocutaneous Nerve Injury | 1094 | ||
| Etiology | 1094 | ||
| Nonoperative Treatment | 1095 | ||
| Operative Treatment | 1095 | ||
| Axillary Nerve | 1095 | ||
| Anatomy | 1095 | ||
| Etiology and Clinical Manifestation | 1095 | ||
| Nonoperative Treatment | 1096 | ||
| Operative Treatment | 1097 | ||
| Spinal Accessory Nerve | 1097 | ||
| Etiology | 1097 | ||
| Anatomy | 1098 | ||
| Diagnosis | 1099 | ||
| Operative Treatment | 1100 | ||
| Nerve Transfer | 1100 | ||
| Muscle Transfer | 1100 | ||
| Long Thoracic Nerve | 1102 | ||
| Anatomy | 1102 | ||
| Etiology | 1102 | ||
| Clinical Manifestation | 1103 | ||
| Nonoperative Treatment | 1103 | ||
| Operative Treatment | 1103 | ||
| Tendon Transfer | 1103 | ||
| Pectoralis Major Transfer | 1104 | ||
| Technique | 1104 | ||
| Postoperative Management | 1105 | ||
| Suprascapular Nerve | 1106 | ||
| Anatomy | 1106 | ||
| Etiology | 1106 | ||
| Clinical Manifestation and Diagnosis | 1107 | ||
| Nonoperative Treatment | 1108 | ||
| Operative Treatment | 1108 | ||
| Outcomes | 1108 | ||
| Thoracic Outlet Syndrome | 1108 | ||
| Clinical Manifestation | 1109 | ||
| Diagnosis | 1109 | ||
| Treatment | 1109 | ||
| Parsonage-Turner Syndrome (Brachial Plexus Neuropathy) | 1111 | ||
| Etiology | 1111 | ||
| Clinical Manifestation | 1111 | ||
| Diagnosis | 1111 | ||
| Treatment | 1111 | ||
| Prognosis | 1111 | ||
| Brachial Plexus Injuries | 1112 | ||
| Types | 1112 | ||
| Diagnosis | 1113 | ||
| Nonoperative Treatment | 1114 | ||
| Operative Treatment | 1114 | ||
| Indications | 1114 | ||
| Planning | 1115 | ||
| General Technique | 1115 | ||
| Nerve Repair | 1115 | ||
| Nerve Transfer | 1116 | ||
| Nerve Reimplantation | 1117 | ||
| Muscle Transfer | 1117 | ||
| Outcomes | 1118 | ||
| Amputation | 1118 | ||
| Shoulder Reconstruction Options in Adult Patients With Brachial Plexus Injury | 1118 | ||
| Tendon Transfer Options to Restore Shoulder External Rotation in Patients With BPI | 1119 | ||
| Technique of Lower Trapezius Transfer to the Infraspinatus to Restore Shoulder External Rotation | 1119 | ||
| Technique of Upper/Middle Trapezius Transfer | 1120 | ||
| Technique of Contralateral Lower Trapezius Origin Transfer to the Infraspinatus Tendon to Restore Shoulder External Rotation | 1120 | ||
| Editor Commentary | 1122 | ||
| Senior Editor Commentary | 1122 | ||
| References | 1122.e1 | ||
| 19 The Stiff Shoulder | 1123 | ||
| Definition and Classification | 1123 | ||
| Classification | 1123 | ||
| Primary, Idiopathic Frozen Shoulder | 1123 | ||
| Secondary Frozen Shoulder | 1124 | ||
| Diagnostic Criteria | 1124 | ||
| Idiopathic Frozen Shoulder | 1124 | ||
| Normal Motion and Pathomechanics | 1125 | ||
| Glenohumeral Articulation | 1125 | ||
| Subacromial-Subdeltoid Plane | 1126 | ||
| Scapulothoracic Motion | 1126 | ||
| Pathophysiology | 1127 | ||
