Case: We present a case of a patient who sustained a rhomboid major origin tear with subsequent seroma formation. The rhomboid major origin was reattached using an Achilles tendon allograft to supplement the repair, and the seroma wall was excised. We were able to alleviate the patient's pain and improve his shoulder function. We present our surgical technique. Conclusion: Scapular winging is most often attributed to neurogenic causes, but the goal of this case report is to help orthopaedic surgeons realize that scapular winging is not only a nerve issue but can result from an acute muscle tear.
A chicken tendon explant model system has been developed to investigate the effects of extremely-low-frequency (ELF), low-amplitude, unipolar, square wave pulsed electric fields on fibroplasia in vitro. An electric field parameter set consisting of 1-Hz, 1-ms duration pulses, with a time-averaged current density of 7 mA/m2 (peak current density 7 A/m2) induced maximal (32%) increase in fibroblast proliferation in tendon explants exposed for 4 days. Exposure to the same field at an average current density of 1.8 mA/m2 had no effect on fibroblast proliferation, whereas exposure to current densities on greater than 10 mA/m2 inhibited proliferation and relative collagen synthesis, without affecting noncollagen protein synthesis. Fibroplasia was significantly increased in explants oriented parallel to applied electric fields having current densities of 3.5 or 7 mA/m2, but there was no detectable effect on explants oriented perpendicular to the same electric field. Fibroblast proliferation and relative collagen synthesis were inversely proportional to donor age for chickens in the 3- to 16-week age group used in this study. For these dependent variables (proliferation and relative collagen synthesis), there was no interaction between donor age and ELF electric field exposure.
Background Although a variety of standardized measurements have been described to evaluate acetabular dysplasia, no single measurement is without limitations. We describe the Sourcil Index (SI), a novel measure of the weight-bearing surface of the acetabulum on anteroposterior pelvis films. The SI is the angle formed by the medial and lateral margins of the sourcil and the center of rotation of the femoral head. Methods Anteroposterior pelvis radiographs of skeletally mature patients from 2015 were reviewed. Studies with fractures or implants were excluded. Films were read by 2 orthopedic surgeons and a radiologist 3 times each, 8 weeks apart. The SI, Sharp's Angle (SA), and lateral center edge angle (LCEA) were recorded. Pearson intraclass correlation coefficients with 95% confidence intervals were calculated. The SI was then compared to the SA and LCEA to preliminarily assess diagnostic accuracy. Results Five hundred thirty-five hips in 292 patients met inclusion. Intraobserver reliability is as follows: SI = 0.95 (0.93-0.98), LCEA = 0.89 (0.82 -0.96), and SA = 0.90 (0.85-0.96). Interobserver reliability is as follows: SI = 0.90 (0.84-0.94), SA = 0.78 (0.64-0.86), and LCEA = 0.73 (0.56-0.82). There were 51 dysplastic hips within this cohort. Conclusion The SI is a reproducible measurement on plain radiographs. The SI is a two-dimensional representation of the size of the weight-bearing surface of the acetabulum and could provide an estimation of joint contact pressures. Used with existing measures, the SI may provide a more nuanced understanding of acetabular morphology.
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