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Charcot arthropathy of the shoulder caused by syringomyelia is a unusual degenerative disorder, frequently misdiagnosed and with few cases described in the literature. The diagnosis is made by clinical evaluation and radiological examinations with radiography and magnetic resonance imaging. However, the correct diagnosis and treatment is possible by carefully medical evaluation and can improve patient symptoms. Therefore, this study aimed to report two cases of Charcot arthropathy caused by syringomyelia. After achieving correct neurosurgical evaluation and magnetic resonance imaging, the diagnosis was made. The first case is a 53-year-old man with a click on his right shoulder for at least 12 months, associated with local edema, pain and limitation of joint range of motion. The second is a 45-year-old man with pain in the right upper limb and difficulty moving the joint for at least 24 months, associated with progressive worsening of the collection and edema in the ipsilateral upper limb. Posterior fossa decompression was performed, with symptoms relief after surgery. Posterior fossa decompression is a treatment that seems to be effective in reducing symptoms, especially when the diagnosis is early. However, this type of treatment still remains controversial, requiring further studies.

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Introdução: O alto volume de treino e movimentos em amplitudes extremas na natação geram um alto estresse sobre as estruturas articulares e musculoesqueléticas do atleta, sendo comum as queixas de dores articulares em atletas de natação. Objetivo: Identificar a prevalência de dor no ombro em nadadores federados do estado do Rio de Janeiro na categoria master. Materiais e métodos: 61 atletas masculinos da categoria master, com faixa etária de 51,26 ±15,99 anos, participaram deste estudo. Estes competidores de natação federados por clubes participaram da II Etapa do Circuito Estadual Master de Natação, promovido pela FARJ em 2019. A coleta de dados foi realizada a partir da aplicação do questionário McGill reduzido e da EVA (Escala Visual Analógica). Resultados: A prevalência de dor foi de 73,8%. Na dimensão sensorial, o descritor cálico obteve a menor média (0,08) e o descritor dolorida apresentou a maior (0,74). Na dimensão afetiva, o descritor amedrontado obteve a menor média (0,13), e o descritor cansativo/exaustiva a maior média (0,38). A média da EVA (1,94 ±2,13) sugere que os ní­veis de dor foram baixos. Conclusão: Embora a alta prevalência de dor identificada, os atletas participantes deste estudo apresentaram baixo ní­vel de dor no ombro.

RESUMO O movimento de remada representa 51,4% do tempo total de prática do surfe, gerando alta demanda muscular do complexo do ombro. Apesar disso, há uma lacuna na literatura sobre a prevalência de dor e discinese escapular (DE) em surfistas. Este estudo teve o objetivo de avaliar a prevalência de dor no ombro em surfistas amadores do estado do Rio Grande do Sul, no Brasil. Trata-se de estudo observacional descritivo transversal. Foram incluídos 21 homens, com idade entre 18 e 42 anos, que praticassem surfe há no mínimo dois anos. Os desfechos avaliados foram DE estática, DE dinâmica, dor no ombro - através da escala numérica da dor -, comprimento do músculo peitoral menor, e escore no The Western Ontario Shoulder Instability Index. As variáveis contínuas foram apresentadas em média e desvio-padrão. As variáveis categóricas foram expressas em percentual. Associações dos dados foram testadas através do teste qui-quadrado e do teste de correlação de Pearson. A DE estava presente em 71,4% da amostra, tendo uma maior prevalência a discinesia do tipo I (57,1%), e 42,9% apresentaram dor no ombro durante o momento da avaliação. DE foi observada na maioria da população estudada, enquanto dor foi apresentada por pouco menos da metade dos participantes. Embora a DE seja um achado muito prevalente em surfistas amadores, não foi observada correlação com dor e redução da qualidade de vida.

