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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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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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Reverse Total Shoulder Arthroplasty
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Posterior shoulder instability.

Jérôme Garret1, Stanislas Gunst2, Marc Olivier Gauci3

  • 1Clinique du Parc de Lyon, 155(ter), Boulevard Stalingrad, 69006 Lyon, France.

Orthopaedics & Traumatology, Surgery & Research : OTSR
|November 23, 2024
PubMed
Summary

Posterior shoulder instability (PSI) involves recurrent loss of posterior joint contact. Treatment varies from non-operative rehabilitation for functional PSI to surgical repair for structural PSI with bone lesions.

Keywords:
InstabilityPosteriorShoulder

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Biomechanics

Background:

  • Posterior shoulder instability (PSI) is characterized by recurrent, symptomatic loss of posterior joint contact.
  • Risk factors include ligament hyperlaxity, glenoid retroversion/dysplasia, and acromial morphology.
  • Associated lesions include labral tears, posterior glenoid erosion/fracture, and anterior humeral head notching.

Purpose of the Study:

  • To define and categorize posterior shoulder instability.
  • To outline clinical presentations and treatment strategies for functional and structural PSI.
  • To discuss surgical advancements for structural PSI.

Main Methods:

  • Classification of PSI into functional and structural subtypes.
  • Review of clinical manifestations, risk factors, and associated lesions.
  • Analysis of non-operative and surgical treatment options.

Main Results:

  • Functional PSI involves impaired muscle activity and is treated non-operatively.
  • Structural PSI involves anatomic lesions, often from microtrauma, and may require surgery.
  • Arthroscopic repair is effective for labral tears without bone loss; bone blocks are used for significant bone lesions.

Conclusions:

  • PSI can be functional (without anatomic lesions) or structural (with anatomic lesions).
  • Treatment is tailored to the subtype, ranging from rehabilitation to surgical interventions.
  • 3D planning and specialized fixation enhance surgical outcomes for structural PSI.