Reverse Fosbury Flop Tear of the Rotator Cuff

Introduction. “Fosbury flop” tear is an avulsion of the posterosuperior rotator cuff from the bone with reversal healing on its medial bursal-side. This case report describes a unique variant of Fosbury flop tear with a lesion of the musculotendinous junction that healed, for its tendon part, on the anterior humerus and coracoid process. Case Presentation. A 62-year-old man developed a posttraumatic painful shoulder with active loss of range of motion. Magnetic resonance arthrography demonstrated a lesion of the musculotendinous junction of the supraspinatus with healing of the tendon on the above-mentioned structures (reverse Fosbury flop). During arthroscopic evaluation, tendon repair was not possible and a debridement to avoid subacromial and anterior impingement associated with a tenotomy of the long head of the biceps were carried out. One year postoperatively, the patient had complete range of motion and was satisfied with the clinical results. Discussion and Conclusion. Different Fosbury flop tears exist. Radiologists and orthopedic surgeons should be aware of these tear patterns as failure to recognize them may lead to inadequate treatment

Appréhension d’épaule : problème du système nerveux central, périphérique ou articulaire ?

L’instabilité antérieure de l’épaule est un problème touchant 1.7% de la population. De nombreuses techniques de stabilisation existent et sont efficaces dans la prévention de nouvelles récidives. En revanche, un nombre important de patients opérés ou non-opérés garderont une appréhension, dont l’origine n’est pas claire. Trois niveaux semblent toutefois impliqués. Le premier se situe au niveau cérébral avec l’apprentissage de stimuli négatifs induisant des modifications de connections neuronales. Le deuxième se trouve au niveau du système nerveux périphérique avec des microlésions qui cliniquement ne seraient pas détectables, mais qui créeraient une dégradation de la proprioception et ainsi un moins bon contrôle positionnel. Troisièmement, au niveau glénohuméral, nous avons mis en évidence la persistance de micro-mouvements post-stabilisation. Les stabilisations chirurgicales permettraient uniquement d’éviter de nouvelles luxations mais pas de réellement stabiliser l’épaule. La prise en compte de ces trois aspects dans la rééducation devrait permettre de meilleurs résultats au long terme

Reverse Fosbury Flop Tear of the Rotator Cuff

"Fosbury flop" tear is an avulsion of the posterosuperior rotator cuff from the bone with reversal healing on its medial bursal-side. This case report describes a unique variant of Fosbury flop tear with a lesion of the musculotendinous junction that healed, for its tendon part, on the anterior humerus and coracoid process

An Interesting Case of Intramuscular Myxoma with Scapular Bone Lysis

Introduction. Intramuscular myxoma is a rare benign primitive tumor of the mesenchyme founded at the skeletal muscle level; it presents itself like an unpainful, slow-growing mass. Myxomas with bone lysis are even more rare; only 7 cases have been reported in the English literature, but never at the shoulder level. Case Presentation. We describe an 83-year-old patient with a growing mass in the deltoid muscle with unique scapular lysis, without any symptom. Magnetic resonance imaging (MRI) and a biopsy were performed and the diagnosis of intramuscular myxoma has been retained. In front of this diagnosis of nonmalignant lesion, the decision of a simple follow-up was taken. One year after this decision, the patient was still asymptomatic. Conclusion. In the presence of an intramuscular growing mass with associated bone lysis, intramuscular myxoma as well as malignant tumor should be evoked. MRI has to be part of the initial radiologic appraisal but biopsy is essential to confirm the diagnosis. By consensus, the standard treatment is surgical excision but conservative treatment with simple follow-up can be an option

Functional recovery following early mobilization after middle third clavicle osteosynthesis for acute fractures or nonunion: A case-control study

Good outcomes have been reported after surgical treatment for acute or nonunion of displaced midshaft clavicle fractures. However, the postoperative rehabilitation and timeline for a complete functional recovery are poorly documented. The purpose of the current study was to evaluate the efficacy of an immediate motion protocol following plate fixation of a midshaft clavicle fracture and to compare functional recovery between acute and nonunion cases