RESUMO Dentre as diferentes intervenções fisioterapêuticas existentes, a terapia com laser de baixa intensidade (LBI) é altamente utilizada em distúrbios musculoesqueléticos. Evidências sugerem que o LBI é eficaz na modulação de mediadores inflamatórios, contribuindo para o reparo tecidual e sendo, portanto, indicado para o tratamento de condições inflamatórias em geral. Contudo, resultados heterogêneos foram relatados sobre sua eficácia em tendinopatias de ombro. Assim, o objetivo deste estudo foi revisar sistematicamente ensaios clínicos randomizados sobre os efeitos do LBI na dor e na funcionalidade de pacientes com tendinopatia de ombro. Dois revisores realizaram independentemente buscas nas bases de dados PubMed, SciELO, Cochrane e PEDro. Foram incluídos ensaios clínicos randomizados, com seres humanos diagnosticados com tendinopatia de ombro e submetidos ao LBI, com desfechos de dor e/ou funcionalidade. A avaliação do risco de viés de cada estudo foi realizada por meio da escala PEDro. Oito estudos (73%) foram considerados com menor risco de viés, e três (27%) foram considerados com alto risco de viés. Onze estudos, totalizando 486 participantes, foram incluídos nesta revisão. O LBI reduz de forma estatisticamente significativa a dor em 45% dos estudos, e apenas um estudo apresentou aumento estatisticamente significativo na funcionalidade. Futuras revisões sistemáticas sobre o efeito combinado de LBI e exercícios, assim como sobre o efeito da terapia de LBI com dosagens recomendadas no tratamento de tendinopatias de ombro, são ainda necessárias.

Introduction: Painful shoulder syndrome is a frequent condition among the elderly and an important cause of functional disability. As the conservative treatment is not always effective, ultrasound guided suprascapular nerve blockade presents as an important alternative treatment. Objective: To evaluate the efficacy and safety of the use of 0.25% levobupivacaine and 40 mg of triamcinolone in the suprascapular nerve blockade in patients with chronic pain in the shoulder. Methods: A retrospective, descriptive and analytical study of 71 patients submitted to suprascapular nerve infiltration between August 2014 and March 2017. Surveys were carried out to patients before the technique was performed, after 72 hours and at 1, 3 and 6 months. Pain intensity was assessed using a numeric pain scale (NPS). Results: Out of the 71 patients who underwent a blockade of the suprascapular nerve, 81.2% reported a decrease in pain at 72 hours. In the first, third and sixth month, respectively, 89.8%, 76.1% and 61.8% of the patients presented pain relief. A statistically significant difference (p < 0.001) was verified between NPS and the 4 moments assessed after the technique. 43.7% had total pain remission (NPS = 0) at six months. Global effectiveness of suprascapular nerve blockade was 60.6% and for the subgroup of patients with rotators’ cuff patology was 62.2%. No complications were reported regarding the suprascapular nerve block. Conclusion: The results show that ultrasound-guided blockade of the suprascapular nerve using 0.25% levobupivacaine and 40 mg of triamcinolone is a safe and effective treatment in patients with chronic shoulder pain. Resumo: Introdução: A síndrome do ombro doloroso é uma condição frequente entre os idosos e uma causa importante de incapacidade funcional na população em geral. O tratamento conservador nem sempre é eficaz, pelo que o bloqueio do nervo supraescapular guiado por ecografia apresenta-se como uma opção de tratamento válida. Objetivo: Avaliação da eficácia e segurança do uso de levobupivacaína a 0,25% e 40 mg de triancinolona no bloqueio do nervo supraescapular ecoguiado em doentes com dor crônica no ombro. Métodos: Realizou-se um estudo retrospectivo observacional, descritivo e analítico com 71 doentes submetidos à infiltração do nervo supraescapular entre agosto de 2014 e março de 2017. Foram aplicados questionários antes da realização da técnica e após 72 horas, 1, 2 e 6 meses. A intensidade da dor foi avaliada usando a Escala de Avaliação Numérica (EAN). Resultados: Dos 71 doentes submetidos ao bloqueio do nervo supraescapular; 81,2% referiram diminuição da dor às 72 horas. Aos primeiro, terceiro e sexto mês, respectivamente 89,8%; 76.1% e 61,8% apresentaram melhoria da dor. Verificou-se uma diferença estatisticamente significativa (p < 0,001), entre a EAN inicial e os 4 momentos após a realização da técnica. 43,7% dos doentes tiveram remissão total da dor (EAN = 0) aos seis meses. A eficácia global do bloqueio do nervo supraescapular foi de 60,6% e, para o subgrupo com patologia da coifa dos rotadores, de 62,2%. Nenhuma complicação do bloqueio do NSE foi registrada. Conclusão: Este estudo mostra que o bloqueio ecoguiado do NSE usando levobupivacaína a 0,25% e 40 mg de triancinolona é um procedimento seguro e eficaz em doentes com dor crônica no ombro.

