The acromioclavicular (AC) joint enjoys the dubious distinction of being one of the few joints in the body whose total dislocation is routinely treated by simply leaving the joint dislocated. Adherents of both conservative and operative treatment have presented reasons for their viewpoints. Residual shoulder weakness has been offered as a sequela of untreated acromioclavicular injury and a reason for repairing the joint. An objective evaluation of shoulder strength would be valuable in determining the optimum treatment for this injury. The purpose of our study was to quantitate, using the Cybex II, the residual shoulder weakness following various modes of treatment. Seventeen patients with Grade III AC separations and eight patients with Grade II AC sprains were reviewed. Nine of the Grade III injuries were treated and eight nonoperatively. All Grade II injuries were treated nonsurgically. All patients were tested on the Cybex II isokinetic dynamometer at both slow and fast speeds through various ranges of motion. Grade III injuries treated nonoperatively showed no significant strength deficits. Surgically treated Grade III injuries had a significant strength deficit in vertical abduction at fast speeds (19.8%) when compared to the uninjured shoulder. Interestingly, the Grade II injuries led to a significant weakness in horizontal abduction (24.3%) at fast velocity. Evaluation of subjective results showed that Grade III injuries treated conservatively had the most pain and stiffness, despite their strong shoulders. Patients with Grade III injuries treated operatively rated their overall outcome below that of those treated conservatively.(ABSTRACT TRUNCATED AT 250 WORDS)
Twenty major issues in remarriage families are identified from the professional literature and are placed in four categories: initial family issues, developing family issues, feelings about self and others, and adult issues. Each issue is discussed using citations from the primary sources. Many suggestions for counselor assessment and intervention are offered.
A numerical rating system was designed as a method of evaluating results of extensor mechanism reconstructions of the knee. The method was applied in evaluating the long-term results of patients treated at one orthopaedic clinic. A paramount goal was to maintain objectivity in evaluations of patients' knees after reconstruction. Parameters of evaluations were swelling, pain, symptoms of instability, and limitations of activity. Each factor was rated on a scale of zero to three. Results were separated into four categories (excellent, good, fair, and poor). Weighted consideration was given to each parameter in relationship to others. Forty-four females (average follow-up time, 4.80 years) and 52 males (average follow-up time, 4.72 years) were evaluated subjectively and objectively. Twenty-two patients were older than 30 years of age and 74 were younger than 30 years of age at the time of surgery. Age had no effect on an "excellent" result; patients younger than 30 years had a higher proportion in the "good" category both subjectively and objectively than those older than 30 years of age. The data show no differences in the results for men and women. The presentation of the rating system and the criteria for definitions of the terms excellent and good form the intent of this paper, not the reporting of results. As one gains experience in these examinations, subjectivity will be minimized. A universally applicable scale, such as presented in this design, is one way investigators may compare results obtained by any surgical technique. Furthermore, the strict criteria can be applied preoperatively and post-operatively so that the results can be placed in perspective. The numerical rating system The literature stressing orthopaedic surgical techniques is voluminous compared with that which evaluates results. 1-14 Our objective is to begin establishing a method of evaluating results of extensor mechanism reconstructions of the knee and to apply this method to the study of long-term results at the Hughston Orthopaedic Clinic. We could find no previously developed criteria that were consistent or satisfactory. In designing such criteria, a paramount goal is to maintain objectivity. Ideally, a Binary system of yes/no answers should be used for each parameter that is evaluated. However, we find that there are many shades of grey that confuse the issue. Thus, we have developed a numerical average system somewhat similar to, but simpler than, the Harris method of hip evaluation. We have purposely developed a system simple enough to be practical and usable for the practicing orthopaedic surgeon.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2025 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.