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Both before and after reduction, with lesions labeled. Vector (.svg) version is available. The bony Bankart lesion is new, as evidenced by lack of cortex on the superior part of the fragment, and is presumed to be caused by glenohumeral ligaments pulling the humerus towards the glenoid as the shoulder dislocates, causing a fracture even without significant external forces.
Various non-operative reduction techniques are employed. They have certain principles in common, including gentle in-line traction, reduction or abolition of muscle spasm, and gentle external rotation. They all strive to avoid inadvertent injury. Two of them, the Milch and Stimson techniques, have been compared in a randomized trial. [3]
Cunningham shoulder reduction was originally published in 2003 [1] and is an anatomically based method of shoulder reduction that utilizes positioning (analgesic position), voluntary scapular retraction, and bicipital massage. It is designed for true anterior/subcoracoid glenohumeral dislocations in patients who can fully adduct their humerus. [2]
Orthopedic surgery attempts to recreate the normal anatomy of the fractured bone by reduction of the displacement. [citation needed] This sense of the term "reduction" does not imply any sort of removal or quantitative decrease but rather implies a restoration: re ("back [to initial position]") + ducere ("lead"/"bring"), i.e., "bringing back to ...
Alfred Blaschko, a private practice dermatologist from Berlin, first described and drew the patterns of the lines of Blaschko in 1901. He obtained his data by studying over 140 patients with various nevoid and acquired skin diseases and transposed the visible patterns the diseases followed onto dolls and statues, then compiled the patterns onto a composite schematic of the human body.
This rash was known as erythema chronicum migrans, the skin rash found in early-stage Lyme disease. [ 18 ] In the 1920s, French physicians Garin and Bujadoux described a patient with meningoencephalitis, painful sensory radiculitis, and erythema migrans following a tick bite, and they postulated the symptoms were due to a spirochetal infection.
Anterior shoulder dislocation while carrying a frail elder. A dislocated shoulder is a condition in which the head of the humerus is detached from the glenoid fossa. [2] Symptoms include shoulder pain and instability. [2] Complications may include a Bankart lesion, Hill-Sachs lesion, rotator cuff tear, or injury to the axillary nerve. [1]
X-ray at right shows same shoulder after reduction and internal rotation, revealing both a Bankart lesion and a Hill-Sachs lesion. Diagnosis can be suspected by history and physical examination which is usually followed by imaging. Because of the mechanism of injury, apprehension of anterior dislocation is common with provocative maneuvers.