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RESUMO Na artrocinemática do ombro, o manguito rotador atua estabilizando a cabeça umeral em contato com a cavidade glenoidal, enquanto realiza a translação inferior para contrabalancear a força rotacional promovida principalmente pelo deltoide. Exercícios de rotação externa (RE) vêm sendo utilizados na reabilitação de pacientes com disfunções no complexo do ombro buscando restaurar a artrocinemática. Porém, poucos estudos abordam a utilização da faixa elástica e a avaliação dos músculos da cintura escapular, determinantes para uma cinemática adequada. O objetivo deste estudo é comparar a atividade eletromiográfica (EMG) de músculos do complexo do ombro durante exercícios de rotação externa com faixa elástica. Participaram 11 sujeitos do sexo masculino que foram avaliados durante os movimentos de (1) RE em ortostase; (2) RE com abdução de ombro; (3) RE em decúbito lateral (DL). Os músculos avaliados pela EMG foram: (1) trapézio superior (TS); (2) deltoide médio (DM); (3) deltoide posterior (DP); e (4) infraespinal (IN). A resistência foi determinada por uma faixa elástica cinza calibrada com carga de 5% do peso corporal. A análise dos dados foi realizada no software Biomec-SAS e as estatísticas foram calculadas por meio da Anova de medidas repetidas no software SPSS v20.0. Pôde-se constatar que os músculos TS e DM obtiveram maior atividade EMG durante o exercício de RE com abdução de ombro, o músculo DP durante a RE com abdução de ombro e RE em decúbito lateral, enquanto o IN a obteve durante a RE em ortostase e RE em decúbito lateral.

RESUMO A dor no ombro representa a terceira principal queixa musculoesquelética da população. Afeta fatores físicos, psicológicos e econômicos do indivíduo. A atenção primária à saúde é essencial para a eficácia do cuidado dos pacientes acometidos. Este estudo é observacional transversal e obteve um perfil dos usuários e das consultas médicas com relato de dor no ombro durante um ano na atenção primária do município de Ribeirão Preto (SP). Foram analisados em prontuários os registros das consultas médicas agendadas e sem agendamento prévio. Nestes registros foram coletados dados dos pacientes que apresentaram queixas de dor musculoesquelética no ombro (dados sociodemográficos e características das consultas), que foram analisados de forma descritiva e pelos testes qui-quadrado de Pearson, razão de chance e regressão logística múltipla. A frequência de consultas médicas por queixa de dor no ombro foi de 9,2%. O perfil dos indivíduos que se queixaram de dor no ombro se caracterizava por mulheres, com idade avançada, casadas, alfabetizadas e que apresentavam alguma ocupação. As consultas em sua maioria tiveram retornos agendados, oferecimento de orientações terapêuticas e poucos encaminhamentos.

Objective: To evaluate the anatomical variations of the attachment of the inferior glenohumeral ligament (IGHL) to the anterior glenoid rim. Materials and Methods: This was a retrospective review of 93 magnetic resonance arthrography examinations of the shoulder. Two radiologists, who were blinded to the patient data and were working independently, read the examinations. Interobserver and intraobserver agreement were evaluated. The pattern of IGHL glenoid attachment and its position on the anterior glenoid rim were recorded. Results: In 50 examinations (53.8%), the glenoid attachment was classified as type I (originating from the labrum), whereas it was classified as type II (originating from the glenoid neck) in 43 (46.2%). The IGHL emerged at the 4 o'clock position in 58 cases (62.4%), at the 3 o'clock position in 14 (15.0%), and at the 5 o'clock position in 21 (22.6%). The rates of interobserver and intraobserver agreement were excellent. Conclusion: Although type I IGHL glenoid attachment is more common, we found a high prevalence of the type II variation. The IGHL emerged between the 3 o'clock and 5 o'clock positions, most commonly at the 4 o'clock position. [ABSTRACT FROM AUTHOR]

