Background:The incidence of superior labral surgery has increased in the past decade in the United States, and a contributing factor could be an increased rate of superior labral tears diagnosed with magnetic resonance imaging (MRI). Prior MRI studies of the asymptomatic shoulder have focused on rotator cuff pathology or pathology in a narrow and specific group of athletes. Labral abnormalities have not previously been thoroughly evaluated in asymptomatic middle-aged individuals.Purpose:To evaluate the prevalence of superior labral tears diagnosed by MRI in the asymptomatic shoulders of middle-aged people (age range, 45-60 years).Study Design:Cross-sectional study; Level of evidence, 3.Methods:A total of 53 asymptomatic adults (age range, 45-60 years) with no history of surgery or injury to either shoulder were included in the study. Physical examinations of all shoulders were performed. Noncontrast MRI (1.5 T) was performed in 1 randomly determined shoulder of each subject. Two fellowship-trained musculoskeletal radiologists who were blinded to the purpose of the study and ages of the subjects evaluated each MRI.Results:Radiologists interpreted the MRIs as consistent with superior labral tears in 55% and 72% of the cohort. Comparison of the radiological evaluations of the superior labra were moderate (κ = 0.410, P = .033). There were no differences in readings for superior labral tear regarding age (P = .87), sex (P = .41), whether the dominant shoulder underwent MRI (P = .99), whether the subject worked a physical job (P = .08), or whether the subject participated in overhead sports for a period of 1 year (P = .62).Conclusion:Superior labral tears are diagnosed with high frequency using MRI in 45- to 60-year-old individuals with asymptomatic shoulders. These shoulder MRI findings in middle-aged populations emphasize the need for supporting clinical judgment when making treatment decisions for this patient population.Clinical Relevance:To avoid overtreatment, physicians should realize that superior labral tears diagnosed by MRI in individuals between the ages of 45 and 60 years may be normal age-related findings.
The stronger and stiffer intramedullary screw technique offers mechanical advantages over the crossed interfragmentary screw technique.
Augmentation with K-wires may decrease the incidence of loss of fixation in distal humeral fractures.
Rupture to the anterior cruciate ligament is a common athletic injury in American football. The lower extremity biomechanics related to increased ACL injury risk are not completely understood. However, foot landing has been purported to be a significant contributing factor to the ACL injury mechanism. In this case report, information is presented on an athlete previously tested for in-shoe loading patterns on artificial turf and subsequently went on to non-contact ACL rupture on the same surface. This case report describes the specific findings in a study participant who suffered an ACL rupture after testing and suggests that flatfoot tendency in running and cutting maneuvers might lead to an increased risk of ACL injury.
Objetivos: Se sabe que un incremento continuo de la presión venosa aumenta el crecimiento óseo, estimula la consolidación de las fracturas y previene la pérdida ósea. Sin embargo, también causa trastornos en las partes blandas a consecuencia del edema crónico. El objetivo de este estudio ha sido demostrar la hipótesis de que un aumento intermitente de la presión venosa mejora la consolidación de las fracturas, sin lesionar las partes blandas. Diseñ o: Se realizó una osteotomía de radio derecho a 30 perros de sexo masculino y de raza ''beagle,'' esqueléticamente maduros. Al séptimo día de la intervención se colocó un manguito de isquemia alrededor de las patas delanteras de cada perro. En los 13 animales del estudio se comprimió el manguito durante 5 minutos, siguiéndose después de una ausencia de compresión durante 2,5 minutos. El ciclo mencionado se repitió 100 veces al día durante 8 semanas. En 15 animales que sirvieron como grupo de control se colocó un manguito no funcionante. La consolidación de las fracturas se valoró mediante absorptiometría de energia dual de rayos X, análisis histológicos y pruebas biomecánicas. Resultados: No se detectaron complicaciones en las partes blandas. El contenido óseo mineral de la zona de osteotomía aumentó de forma significativa en el grupo experimental con respecto al grupo control (P , 0,05). La histología demostró que los defectos óseos del grupo experimental consolidaron mucho más que los del grupo control (P , 0,005). No se encontraron diferencias entre los dos grupos con respecto a las propiedades biomecánicas. Conclusiones: Un aumento intermitente de la presión venosa en un defecto óseo parece incrementar la formación de hueso nuevo, sin que por ello produzcan complicaciones en las partes blandas. Tales hallazgos podrían, en teoría, ser aplicados al tratamiento clínico de las fracturas de ''difícil consolidació n''. Sin embargo, hacen falta más estudios para determinar el cociente que sea más eficaz con respecto a la presencia o ausencia de compresión neumática. Palabras Clave: retardo de consolidación, pseudoartrosis, estudio canino, consolidación de las fracturas, DXA
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