| Original Theories, Anatomic and Histologic Analysis | 1127 | ||
| Immunologic Analysis | 1127 | ||
| Association With Dupuytren Contracture | 1127 | ||
| Association With Diabetes Mellitus | 1128 | ||
| Cytokinetic, Genetic, and Enzymatic Analysis | 1128 | ||
| Epidemiology | 1128 | ||
| Predisposing Factors | 1128 | ||
| Age | 1128 | ||
| Diabetes Mellitus | 1129 | ||
| Non-Shoulder Surgery | 1129 | ||
| Immobility | 1129 | ||
| Cervical Disk Disease | 1129 | ||
| Thyroid Disorders | 1129 | ||
| Cardiac Disease | 1129 | ||
| Pulmonary Disorders | 1130 | ||
| Malignancy | 1130 | ||
| Neurologic Conditions | 1130 | ||
| Personality Disorders | 1130 | ||
| Reaction to Medication | 1130 | ||
| Genetics | 1131 | ||
| Hypertension | 1131 | ||
| Natural History | 1131 | ||
| Evaluation | 1131 | ||
| History | 1131 | ||
| Stages | 1131 | ||
| Stage 1: Freezing | 1131 | ||
| Stage 2: Frozen | 1132 | ||
| Stage 3: Thawing | 1132 | ||
| Differentiating Primary From Secondary Frozen Shoulder | 1132 | ||
| Physical Examination | 1132 | ||
| Laboratory Studies | 1132 | ||
| Imaging | 1133 | ||
| Radiographs | 1133 | ||
| Arthrography | 1133 | ||
| Nuclear Imaging | 1133 | ||
| Magnetic Resonance Imaging | 1133 | ||
| Ultrasound | 1133 | ||
| Arthroscopy | 1134 | ||
| Treatment | 1134 | ||
| Nonoperative Treatment | 1134 | ||
| Medication | 1134 | ||
| Physical Therapy | 1134 | ||
| Injections | 1135 | ||
| Intra-Articular Injections | 1135 | ||
| Capsular Distention | 1136 | ||
| Periarticular Trigger Point Injection and Nerve Blockade | 1137 | ||
| Other Modalities | 1137 | ||
| Acupuncture | 1137 | ||
| Calcitonin | 1138 | ||
| Radiation Therapy | 1138 | ||
| Operative Treatment | 1138 | ||
| Manipulation Under Anesthesia | 1138 | ||
| Manipulation and Arthroscopy | 1140 | ||
| Open Surgical Release | 1140 | ||
| Arthroscopic Capsular Release | 1141 | ||
| History | 1141 | ||
| Clinical Outcomes | 1142 | ||
| Subscapularis Release | 1142 | ||
| Cost-Effectiveness and Value | 1143 | ||
| Comparative Analysis | 1143 | ||
| Authors’ Prefered Treatment | 1143 | ||
| Nonoperative Treatment | 1143 | ||
| Manipulation Under Anesthesia | 1143 | ||
| Indications and Contraindications | 1143 | ||
| Technique | 1144 | ||
| Strategy | 1144 | ||
| Postoperative Management | 1144 | ||
| Operative Treatment | 1144 | ||
| Arthroscopic Capsular Release | 1144 | ||
| Technique | 1145 | ||
| Rotator Interval and Anterior Capsular Release | 1145 | ||
| Posterior Capsular Release | 1145 | ||
| Subacromial Lysis of Adhesions | 1146 | ||
| Postoperative Management | 1147 | ||
| Open Surgical Release | 1147 | ||
| Technique | 1147 | ||
| Subscapularis Lengthening | 1147 | ||
| Postoperative Management | 1148 | ||
| Summary | 1148 | ||
| Acknowledgments | 1148 | ||
| International Expert Commentary | 1149 | ||