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Introdução: A Tendinopatia do Manguito Rotador (TMR) acarreta dor e prejuízo na função do ombro, porém não se sabe se ambas na mesma proporção. Objetivo: Verificar se a intensidade dolorosa se correlaciona com a função do membro superior em sujeitos com TMR. Métodos: Estudo observacional transversal, com 60 indivíduos com TMR. Utilizou-se a Escala Visual Analógica (EVA) para avaliar a dor e o questionário Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH) para função do ombro. Para análise dos dados foi realizada estatística descritiva (médias e desvio-padrão, apresentação numérica e percentual) e aplicada a correlação de Spearman utilizando nível de significância de 5%. Resultados: A dor média pela EVA foi de 5,02 (moderada). Verificou-se limitação leve (pontuação média de 34,43) nas 30 questões do questionário DASH. Em relação aos módulos opcionais, no módulo destinado a atletas/músicos, não houve limitação dos sujeitos que praticavam este (média de pontuação de 11,82). No módulo referente ao trabalho houve limitação leve (média de pontuação de 35,38). Houve correlação baixa entre dor e a função do ombro (rs=0,2949; p=0,0222). Conclusão: Embora os sujeitos com TMR apresentassem dor moderada, a correlação foi fraca entre dor e função do ombro.

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Copyright of Revista Brasileira de Prescrição e Fisiologia do Exercício is the property of Instituto Brasileiro de Pesquisa e Ensino em Fisiologia do Exercicio and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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Copyright of Fisioterapia e Pesquisa is the property of Universidade de Sao Paulo, Faculdade de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Fisioterapia e Pesquisa is the property of Universidade de Sao Paulo, Faculdade de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A síndrome do ombro doloroso é uma condição frequente entre os idosos e uma causa importante de incapacidade funcional na população em geral. O tratamento conservador nem sempre é eficaz, pelo que o bloqueio do nervo supraescapular guiado por ecografia apresenta‐se como uma opção de tratamento válida. Avaliação da eficácia e segurança do uso de levobupivacaína a 0,25% e 40 mg de triancinolona no bloqueio do nervo supraescapular ecoguiado em doentes com dor crônica no ombro. Realizou‐se um estudo retrospectivo observacional, descritivo e analítico com 71 doentes submetidos à infiltração do nervo supraescapular entre agosto de 2014 e março de 2017. Foram aplicados questionários antes da realização da técnica, após 72 horas; 1, 2 e 6 meses. A intensidade da dor foi avaliada usando a Escala de Avaliação Numérica (EAN). Dos 71 doentes submetidos ao bloqueio do nervo supraescapular; 81,2% referiram diminuição da dor às 72 horas. Aos primeiro, terceiro e sexto mês, respectivamente 89,8%; 76,1% e 61,8% apresentaram melhoria da dor. Verificou‐se uma diferença estatisticamente significativa (p < 0,001), entre a EAN inicial e os 4 momentos após a realização da técnica. 43,7% dos doentes tiveram remissão total da dor (EAN = 0) aos seis meses. A eficácia global do bloqueio do nervo supraescapular foi de 60,6% e, para o subgrupo com patologia da coifa dos rotadores, de 62,2%. Nenhuma complicação do bloqueio do NSE foi registrada. Este estudo mostra que o bloqueio eco‐guiado do NSE usando levobupivacaína a 0,25% e 40 mg de triancinolona é um procedimento seguro e eficaz em doentes com dor crônica no ombro. Painful shoulder syndrome is a frequent condition among the elderly and an important cause of functional disability. As the conservative is not always effective, ultrasound guided suprascapular nerve blockade presents as an important alternative treatment. To evaluate the efficacy and safety of the use of 0.25% levobupivacaine and 40 mg of triamcinolone in the suprascapular nerve blockade in patients with chronic pain in the shoulder. A retrospective, descriptive and analytical study of 71 patients submitted to suprascapular nerve infiltration between August 2014 and March 2017. Surveys were carried out to patients before the technique was performed, after 72 hours, at 1, 3 and 6 months. Pain intensity was assessed using a numeric pain scale (NPS). Out of the 71 patients who underwent a blockade of the suprascapular nerve, 81.2% reported a decrease in pain at 72 hours. In the first, third and sixth month, respectively, 89.8%, 76.1% and 61.8% of the patients presented pain relief. A statistically significant difference (p < 0.001) was verified between NPS and the 4 moments assessed after the technique. 43.7% had total pain remission (NPS = 0) at six months. Global effectiveness of suprascapular nerve blockade was 60.6% and for the subgroup of patients with rotators' cuff patology was 62.2%. No complications were reported regarding the suprascapular nerve block. The results show that ultrasound‐guided blockade of the suprascapular nerve using 0.25% levobupivacaine and 40 mg of triamcinolone is a safe and effective treatment in patients with chronic shoulder pain. [ABSTRACT FROM AUTHOR]

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Copyright of Revista Brasileira de Ciência e Movimento: RBCM is the property of Revista Brasileira de Ciencia e Movimento and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

