Effects of Immobilization on the Capsule of the Canine Glenohumeral Joint

Schollmeier, Georg; Uhthoff, Hans K.; Sarkar, Kiriti; Fukuhara, Kohei

doi:10.1097/00003086-199407000-00008

Cited by 51 publications

(45 citation statements)

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“…[12][13][14] Restriction in range of movements in conservative group is due to increased bursal and capsular adhesions. 15 The early mobilization could be achieved by the use of external fixator (JESS) which allows shoulder mobilization within one week. In cases of open reduction and internal fixation, due to excessive soft tissue dissection there is increased risk of avascular necrosis of humeral head because of the disruption of the residual vascularity.…”

Section: Discussionmentioning

confidence: 99%

Functional outcome following external fixator (JESS) application for proximal humeral fractures

et al. 2016

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Background: Proximal humeral fractures account for 5% of all fractures. Observed frequently in older osteoporotic patients but found in young patients with high-energy trauma.About 80% of these fractures are undisplaced or minimally displaced. Non-operative method requiring immobilization of shoulder often leads to a stiff shoulder, whereas surgical procedures such as plating need excessive soft tissue dissection. It was overcome in this study by less soft tissue dissection by use of external fixator application and early mobilization.Methods: Total of 18 patients mean age 40.5 years, predominantly male (16/18) treated with external fixator - JESS (Joshi’s external immobilization system) for Neer’s two, three and four part proximal humeral fractures. Vehicular accidents were the most common mode of injury followed by fall. There were 8 cases each of Neer's two and three part fractures. Shoulder mobilization started within a week as postoperativelyas pain allowed. Patients followed up at 3, 6, 12 and 18 weeks for pain, function, range of motion and anatomy with check X-ray. After radiological union at 8-10 weeks JESS was removed. Cases were evaluated for functional result by constant scoring system.Results: Average score on constant scoring system was 72 after a mean follow-up of 6 months. All fractures united in mean duration of 9.33 weeks. The complications included shoulder stiffness in one case and pin tract infection in two cases.Conclusions: Early shoulder mobilization a prerequisite for good results can be achieved without compromising fracture union. Less soft tissue dissection required and significant cost effective.

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Section: Discussionmentioning

confidence: 99%

Functional outcome following external fixator (JESS) application for proximal humeral fractures

et al. 2016

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“…Gaining ROM too quickly can limit the normal tissue-healing process and lead to capsuloligamentous attenuation. 93 Therefore, an initial period of immobilization is common after arthroscopic anterior capsulolabral repair to facilitate healing of the surgically repaired tissues, 40,45,52,65,76 theoretically allowing the surgically reattached labrum a chance to bind to the glenoid and the plicated layers of capsule to heal to each other.…”

Section: Guiding Principlementioning

confidence: 99%

The American Society of Shoulder and Elbow Therapists' Consensus Rehabilitation Guideline for Arthroscopic Anterior Capsulolabral Repair of the Shoulder

Gaunt¹,

Shaffer²,

Sauers³

et al. 2010

Journal of Orthopaedic & Sports Physical Therapy

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Synopsis This manuscript describes the consensus rehabilitation guideline developed by the American Society of Shoulder and Elbow Therapists. The purpose of this guideline is to facilitate clinical decision making during the rehabilitation of patients following arthroscopic anterior capsulolabral repair of the shoulder. This guideline is centered on the principle of the gradual application of stress to the healing capsulolabral repair through appropriate integration of range of motion, strengthening, and shoulder girdle stabilization exercises during rehabilitation and daily activities. Components of this guideline include a 0- to 4-week period of absolute immobilization, a staged recovery of full range of motion over a 3-month period, a strengthening progression beginning at postoperative week 6, and a functional progression for return to athletic or demanding work activities between postoperative months 4 and 6. This document represents the first consensus rehabilitation guideline developed by a multidisciplinary society of international rehabilitation professionals specifically for the postoperative care of patients following arthroscopic anterior capsulolabral repair of the shoulder. J Orthop Sports Phys Ther 2010;40(3):155–168. doi:10.2519/jospt.2010.3186

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“…Many investigators (Evans et al 1960;Furlow and Peacock 1965;Finsterbush and Friedman 1973;Woo et al 1975;Langenskiöld et al 1979;Wilson and Dahners 1988;Akai et al 1993;Schollmeier et al 1994;Reynolds et al 1996;Trudel et al 1999;Hildebrand et al 2004) have measured ROM to assess how joint stiffness increases and angular displacement progressively decreases after immobilization. Evidence exists that contractures produced by immobilizing joints with internal fixation progress more rapidly at the beginning of the immobilization period (Trudel et al 1999).…”

Section: Postoperative Carementioning

confidence: 99%

Progression and Direction of Contractures of Knee Joints Following Spinal Cord Injury in the Rat

Moriyama

Yoshimura

Sunahori

et al. 2004

Tohoku J. Exp. Med.

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following central nervous system injuries remain a prevalent and significant complication, but no reports are available on evidence of contracture formation over time. The objective of this study was to determine the rate of contracture progression and the direction of loss in joint movement following spinal cord injuries (SCI). Forty-eight female Wistar rats were used. Twenty-four experimental rats underwent a spinal cord transection at the level of T8 and 24 control rats underwent a sham-operation. The animals were studied at each of 5 time points: 2, 4, 8, 12, 16, and 24 weeks after surgical intervention. The degree of contractures was assessed by measuring the femorotibial angle on both hindlimbs with the use of a goniometer. Knee joint motion was measured for flexion and extension direction. Knee flexion contractures developed in all experimental rats. The restriction in motion progressed during the first 12 weeks and plateaued thereafter. The contractures were produced almost exclusively by a loss in the extension range of motion. This study defined the time course that contracture progression was more rapid in the early stage after SCI and stabilized in the later stage of injury. Contractures following SCI occurred in flexion at the knees and resulted from a loss of extension. These findings should help guide timely treatment and provide a better understanding of contracture development. ----contracture; range of motion, articular; spinal cord injuries; rats

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Effects of Immobilization on the Capsule of the Canine Glenohumeral Joint

Cited by 51 publications

References 0 publications

Functional outcome following external fixator (JESS) application for proximal humeral fractures

Functional outcome following external fixator (JESS) application for proximal humeral fractures

The American Society of Shoulder and Elbow Therapists' Consensus Rehabilitation Guideline for Arthroscopic Anterior Capsulolabral Repair of the Shoulder

Progression and Direction of Contractures of Knee Joints Following Spinal Cord Injury in the Rat

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