| Editor Commentary | 1150 | ||
| References | 1150.e1 | ||
| Bibliography | 1150.e6 | ||
| 20 The Shoulder in Athletes | 1151 | ||
| Sports-Specific Biomechanics | 1151 | ||
| The Kinetic Chain | 1151 | ||
| Throwing Athletes | 1151 | ||
| Baseball Pitching | 1151 | ||
| Wind-up | 1152 | ||
| Early Cocking | 1152 | ||
| Late Cocking | 1154 | ||
| Acceleration | 1155 | ||
| Deceleration | 1155 | ||
| Follow-through | 1155 | ||
| Football Throwing | 1156 | ||
| Nonthrowing Overhead Athletes | 1156 | ||
| Tennis | 1156 | ||
| Swimming | 1156 | ||
| Phases of Freestyle Swimming | 1157 | ||
| Hand Entry | 1157 | ||
| Catch | 1157 | ||
| In-Sweep | 1157 | ||
| Finish | 1158 | ||
| Recovery | 1158 | ||
| Instability in Swimmers | 1158 | ||
| Impingement in Swimmers | 1158 | ||
| Golf | 1159 | ||
| Subacromial Impingement and Rotator Cuff Injury | 1159 | ||
| Acromioclavicular Joint Disease | 1160 | ||
| Glenohumeral Instability | 1160 | ||
| Superior Labrum and Biceps Disease | 1160 | ||
| Glenohumeral Arthritis | 1160 | ||
| Asymptomatic Throwing Shoulder Adaptation | 1160 | ||
| Overall Motion | 1160 | ||
| Bone Adaptations | 1160 | ||
| Capsuloligamentous Changes | 1161 | ||
| Posterior Capsular Contracture Theory | 1161 | ||
| Adaptive Capsular Laxity Theory | 1162 | ||
| Muscle Strength and Proprioception | 1163 | ||
| Scapulothoracic Motion | 1163 | ||
| Throwing Shoulder Conditions | 1163 | ||
| Internal Impingement | 1164 | ||
| Posterior Capsular Contracture | 1165 | ||
| Glenohumeral Internal Rotation Deficit | 1165 | ||
| SICK Scapula and Scapular Dyskinesis | 1166 | ||
| Evaluation of the Overhead Athlete | 1167 | ||
| History | 1168 | ||
| Physical Examination | 1168 | ||
| Inspection | 1168 | ||
| Range of Motion | 1168 | ||
| Palpation | 1168 | ||
| Strength | 1168 | ||
| Internal Impingement | 1168 | ||
| Apprehension Relocation | 1168 | ||
| Active Compression Test | 1168 | ||
| Impingement | 1169 | ||
| Neer Impingement Sign | 1169 | ||
| Hawkins Impingement Sign | 1169 | ||
| Acromioclavicular Joint | 1169 | ||
| Scapular Provocative Maneuvers | 1169 | ||
| Scapular Assistance Test | 1169 | ||
| Scapular Retraction Test | 1169 | ||
| Imaging | 1169 | ||
| Treatment | 1169 | ||
| Posterior Capsule Contracture | 1169 | ||
| Nonoperative Treatment | 1169 | ||
| Operative Management | 1169 | ||
| SLAP Lesions | 1169 | ||
| Variations in Normal Superior Labrum Anatomy | 1169 | ||
| Superior Labrum-Biceps Complex and Stability | 1171 | ||
| Classification | 1171 | ||
| SLAP Lesions and Throwing | 1171 | ||
| Diagnosis | 1172 | ||
| History | 1172 | ||
| Physical Examination | 1172 | ||
| Imaging | 1173 | ||
| Arthroscopic Evaluation | 1173 | ||
| Treatment | 1173 | ||
| Nonoperative Management | 1173 | ||
| Operative Management | 1174 | ||
| Surgical Repair Technique | 1174 | ||