RESUMO O dinamômetro manual é um equipamento portátil e de fácil uso na prática clínica. Entretanto, sua utilização necessita de parâmetros de confiabilidade e reprodutibilidade em posições de ombro com e sem estabilização. O objetivo deste estudo foi avaliar a confiabilidade inter e intraexaminador na medida de força dos músculos rotadores do ombro nas posições a 0° e 90° de abdução com avaliadores inexperientes. Vinte sujeitos (27,05±8,17 anos; 76,6±10,97kg; 1,74±0,07m) de ambos os sexos e sem queixas anteriores ou atuais de dor no ombro e cervical participaram do estudo. A avaliação dos rotadores mediais e laterais do ombro foi realizada por meio de um dinamômetro manual digital (MicroFET 2, Hoggan Health Industries, West Jordan, UT, USA) em duas posições: sentado, com 0° de abdução do ombro, e em supino, com 90° de abdução de ombro. A confiabilidade interexaminador e a reprodutibilidade intraexaminador foram avaliadas pelo coeficiente de correlação intraclasse (ICC) considerando o intervalo de confiança de 95% (p

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Copyright of ConScientiae Saúde is the property of Nove de Julho University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Snapping scapula syndrome manifests as an audible or palpable crackling during the sliding movements of the scapula over the rib cage, often perceived during physical or professional activities. It can be caused by morphological alteration of the scapula and rib cage, by an imbalance in periscapular musculature forces (dyskinesia), or by neoplasia (bone tumors or soft tissue tumors). In this pictorial essay, we review the main causes of snapping scapula syndrome, exemplified by a collection of didactic cases. [ABSTRACT FROM AUTHOR]

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Copyright of Fisioterapia e Pesquisa is the property of Universidade de Sao Paulo, Faculdade de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article analyzes the relationship between the range of motion of the shoulder rotators and the injury history in sitting volleyball athletes. The research was conducted with 8 female athletes who participated voluntarily. It was observed that athletes with a history of injury had a lower range of motion in the shoulder joint. The study concludes that injuries significantly affected the mobility of the rotators in the right shoulder. [Extracted from the article]

ABSTRACT OBJECTIVE: Description of a new surgical technique for treating the shoulders of patients with sequelae of obstetric paralysis. Preliminary analysis on the results obtained from this technique. METHODS: Five consecutive patients underwent the proposed surgical procedure, consisting of arthroscopic anterior joint release followed by transfer of the latissimus dorsi tendon (elongated and reinforced with a homologous tendon graft) to the posterosuperior portion of the greater tubercle, using a single deltopectoral approach. All the patients were reevaluated after a minimum postoperative period of twelve months. The functional assessment was based on the range of motion and the modified Mallet classification system. Statistical analyses were not possible because of the small sample. RESULTS: Overall, passive and active lateral rotations increased, while medial rotation decreased. The other movements (elevation, capacity to place a hand in the mouth and capacity to place a hand behind the neck) had less consistent evolution. The mean modified Mallet score improved by 4.2 points (from 11.4 to 15.6). CONCLUSION: The latissimus dorsi tendon can be transferred to the posterosuperior portion of the greater tubercle through a single deltopectoral approach when elongated and reinforced with a homologous tendinous graft.

ABSTRACT OBJECTIVE: To evaluate the prevalence of rotator cuff tears and describe the profile of reoperated patients, causes of repeated tendon tears, tear evolution and range of times between surgical procedures. METHOD: This was a cross-sectional study involving 604 surgical procedures performed at two regional referral hospitals between January 2006 and December 2012. After approval by the ethics committee, data describing the patients' epidemiological profile were gathered at a single time, using Cofield's classification to measure the extent of the tears, all of which underwent arthroscopic surgery. The data were entered into Epi Info 3.5.3 and were analyzed using SPSS version 18.0. RESULTS: Among the 604 surgical procedures, females were affected in more cases (351; 58.1%). When the dominant limb was the right limb, it was affected in 90% of the cases (p < 0.05). The supraspinatus tendon was affected in 574 cases (95%) and the tears were of medium size in 300 cases (49.7%). Eighteen reoperations were performed (2.98%) and the upper right limb was the most affected (66.6%). The cause was non-traumatic in 12 patients. The repeated tears were mostly smaller (44%), and the length of time between the two surgical procedures ranged from 6 to 298 weeks. CONCLUSION: Female gender, smaller extent in the second procedure and non-traumatic cause were found in most of the cases analyzed.

