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Il trattamento chirurgico artroscopico: quando proporlo e risultati. Artropatia Acromio Clavicolare.
No full text
Arm sqeeze test: a new clinical test for differential diagnosis between cervical nerve root compression and shoulder disease.
No full textIntroduction Objective of this study is to evaluate the diagnostic
Values of the Arm Squeeze Test. The test consists in squeezing the
middle third of the upper arm. Our hypothesis is that squeezing is
responsible for pain only in patients with cervical nerve root compression from C5 to Tl.
Materials and methods. 1567 patients were included in this study,
Diagnosis of cervical nerve root compression or shoulder disease was
clinically and strumentally formulated before performing test. Secondary, patients were subdivided as follow: 903 with rotator cuff tear,
155 with shoulder adhesive capsulitis 101with acromioclavicular
(AC) joint arthropathy, 55 with calcifying tendonitis, and 48 affected
by gleno-humeral arthritis. The study sample included 305 patients
with cervical nerve root compression from C5 to Tl with pain irradiating to one or both shoulders, 350 healthy volunteers were
recruited as contrails. The test was positive when score on a VAS
Scale was 3 points or higher on squeezing the middle third of the
upper arm compared to AC joint and antero-lateral-subacromial area.
Results were analyzed with Pearson Test.
Results The test was positive in 295/305 (96.7 %) of patients with
cervical nerve root compression, compared to 35/903 (3.87 %), 3/155
(1.93 %), O/lO1 (0 %>, 1/55 (I.SI %), 4/4S (833 %) of those with
rotator cuff tear, adhesive capsulitis, AC arthropaty, calcifying tendonitis and glenohumeral arthritis, respectively. A positive result was
obtained in 14/350 asymptomatic subjects (4 %). If cervical nerve
root compression was compared to shoulder conditions, the test had
sensitivity from 0.97 to 0.99 and specificity from 0,93 lo 0.96.
Respect to controls, sensitivity was 0.98 and specificity was 0,97,
Discussion Differential diagnosis between cervico-brachialgy and
shoulder pain is often challenging,
Conclusions The Arm Squeeze Test may be useful to distinguish
cervical nerve root compression from shoulder disease in case of
doubtful diagnosis
Relazione tra lo spessore acromiale e l’habitus corporeo. Implicazioni pratiche nella procedura di decompressione subacromiale.
No full textL’effetto preoperatorio dell’ipertensione arteriosa sulla rottura della cuffia dei rotatori. L’ipertensione arteriosa può influenzare la dimensione della rottura.
No full textThe safe zone for avoiding suprascapular nerve injury: an anatomical study on 500 dry scapulae
No full textPurpose Suprascapular nerve injury may be a complication during shoulder arthroscopy. Our aim was to verify the reliability of the existing data, assess the differences between scapulae in the two genders and in the same subject, obtain a safe zone useful to avoid iatrogenic nerve lesions, and analyze the existing correlations between the scapular dimensions and the safe zone. Material and Methods We examined five hundred dried scapulae, measuring six distances for each one, referring to the scapular body, glenoid and the course of the suprascapular nerve, also catalogued according to gender and side. Differences due to gender were assessed comparing mean ± sd of each distance in males and females ; paired t-test was used to compare distances deriving from each couple. Successively we calculated our safe zone and Pearson's correlation. Results We found non-significant differences between the right and left distances deriving from each couple ; differences due to gender were stated. We defined three kinds of safe zones referring to : 500 scapulae ; males (139 scapulae) and females (147 scapulae). The correlation indexes calculated between the axis of the scapular body and glenoid and the posterosuperior distance (referring to the suprascapular nerve) were0.624,0.694,0.675, 0.638 ; while those with the posterior distance were0.230,0.294,0.232,0.284. Discussion Knowledge of the safe zone, for avoiding suprascapular nerve injury, is important ; gender and specific scapular dimensions should be evaluated since they influence the dimensions of the safe zone. The linear predictors should be used to obtain specific values of the posterosuperior limit in each patient
Associazione tra tabagismo e dimensioni della rottura della cuffia dei rotatori della spalla
No full textThe prevalence of concomitant pathologies and smoking habit in patients with rotator cuff tear.
No full textPurpose
We verified if patients with rotator cuff tear have a higher
prevalence of pathologies responsibie for microcirculation
diseases that have been considered as risk factors for
tendinous degeneration. We also verified if smoking habit is more frequent in patients with rotator cuff tear. Investigated pathologies and smoking habit were correlated to cuff tear size.
Material and Methods
We studied 203 consecutive patients (93M-110F mean
aged 64 yo (range: 41 -68) with full-thickness postero-
superior rotator cuff tear. Information regarding the
presence of hypertension, diabetes, hypercholesterolemia,
arrhythmia, myocardial ischemia, lung diseases, duration
therapy and smoking habit was obtained.
2OO asymptomatic volunteers (97M-103F) mean aged
66 yo (range : 15-70) represented the control group.
Results
The prevalence of hypertension was 38,9% and 28,5% in
patients with rotator cuff tear and in control group,
respectively (p = 0.032). The prevaience of
hypercholesterolemia was 21 % and 11% (p = 0.041).
Subjects with or without rotator cuff tear and treated for five years, or more, for hypertension were, respectively 65% and 35% (p = 0.024). We observed 47 small, 99 large and 57 massive cuff tears. The prevalence of hypertenston and hypercholesterolemia in patients with large or massive cuff tear resuIted signiticantly higher than those registered in patients with small cuff tear. No other signiticant correlation was found between the other investigated comorbidities and
size ot cuff tear. The mean number of concomitant
pathologies was 2.1 in patients with rotator cuff and 1.2 in
controls (p: 0.045). Smoker percentage was 29% and
27%, respectively.
Conclusion
Tendinous degeneration is considered as a possibie cause of
cuff tear. This hypothesis seems to be confirmed by our data. They suggest that some pathologies responsibie for
microcirculation diseases and tendinous hypoxia, are
signiticantiy more frequent in patients with rotator cuff than in controls. Hypertension and hypercholesterolemia seem also to influence size of cuff tear
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