| Rehabilitation | 1175 | ||
| Outcomes | 1175 | ||
| Biceps Tenodesis | 1177 | ||
| Arthroscopic Biceps Tenodesis Technique | 1177 | ||
| Outcomes | 1178 | ||
| Rotator Cuff Tears | 1179 | ||
| Partial-Thickness Rotator Cuff Tears | 1179 | ||
| Nonoperative Treatment | 1179 | ||
| Operative Treatment | 1179 | ||
| Tear Completion Technique | 1179 | ||
| In Situ Transtendon Technique | 1180 | ||
| Rehabilitation | 1180 | ||
| Outcomes | 1181 | ||
| PAINT Lesions | 1182 | ||
| Technique | 1182 | ||
| Rehabilitation | 1184 | ||
| Outcomes | 1184 | ||
| Full-Thickness Rotator Cuff Tears | 1184 | ||
| Posterior Ossification of the Shoulder (Thrower’s Exostosis) | 1185 | ||
| Anterior Shoulder Instability in Athletes | 1186 | ||
| Initial Management | 1187.e1 | ||
| Nonoperative Treatment | 1187 | ||
| Operative Treatment | 1187 | ||
| Risk Factors for Failure of Arthroscopic Stabilization | 1188 | ||
| Bone Deficiencies and Anterior Instability | 1188 | ||
| Glenoid Bone Loss | 1188 | ||
| Humeral Head Bone Loss | 1189 | ||
| Arthroscopic Bankart Repair Surgical Technique | 1191 | ||
| Posterior Shoulder Instability in Athletes | 1192 | ||
| Posterior Labral Repair Surgical Technique | 1193 | ||
| Rehabilitation | 1195 | ||
| Outcomes | 1195 | ||
| Neurovascular Injuries | 1195 | ||
| Burner (Stinger) Syndrome | 1195 | ||
| History | 1196 | ||
| Physical Examination | 1196 | ||
| 21 Occupational Shoulder Disorders | 1203 | ||
| Occupational Shoulder Disorders | 1204 | ||
| Epidemiology | 1204 | ||
| Etiology | 1206 | ||
| Management | 1208 | ||
| Degenerative Joint Disease | 1209 | ||
| Prevention | 1210 | ||
| Primary Prevention | 1211 | ||
| Secondary Prevention | 1212 | ||
| Case Examples | 1213 | ||
| Case 1 | 1213 | ||
| Case 2 | 1213 | ||
| Outcomes of Treatment | 1213 | ||
| Evaluation of Upper Extremity Disability and Impairment | 1215 | ||
| Disability Versus Impairment | 1215 | ||
| Disability Determination | 1216 | ||
| Guidelines for Degree of Impairment | 1216 | ||
| Current Disability Compensation Systems | 1217 | ||
| The Americans With Disabilities Act | 1217 | ||
| Workers’ Compensation | 1218 | ||
| Railroad and Maritime Workers’ Compensation | 1219 | ||
| Social Security | 1219 | ||
| Private Insurance Companies | 1219 | ||
| Conclusion | 1219 | ||
| Editor Commentary | 1220 | ||
| Senior Editor Commentary | 1221 | ||
| References | 1222.e1 | ||
| 22 Tumors and Related Conditions | 1223 | ||
| Historical Review | 1223 | ||
| Anatomy | 1224 | ||
| Staging and Classification of Tumors | 1225 | ||
| Benign Tumors of Bone | 1225 | ||
| Malignant Soft Tissue and Bone Tumors | 1226 | ||
| Molecular Biology | 1228 | ||
| Classification of Tumors | 1229 | ||
| Benign Osseous Lesions | 1229 | ||
| Osteoid Osteoma | 1229 | ||
| Osteoblastoma | 1229 | ||
| Myositis Ossificans | 1230 | ||
