By Aldo O., M.D. Perotto, Edward F. Delagi, John, M.D. Iazzetti, Daniel, M.D. Morrison
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Additional resources for Anatomical Guide For The Electromyographer: The Limbs And Trunk
Hemiarthroplasty : the prosthetic element restore the fulcrum and the healing of anatomic tuberosity enables a functional rotator cuff (engine) and is critical for patient satisfaction and functional outcomes following hemiarthroplasty. Boileau et al. found that tuberosity malpositioning occurred in half of all patients who underwent hemiarthroplasty for PHF. This was also highly correlated with unsatisfactory results, prosthesis malalignment, decreased range of motion, and residual pain. Tuberosity healing and outcomes may be improved by use of a fracture-specific humeral component (79 %) compared with those treated by a conventional stem (66 %) .
Di Giacomo et al. When to Choose Surgical Treatment? In decision-making, patient expectations are important: • Young individuals who need to regain preexisting levels of functional requirements • Elderly patients who wish to resume their activities and their functional autonomy • Reduction and internal fixation may be indicated in about 20 % of cases comprising both standards under the following condition: – Tuberosities are displaced over 10 mm. – Risk factors for avascular necrosis (see above vascular patterns).
3 Healing Progression Criteria According to this, the protocol is divided into three sections of work: 1. Early management (0–4 weeks) Goal → Pain control and progressive recovery of range of motion (ROM); this phase includes some different steps: • Control pain and inflammation with immobilization, modalities, analgesics, and nonsteroidal antiinflammatory drugs. Pain, during rehab program, is one of the key points because all the exercises have to be relatively pain-free. It’s difficult to progress a painful joint and it is a sign that either the wrong exercise is being done for that time in the recovery process or it is being done improperly.