OBJECTIVE: To evaluate the clinical outcome of arthroscopic rotator cuff fixation and, when present, simultaneous repair of the Bankart lesion caused by traumatic dislocation; and to assess whether the size of the rotator cuff injury caused by traumatic dislocation has any influence on the postoperative clinical outcomes. METHODS: Thirty-three patients with traumatic shoulder dislocation and complete rotator cuff injury, with at least two years of follow up, were retrospectively evaluated. For analysis purposes, the patients were divided into groups: presence of fixed Bankart lesion or absence of this lesion, and rotator cuff lesions smaller than 3.0 cm (group A) or greater than or equal to 3.0 cm (group B). All the patients underwent arthroscopic repair of the lesions and were evaluated postoperatively by means of the UCLA (University of California at Los Angeles) score and strength measurements. RESULTS: The group with Bankart lesion repair had a postoperative UCLA score of 33.96, while the score of the group without Bankart lesion was 33.7, without statistical significance (p = 0.743). Group A had a postoperative UCLA score of 34.35 and group B, 33.15, without statistical significance (p = 0.416). CONCLUSION: The functional outcomes of the patients who only presented complete rotator cuff tearing after traumatic shoulder dislocation, which underwent arthroscopic repair, were similar to the outcomes of those who presented an associated with a Bankart lesion that was corrected simultaneously with the rotator cuff injury. The extent of the original rotator cuff injury did not alter the functional results in the postoperative evaluation.

ABSTRACT Anatomical variations at the origin of the biceps tendon have been described by several authors, but occurrences of an origin in the supraspinatus are rare. It is unclear whether this variation might contribute toward pathological conditions of the shoulder. Our objective here was to describe a case of an anatomical variation in the origin of the tendon of the long head of the biceps. The clinical information, preoperative images and arthroscopic images relating to a patient with an aberrant origin of the long head of the biceps, which was observed during shoulder arthroscopy, were reviewed. In this case study, the origin of the biceps was found in the rotator cuff, without any origin from the supraglenoid tubercle or upper labrum. This variant did not seem to contribute toward the pathological condition of the shoulder, and standard treatment for the concomitant condition was sufficient for treating it.

ABSTRACT OBJECTIVE: Evaluate the results and complications of Latarjet procedure in patients with anterior recurrent dislocation of the shoulder. METHODS: Fifty-one patients (52 shoulders) with anterior recurrent dislocation, surgically treated by Latarjet procedure, were analyzed retrospectively. The average follow-up time was 22 months, range 12-66 months; The age range was 15-59 years with a mean of 31; regarding sex, 42 (82.4%) patients were male and nine (17.6%) were female. The dominant side was affected in 29 (55.8%) shoulders. Regarding the etiology, 48 (92.3%) reported trauma and four (7.6%) had the first episode after a convulsion. RESULTS: The average elevation, lateral rotation and medial rotation of the operated shoulder were, respectively, 146° (60-80°), 59° (0-85°) and T8 (T5 gluteus), with statistical significance for decreased range of motion in all planes, compared with the other side. The scores of Rowe and UCLA were 90.6 and 31.4, respectively, in the postoperative period. Eleven shoulders (21.2%) had poor results: signs of instability (13.4%), non-union (11.5%) and early loosening of the synthesis material (1.9%). There was a correlation between poor results and convulsive patients ( p = 0.026). CONCLUSION: We conclude that the Latarjet procedure for correction of anterior recurrent dislocation leads to good and excellent results in 82.7% of cases. Complications are related to errors in technique.

A dog was consulted with functional disability of the right thoracic limb. Radiographic image showed lateral luxation of the scapulohumeral joint. The animal was submitted to surgical treatment using tension suture with screws and Nylon wire, with satisfactory result and functional use of the limb 30 days postoperatively.

