The majority of patients who complain of a painful shoulder are suffering either from periarthritis, ' ' frozen shoulder, ' ' or from a supraspinatus lesion. Lesions of the supraspinatus tendon at or close to its insertion, where it is intimately associated with the subacromial bursa, give rise to a characteristic combination of symptoms-the supraspinatus syndrome-which are mechanical in origin. In the middle range of abduction movement the tendon impinges on the overlying lrocesses and the tendon and bursa are compressed between t he humerus and acromion (Fig. 1). When there is abnormality of the tendon or bursa this pressure causes pain, anti any movement which tends to bring the lesion into contact with the acromion causes reflex muscle spasm. The supraspinatus syndrome is usually characteristic, although in its later stages it may be complicated by true limitation of shoulder movement, due partly to disuse and partly to adhesion formation in the region of the subacromial bursa, vhich masks the typical symptoms and complicates both diagnosis and treatment. In the middle range of abduction the supraspinatus tendon and subacromial bursa are compressed between the upper end of the humerus and the acromion. THE AIMS AND PRINCIPLES OF EXCISION OF THE ACROMION THE JOURNAL OF BONE AND JOINT SURGERY EXCISION OF THE ACROMION IN TREATMENT OF THE SUPRASPINATUS SYNDROME \\ATSON-JONES, H. (1939) : " Excision of acromion for supraspinatus tendinitis." Demonstration of cases
Dupuytren's disease may present with well-defined subcutaneous cords or as more diffuse disease with involvement of the skin. Fasciectomy is the procedure commonly carried out for the full range of disease, but is associated with rates of recurrence of up to 66%. We reviewed 143 rays in 103 patients undergoing dermofasciectomy for diffuse disease with involvement of the skin. We found recurrence in 12 rays (8.4% of rays; 11.6% of patients) during a mean follow-up of 5.8 years, eight as cords and four as nodules. We suggest that dermofasciectomy is a better method of disease control than fasciectomy for the more diffuse type of disease with involvement of the skin.
A single stage homodigital reverse pedicle island flap is described for the repair of volar or dorsal tissue loss on the finger or thumb. Donor site morbidity is minimal, and the length of the digit is preserved. Satisfactory function results in 25 patients are presented.
Dupuytren’s disease may present with well-defined subcutaneous cords or as more diffuse disease with involvement of the skin. Fasciectomy is the procedure commonly carried out for the full range of disease, but is associated with rates of recurrence of up to 66%. We reviewed 143 rays in 103 patients undergoing dermofasciectomy for diffuse disease with involvement of the skin. We found recurrence in 12 rays (8.4% of rays; 11.6% of patients) during a mean follow-up of 5.8 years, eight as cords and four as nodules. We suggest that dermofasciectomy is a better method of disease control than fasciectomy for the more diffuse type of disease with involvement of the skin.
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