Double Osteotomy of the Shoulder

Benjamin, Alexander; Hirschowitz, D.; Arden, G. P.; Blackburn, N.

doi:10.1007/978-1-4471-1314-0_36

Cited by 7 publications

(5 citation statements)

References 20 publications

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“…It may also complicate an anterior surgical approach to the shoulder joint. Knowledge of anatomical variations of the brachial plexus, including possible communications between the median and musculocutaneous nerves, may prove valuable in traumatology of the shoulder joint, repair operations of the axilla and shoulder, radical neck dissections, and in the management of fracture dislocations of the surgical neck of the humerus (Benjamin et al, 1981;Seradge and Orme, 1982;Gacek, 1990). Variant nerves having an abnormal origin, course, and distribution are usually more prone to accidental injuries and entrapment neuropathies (Roberts, 1992).…”

Section: Discussionmentioning

confidence: 99%

Median and musculocutaneous nerves: Variant formation and distribution

Saeed

Rufai

2003

Clinical Anatomy

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An unusual formation of the median and musculocutaneous nerves was observed during routine dissection of the left upper limb of a 60-year-old Caucasian male cadaver. The median nerve was formed by the fusion of three roots, two from the lateral and one from the medial cord of the brachial plexus. The variant lateral root of the median nerve followed an anomalous course, crossing anterior to the distal part of the axillary artery. Moreover, in the distal half of the arm, the median nerve contributed a communicating branch to the musculocutaneous nerve. Injury to such a variant median nerve in the proximal arm may lead to paresthesia along the preaxial border of the forearm, weakness of elbow flexion, in addition to other manifestations of median nerve injury. The developmental and clinical significance of this anomaly is discussed.

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Section: Discussionmentioning

confidence: 99%

Median and musculocutaneous nerves: Variant formation and distribution

Saeed

Rufai

2003

Clinical Anatomy

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“…Good knowledge of the possible communications between musculocutaneous and median nerves may prove valuable in traumatology of the shoulder joint (see e.g., Seradge and Orme, 1982), as well as in relation to repair operations (e.g., Benjamin et al, 1981;Ha'eri and Wiley, 1982). As a matter of fact, the anterior surgical approach to the shoulder joint may be complicated by the presence of communicating neural branches.…”

Section: Discussionmentioning

confidence: 99%

Classification of communications between the musculocutaneous and median nerves

1998

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In 16 out of 79 cadavers 22 communications were found between the musculocutaneous and median nerves. In six subjects they were present bilaterally. There were three types, based on the sites of communication. Type I: The communication was proximal to the entrance of the musculocutaneous nerve into coracobrachialis (9/22); Type II: The communication was distal to the muscle (10/22); Type III: The nerve as well as the communicating branch did not pierce the muscle (3/22). Bilateral communications were not necessarily of the same type. The possible clinical implications of these communications (relating either to the surgical approach to the shoulder joint, or to entrapment syndromes) are discussed. Clin. Anat. 11:327–331, 1998. © 1998 Wiley‐Liss, Inc.

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“…Suprascapular nerve blocks and radiosynoviorthesis have also been used with demonstrable benefit [5,6]. Once medical management of the condition has failed, the surgical options include synovectomy, osteotomy, arthrodesis, and resection and interposition arthroplasty [7–12]. Prosthetic shoulder arthroplasty is now an established treatment for RA of the shoulder.…”

Section: Introductionmentioning

confidence: 99%

Resurfacing Hemiarthroplasty for the Treatment of Rheumatoid Arthritis of the Shoulder

et al. 2010

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Background The present study reports a retrospective case series detailing our experience of the use of Copeland surface replacement hemiarthroplasty (CSRA) for the treatment of rheumatoid arthritis (RA) of the shoulder. Methods Fifty‐three CSRAs were performed in 45 patients between 1994 and 2004. Forty‐six shoulders were followed up at a mean of 62.5 months (range 24 months to 150 months). Assessment included a Constant score, patient satisfaction score, and plain radiographs. Results The Constant score improved in all shoulders, from a pre‐operative mean of 15.2 to 46.3. Mean abduction improved from 27° to 78°, mean flexion from 47° to 92°, and mean external rotation from 9° to 34°. Fifty‐two percent of shoulders showed superior subluxation on plain radiographs. Seven shoulders had over 2 mm of glenoid erosion, of which one underwent reoperation. No implants were loose or required revision. One humeral neck fracture was successfully treated non‐operatively. Four shoulders required arthroscopic subacromial decompression. Discussion CSRA provides satisfactory results in RA compared to more conventional stemmed implants and total shoulder arthroplasty.

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Double Osteotomy of the Shoulder

Cited by 7 publications

References 20 publications

Median and musculocutaneous nerves: Variant formation and distribution

Median and musculocutaneous nerves: Variant formation and distribution

Classification of communications between the musculocutaneous and median nerves

Resurfacing Hemiarthroplasty for the Treatment of Rheumatoid Arthritis of the Shoulder

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