resumo Objetivo: Avaliar o resultado funcional da artroplastia reversa, suas complicações e relações com os tipos de lesões. Métodos: Foram tratados 27 ombros, de 26 mulheres e um homem. Os pacientes foram avalia dos pela escala funcional de UCLA. O modelo de implantes usado foi o Delta Xtend Depuy(r). As lesões foram classificadas segundo Seebauer para o grau de artropatia e Nerot para o notching. Resultado: Aidade média foi de 77,4 (67-89), o seguimento foi de 25,8 meses (6-51), o UCLA pré era de 10,1 (6-15) e o UCLA pós foi de 29,8 (22-35), com uma melhoria estatisticamente signi ficativa (p < 0,001). Pela classificação de Seebauer, cinco eram 1B, 19 eram 2 A e três eram 2 B. Tivemos 15 complicacões (55,5%), o notching foi o mais comum e ocorreu em 14 pacientes, nove deles grau I e cinco grau II, mas nenhum deles gerou instabilidade. Apenas uma paci ente (3,7%) teve complicação maior, com luxacão no pós-operatório imediato. Dois pacientes (7,4%) alegaram que não repetiriam o procedimento. Uma paciente (3,7%) foi submetida a revisão. Conclusão: A artroplastia reversa mostrou-se uma excelente opção para o tratamento de pacientes com artropatia do manguito rotador com baixo índice de complicações maio res. O notching é uma complicação frequente, mas que na maioria dos casos não apresenta repercussão clínica

ABSTRACTOBJECTIVES: To evaluate the functional results from patients with arthrosis who underwent an arthroscopic procedure, in an attempt to correlate these results with the patients' epidemiological profile, surgical technique used, possible complications and postoperative protocol. METHODS: Between 1998 and 2011, 31 patients (32 shoulders) with shoulder arthrosis underwent arthroscopic treatment performed by the Shoulder and Elbow Group of the Department of Orthopedics and Traumatology of Santa Casa de São Paulo. Primary or secondary cases of shoulder arthrosis under the age of 70 years, in which the rotator cuff was intact, were included. Furthermore, cases in which, despite an indication for an arthroplastic procedure, an attempt to perform an alternative procedure had been chosen, were also included. The following were evaluated: sex, age, dominance, comorbidities, length of time with complaint, associated lesions, etiology, previous treatment, operation performed, postoperative protocol and pre and postoperative active ranges of motion. The functional evaluation was conducted using the UCLA criteria, before and after the operation. The joint cartilage alterations were classified in accordance with Outerbridge and the arthrosis by means of Walch. RESULTS: There were statistically significant mean differences in the values for elevation, lateral rotation and medial rotation from before to after the operation ( p< 0.001) and there was a tendency ( p= 0.057) toward poor results with greater length of time with complaints before the surgery. The total gain in UCLA score did not have any statistically significant relationship with any of the other variables analyzed. CONCLUSION: Arthroscopic treatment of glenohumeral arthrosis provided functional improvement of the glenohumeral joint, with significant gains in elevation and lateral and medial rotation, and improvements in function and pain. Greater length of time with complaints was a factor strongly suggestive of worse results.

Abstract Sternoclavicular dislocations account for less than 5% of all dislocations of the scapular belt. Most cases of anterior dislocation of the sternoclavicular joint do not present symptoms. However, some patients may develop chronic anterior instability and remain symptomatic, and surgical treatment is indicated in these cases. There is a scarcity of reports in the literature relating to reconstruction using the long palmar tendon in cases of traumatic anterior instability. Although rare, these injuries deserve rapid diagnosis and efficient treatment in order to avoid future complications. The aim of this report was to report on a case of a motocross competitor who developed chronic traumatic anterior instability of the sternoclavicular joint and underwent surgical reconstruction using the autogenous long palmar tendon. The patient was a 33-year-old man with a history of anterior dislocation of the sternoclavicular subsequent to a fall during a maneuver in a motocross competition. Conservative treatment was instituted initially, consisting of use of a functional sling to treat the symptoms for 3 weeks, along with physiotherapeutic rehabilitation for 3 months. We chose to use a modification of the "figure of eight" technique based on the studies by Spencer and Kuhn. A longitudinal incision of approximately 10 cm was made at the level of the sternoclavicular joint. The graft from the ipsilateral long palmar tendon was passed through the orifices in the form of a modified "figure of eight" and its ends were sutured together. The patient was immobilized using an American sling for 4 weeks. After 6 months of follow-up, the patient no longer presented pain or instability when movement of the sternoclavicular joint was required. Minor discomfort and slight prominence of the sternoclavicular joint continued to be present but did not affect the patient's activities. Thus, the patient was able to return to racing 6 months after the operation. Our study presented a case of chronic anterior dislocation of the sternoclavicular joint that was successfully treated by using a modification of the "figure of eight" reconstruction technique. This technique was shown to be safe and effective, and it allowed the patient to fully return to his sports activities.