| Malignant Osseous Lesions | 1230 | ||
| Osteosarcoma | 1230 | ||
| Benign Cartilaginous Lesions | 1231 | ||
| Osteochondroma | 1231 | ||
| Chondroblastoma | 1232 | ||
| Periosteal Chondroma | 1232 | ||
| Enchondroma | 1232 | ||
| Malignant Cartilaginous Lesions | 1233 | ||
| Chondrosarcoma | 1233 | ||
| Synovial Dysplasias | 1234 | ||
| Miscellaneous Intraosseous Tumors | 1234 | ||
| Simple Bone Cyst | 1234 | ||
| Aneurysmal Bone Cyst | 1235 | ||
| Fibrous Dysplasia | 1235 | ||
| Nonossifying Fibroma | 1236 | ||
| Giant Cell Tumor | 1237 | ||
| Reticuloendothelial Tumors | 1237 | ||
| Multiple Myeloma | 1237 | ||
| Ewing Sarcoma | 1237 | ||
| Miscellaneous Dysplasias | 1239 | ||
| Gaucher Disease | 1239 | ||
| Paget Disease | 1239 | ||
| Benign Soft Tissue Tumors | 1241 | ||
| Ganglion | 1241 | ||
| Lipoma | 1241 | ||
| Hemangioma | 1241 | ||
| Fibromatosis | 1241 | ||
| Soft Tissue Sarcomas | 1241 | ||
| Incidence of Neoplasms | 1243 | ||
| Clinical Features | 1243 | ||
| Radiographic and Laboratory Evaluation | 1245 | ||
| Location | 1245 | ||
| Margin | 1245 | ||
| Density | 1245 | ||
| Evaluation | 1245 | ||
| Laboratory | 1246 | ||
| Complications of Tumors | 1246 | ||
| Differential Diagnosis | 1247 | ||
| Surgery | 1248 | ||
| Biopsy | 1248 | ||
| Placement of the Incision | 1249 | ||
| Contamination by Tumor Hematoma | 1249 | ||
| Adequacy of the Specimen | 1249 | ||
| Open Versus Closed Biopsy | 1250 | ||
| Surgical Resections About the Shoulder Girdle | 1250 | ||
| Surgical Margin | 1250 | ||
| Limb Salvage Surgery | 1252 | ||
| Short Proximal Humeral Resection | 1253 | ||
| Long Proximal Humeral Resections | 1253 | ||
| Glenohumeral Resections | 1253 | ||
| Scapulohumeral Resections | 1254 | ||
| Scapular Resections | 1254 | ||
| Reconstructive Procedures | 1254 | ||
| Management of Specific Lesions | 1257 | ||
| Aggressive Benign Bone Tumors | 1257 | ||
| Chondrosarcoma of Bone | 1257 | ||
| High-Grade Malignancies of Bone | 1258 | ||
| Osteosarcoma | 1258 | ||
| Ewing Sarcoma | 1258 | ||
| Adult Soft Tissue Sarcomas | 1258 | ||
| Metastatic Disease | 1258 | ||
| Authors’ Preferred Methods of Treatment | 1259 | ||
| Biopsy | 1259 | ||
| Surgical Choices | 1259 | ||
| High-Grade Tumors and Preoperative Chemotherapy | 1259 | ||
| International Expert Commentary | 1260 | ||
| Editor Commentary | 1263 | ||
| References | 1263.e1 | ||
| Index | 1265 | ||
| A | 1265 | ||
| B | 1268 | ||
| C | 1269 | ||
| D | 1271 | ||
| E | 1272 | ||
| F | 1272 | ||
| G | 1273 | ||
| H | 1274 | ||
| I | 1274 | ||
| J | 1275 | ||
| K | 1275 | ||
| L | 1275 | ||
| M | 1276 | ||
| N | 1276 | ||
| O | 1277 | ||
| P | 1277 | ||
| Q | 1278 | ||
| R | 1278 | ||
| S | 1280 | ||
| T | 1283 | ||
| U | 1284 | ||
| V | 1284 | ||
| W | 1284 | ||
| Y | 1284 | ||
| Z | 1284 | ||
| IBC_Clinical Key ad | IBC1 |