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Related Concept Videos

Muscles of the Shoulder01:23

Muscles of the Shoulder

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The muscles surrounding the shoulder girdle, including the clavicle and scapula, primarily stabilize the scapula. This stable base allows other muscles to move the humerus effectively. Scapular movements often mirror those of the humerus and extend its range of motion. For instance, raising the arm above the head would not be feasible without simultaneous upward rotation of the scapula.
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Muscles that Move the Arm01:31

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Nine muscles are involved in arm movements. Two of these, the pectoralis major and latissimus dorsi, originate from the axial skeleton and are called axial muscles. The other seven originate from the scapula and are called the scapular muscles.
The pectoralis major has two origins. Its clavicular head originates on the medial half of the clavicle. In contrast, the sternocostal head originates on the costal cartilages of ribs 1-6, the sternum, and the aponeurosis of the external oblique of the...
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Related Experiment Video

Updated: Sep 5, 2025

Reverse Total Shoulder Arthroplasty
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Chronic posterior dislocation of shoulder.

Ravi Mittal1, Siddharth Jain1, Shivanand Gamanagatti2

  • 1Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.

Journal of Clinical Orthopaedics and Trauma
|July 8, 2022
PubMed
Summary

Chronic posterior shoulder dislocation (PDS) often involves associated fractures. A new classification system guides treatment, improving patient outcomes and reducing instability recurrence.

Keywords:
ChronicFracture dislocation proximal humerusPosterior shoulder dislocationReverse hill-sachs lesion

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Area of Science:

  • Orthopedic Surgery
  • Traumatology
  • Shoulder Reconstruction

Background:

  • Chronic posterior shoulder dislocation (PDS) is a rare injury with limited literature on its varied presentations.
  • Understanding associated injuries is crucial for effective management and classification of PDS.

Purpose of the Study:

  • To investigate the spectrum of associated injuries in chronic PDS.
  • To develop a classification system to guide treatment strategies for chronic PDS.

Main Methods:

  • Retrospective analysis of 16 patients with chronic PDS.
  • CT scans used for injury classification based on humeral head bone loss, greater tuberosity (GT) malunion, and proximal humerus metaphysis malunion.
  • Pre- and post-operative assessment using Visual Analogue Score (VAS), University of California Los Angeles (UCLA) shoulder score, and American Shoulder and Elbow Surgeon (ASES) score.

Main Results:

  • A classification system (Types A1-C2) was proposed based on bone loss and malunion patterns.
  • Treatments ranged from modified McLaughlin procedure (MMP) to hemi-replacement (HRA) and reverse shoulder arthroplasty (RSA).
  • Significant improvements in VAS, UCLA, and ASES scores were observed post-operatively, with no recurrence of instability.

Conclusions:

  • Chronic PDS frequently involves fractures of the tuberosities and/or proximal metaphysis, alongside humeral head bone loss.
  • Treatment selection is guided by humeral head bone loss, GT malunion, and proximal humeral metaphysis malunion.
  • The proposed classification aids in selecting optimal treatment, including joint salvage, anatomic replacement, or reverse arthroplasty.