Evaluation of Arthroscopic Capsular Release Together with Manipulation Under Anesthesia for Treatment of Frozen Shoulder

Objective: In this study, long term outcomes of patients treated with arthroscopic capsular release together with manipulation under anesthesia (MUA) were evaluated. In addition, differences in terms of function and quality of life between patients with and without additional pathologies were investigated. Material and Methods: A total of 20 patients who underwent arthroscopic capsular release together MUA between 2003 and 2008 were evaluated. Sixteen patients were females and four patients were males with a mean age of 55.75 (44-77) years and an average follow-up period 41.60 (12-72) months. Constant score, unweighted Constant score, Western Ontario Rotator Cuff index (WORC), joint range of motion and isometric muscle strenght were used for preoperative clinical assessment. Results: Postoperative anterior flexion and abduction extended from 50.50-50 degrees to 162.25-165.75 degrees (p0.05).Conclusion: Arthroscopic capsular release together with MUA is a technique that improves the functions of shoulder and quality of life in term in patients in whom conservative treatment failed

Evaluation of Arthroscopic Capsular Release Together with Manipulation Under Anesthesia for Treatment of Frozen Shoulder

Objective: In this study, long term outcomes of patients treated with arthroscopic capsular release together with manipulation under anesthesia (MUA) were evaluated. In addition, differences in terms of function and quality of life between patients with and without additional pathologies were investigated. Material and Methods: A total of 20 patients who underwent arthroscopic capsular release together MUA between 2003 and 2008 were evaluated. Sixteen patients were females and four patients were males with a mean age of 55.75 (44-77) years and an average follow-up period 41.60 (12-72) months. Constant score, unweighted Constant score, Western Ontario Rotator Cuff index (WORC), joint range of motion and isometric muscle strenght were used for preoperative clinical assessment. Results: Postoperative anterior flexion and abduction extended from 50.50-50 degrees to 162.25-165.75 degrees (p0.05).Conclusion: Arthroscopic capsular release together with MUA is a technique that improves the functions of shoulder and quality of life in term in patients in whom conservative treatment failed

Medial transposition of the radial nerve for anterolateral plate fixation of the humerus: Cadaveric study

In the operative treatment of humeral shaft fractures the radial nerve may be injured during the reduction of fracture fragments or the application of plate and screws. Also, secondary surgical explorations due to delayed or non-union carry a high risk of radial nerve injury because of the scarring of the neighboring tissue and proximity of the nerve to the implants. Consequently, the need for the transposition of the radial nerve to a safer position arises. A total of 22 (11 right, 11 left) cadaveric upper extremities were studied to evaluate the medial transposition of the radial nerve during the open reduction and anterolateral plate fixation of humeral fractures. The radial nerve was transposed medially in a distal plate fixated humeral fracture model. Distance measurements of the radial nerve and the division points of its branches were carried out in the transposed position and in the original course of the nerve. There was no statistically significant difference between the original course and medially transposed measurements. The distances from the reference point to the division points of other branches (posterior antebrachial cutaneous nerve, motor branch to brachioradialis, most distal motor branch to triceps) were not altered. The mean length of the radial nerve was 185.2 +/- 14.3 mm in its original course and 183.7 +/- 13.8 mm in the medially transposed course. In conclusion, the present study shows that medial transposition of the radial nerve through the fracture line does not increase the nerve's length and may be utilized in cases in which anterolateral plate fixation is indicated

Anatomical evaluation of the superficial veins of the upper extremity as graft donor source in microvascular reconstructions: a cadaveric study

Objective: The aim of study was to investigate the features and resources for vein grafts suitable for upper extremity arteries

Rehabilitation Outcomes After Upper Extremity Replantation

Objective: The aim of this study was to evaluate the rehabilitation outcomes after upper extremity replantation

Evaluation of Bone Mineral Density after Replantation or Revascularization Surgery in the Upper Extremity

Objective: This study was undertaken to examine bone mineral density (BMD) of the hand after replantation or revascularization surgery in the upper extremity and to investigate the relationship between BMD and muscle strength, range of motion and motor activity

Neuralgic amyotrophy as the primary cause of shoulder pain in a patient with rotator cuff tear

A 66-year-old woman with no history of trauma presented with severe shoulder pain. Magnetic resonance imaging revealed rupture of the supraspinatus tendon, for which surgical treatment was considered. However, it was noted that shoulder pain was accompanied by weakness in the shoulder muscles, and the patient underwent electroneuromyographic examination, which revealed neuralgic amyotrophy. Following physical therapy and rehabilitation combined with appropriate medical therapy, her symptoms significantly improved. In cases with severe shoulder pain without a trauma history, characteristics of pain should be thoroughly analyzed and neuralgic amyotrophy considered in the differential diagnosis

A new method for estimating arterial occlusion pressure in optimizing pneumatic tourniquet inflation pressure

To reduce pressure-related injuries resulting from pneumatic tourniquet use, the lowest possible inflation pressure is recommended. Arterial occlusion pressure (AOP) is a measure of the cuff pressure required to maintain a bloodless surgical field. However, its determination method is time consuming, requires operator skill, and is therefore seldom used in current practice. An AOP estimation can be made by knowing the pressure transmitted to the underlying soft tissues. We measured upper and lower extremity tissue pressures under the tourniquet cuff at 100, 200, and 300 mm Hg of tourniquet inflation pressures in 30 anesthetized living adult patients. All patients received general anesthesia with neuromuscular relaxation. A Stryker intra-compartmental pressure monitor was used to measure tissue pressures under the tourniquet cuff. In all patients, the soft tissue pressures were consistently lower than the applied tourniquet inflation pressures. Our results revealed tissue padding coefficients for extremities 20 to 75 cm in circumferences. An estimation method of AOP was developed [AOP = (systolic blood pressure + 10)/Tissue padding coefficient]. The new AOP estimation method may be a simple, rapid, and clinically practical alternative to the AOP determination method