Scapula

Neuromuscular electrical stimulation (NMES) can be used to augment range-of-motion, strengthening, and facilitation treatment programs of the muscles surrounding the shoulder. The purposes of this article are 1) to describe the uses of NMES around the shoulder joint as developed through our clinical use and 2) to detail the effects of an NMES program on chronic shoulder subluxation as determined by a clinical study. Because of the complexities of this multiarticular joint, NMES is most useful in the initial phase of the ROM, and stimulated contractions are compromised, relatively, as the humerus moves above the 90-degree horizontal plane. The use of NMES to provide scapular stabilization often entails unwanted alteration of the pressures on the spinal column, occasionally making the treatment program unusable. Electrical stimulation to prevent or correct shoulder subluxation, especially in the neurologically involved patient, provides the therapist with a powerful new treatment tech...

Abstract:  The Food and Drug Administration does not require surgical sutures to be tracked by manufacturer, physician, or patient; thereby, surgical sutures have been of little use to forensic practitioners who are tasked with establishing a positive identification with biological evidence. This study demonstrates the investigative process used to pinpoint suture manufacturers by presenting a case where surgical sutures were a distinctive characteristic that aided in the positive identification of skeletal remains. The suture’s manufacturer, construction material and structure, size, and medical use was determined by contacting a local surgical suture and orthopedic implant manufacturer and utilizing publicly available manufacturer websites, which provide catalogs and specific product details. This research was one of many lines of evidence used to establish the positive identification of a 47-year-old male.

Gender differences in glenoid anatomy have not been well studied in the current literature. Previous literature demonstrates a mismatch between glenoid anatomy and glenoid implants for shoulder replacements. This may have clinical implications in that glenoid loosening after shoulder arthroplasty has been cited as a frequent cause of poor performance of shoulder implants, and perhaps the most common indication for revision. The purpose of this study was to determine any gender differences in the size and overall shape of the glenoid. Eleven measurements were taken of 363 human scapular bone specimens (equal proportions of females to males and blacks to whites). Glenoid height and width, glenoid notch location, and depth were measured for each specimen using calipers. In addition, the authors developed a classification system to describe anterior glenoid notch morphology. There was a significant difference between female and male specimens for each dimension measured (P < 0.05). Height to width ratios were also significantly different comparing men to women (P < 0.05). These differences resulted in a rounder male glenoid and more oval female glenoid. Our results showed that 80.4% of females had an anterior glenoid notch compared to only 57.6% of males. There was a significant difference between female and male specimens in the location of the anterior glenoid notch: 36.7% from the top of the glenoid in female specimens, and 28.9% in males (P < 0.0001). The clear difference between male and female glenoid anatomy may be important in various shoulder surgeries.

To characterize scapular kinematics and shoulder muscle activity in patients with subacromial impingement syndrome, with and without visually identified scapular dyskinesis. Cross-sectional study. Laboratory. Participants with subacromial impingement syndrome (N=38) were visually classified using a scapular dyskinesis test with obvious scapular dyskinesis (n=19) or normal scapular motion (n=19). Not applicable. An electromagnetic motion capture system measured 3-dimensional kinematics of the thorax, humerus, and scapula. Simultaneously, surface electromyography was used to measure muscle activity of the upper, middle, and lower trapezius; serratus anterior; and infraspinatus during ascending and descending phases of weighted shoulder flexion. Separate mixed-model analyses of variance for the ascending and descending phases of shoulder flexion compared kinematics and muscle activity between the 2 groups. Shoulder disability was assessed with the Pennsylvania Shoulder Score (Penn). Th...

The musculature of the shoulder, arm, and forearm was studied in 19 genera of squirrels, representing the Pteromyinae (flying squirrels) and all 7 tribes of the Sciurinae (tree and ground squirrels). The objective was to locate derived anatomical features of functional or phylogenetic significance and to determine how much morphological variation underlies the diverse locomotor behavior of squirrels, which includes terrestrial and arboreal bounding, climbing, digging, and gliding. The fossil evidence suggests that arboreality is primitive for squirrels, and in fact tree squirrels appear to represent the primitive sciurid morphology. Ground squirrels are less uniform and exhibit a few derived features, including a clavobrachialis muscle not seen in other squirrels. Pygmy tree squirrels, which have evolved independently in three tribes, exhibit convergence of forelimb anatomy, including the loss or reduction of several muscles in the shoulder and forearm. The forelimb anatomy of flyin...

The article discusses the biomechanical processes that occur during an overhead throw. This activity is highly specialized and requires full and proper function from the shoulder joint. It consists of active and passive stabilization and synchronous work of the accelerating and decelerating muscles. The process of the overhead throw can be divided into several phases that differ from each other in biomechanical parameters and involvement of specific muscles.

Safe approach to the posterior shoulder and scapula. Posterior shoulder stabilization. Posterior bony reconstruction of the glenoid. Corrective osteotomies of the glenoid. Treatment of scapular neck fractures. Treatment of posterior glenoid rim fractures. Treatment of fractures of the acromion. Arthrodesis of the shoulder. Biopsy. Tumor resection. Relative: shoulder joint replacement with simultaneous posterior glenoid reconstruction. Relative: treatment of posterior dislocated proximal humerus fractures. General contraindications. Landmarks: scapular spine and acromion. Incision depending on goal of surgery: from horizontal to oblique or vertical: - horizontal incision along the scapular spine to the posterior corner of acromion, - oblique incision along the lateral border of scapula. Authors&#39; preference: angle bisector between scapular spine and lateral border of scapula. Detachment of the deltoid with a bony chip from scapular spine beginning laterally (subacromial space). Un...