By Frederick A. Matsen III MD, Steven B. Lippitt MD
This complete, new consultant basically offers the rules of either basic and irregular shoulder mechanics and exhibits clinicians the best way to effectively practice a number of methods. The authors specialize in time-tested concepts and the fundamental instruments each health care provider has at their disposal...instead of these that want targeted, complicated, or dear gear. Over 1,400 awesome unique illustrations exhibit each vital step.Provides the clinical foundations upon which shoulder surgical procedure needs to be established, allowing the health care provider to make variations in accordance with a patient's particular mechanical situation.Describes systems which have been always profitable in coping with mechanical difficulties of the shoulder.Features 1,400 illustrations by means of a shoulder healthcare professional who's additionally a certified artist properly painting either anatomic positive factors and step by step procedures.Uses a constant structure all through for simple reference.
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Extra resources for Shoulder Surgery: Principles and Procedures
Sample text
Philadelphia: WB Saunders, 1998, p. ) 35 36 CHAPTER 6 Principles of Glenohumeral Mobility The rotational laxity of the glenohumeral joint in a specified direction is the angle through which the humeral head can be rotated from an initial position centered in the glenoid socket (Fig. 6–2). The rotational laxity is determined by (1) the length of the capsule and ligaments constraining the rotation, (2) the position and orientation of the humeral head at the start of the rotation, and (3) the radius of curvature of the humeral head.
6–23), external rotation in abduction (Fig. 6–24), and internal rotation in abduction (Fig. 6–25) can be quantitated. These motions give the examiner a good feel for the rotational laxity of the humerus relative to the scapula. Selective examination of the different components of the capsule can reveal the parts that are tight (Table 6–1). Table 6–1 Relation of Motion Limitation to Location of Capsular Tightness Limitation of this motion External rotation at the side Internal rotation at the side External rotation in abduction Internal rotation in abduction Cross-body movement Flexion Abduction Adduction Suggests tightness of this part of the capsule Anterior superior and coracohumeral ligament Posterior superior Anterior inferior Posterior inferior Posterior Posterior inferior Inferior Superior PART II Limited Adduction Figure 6–18.
When ligaments become shortened, they can limit the range of glenohumeral rotation and translation (Fig. 6–4). Exerting a large torque against strong, tight ligaments can result in a major compressive force at Figure 6–4. Ligament shortening limits rotation If the capsule and ligaments on one side of the joint are shortened, they limit the rotation of the humerus in the direction opposite the tight structures. Mobility 39 40 CHAPTER 6 Principles of Glenohumeral Mobility the glenohumeral joint, which could damage the joint surface or underlying bone (Fig.