Displaying publications 1 - 20 of 135 in total

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  1. Davatchi F
    DOI: 10.1111/j.1479-8077.2006.00177.x
    Matched MeSH terms: Shoulder Pain
  2. Akhavan Hejazi SM, Mazlan M
    Acta Med Iran, 2012;50(4):292-4.
    PMID: 22592581
    Post-stroke shoulder pain is associated with either a peripheral or central pathology. However, most of the time, it is challenging to establish a cause-and-effect relationship between the suggested pathology and shoulder pain reported. We report a 66 year-old man who developed a right hemiplegic shoulder pain two months post stroke with initial investigations suggestive of peripheral pathologies. Pharmacological and non-pharmacological treatment did not improve his shoulder pain. Later he developed complex regional pain syndrome (CRPS) of the right hand and the initial shoulder pain subsequently relieved following resolution of the CRPS.
    Matched MeSH terms: Shoulder Pain/diagnosis; Shoulder Pain/etiology*; Shoulder Pain/therapy
  3. Joseph LH, Hussain RI, Pirunsan U, Naicker AS, Htwe O, Paungmali A
    Acta Orthop Traumatol Turc, 2014;48(2):169-74.
    PMID: 24747625 DOI: 10.3944/AOTT.2014.3184
    The aim of this study was to investigate the intra- and inter-rater reliability of ultrasonography (US) to measure anterior translation of the humeral head (ATHH) among healthy subjects and patients with sacroiliac joint dysfunction.
    Matched MeSH terms: Shoulder Joint/ultrasonography*
  4. Yahya, N.A., Youngson, C.C.
    Ann Dent, 2007;14(1):7-13.
    MyJurnal
    The purpose of this study were to compare the emergence profiles of crowns with their contralateral tooth, in vitro, and to determine if there is any association between the design of tooth preparations and the resultant emergence profile. 50 working models used for single crown construction were examined. Measurements of the faciolingual width of the crowns and contralateral teeth were taken using digital calipers. Internal line angles and the margin width of dies and the emergence profile of the corresponding crowns were measured from longitudinally sectioned polyvinylsiloxane indices mounted on a flat-bed scanner using image analysis software. Using Students t tests, no statistically significant differences (p>0.05) were found for shoulder width (mean 0.94 ± 0.23mm), internal line angle (mean 105.83 ± 13.57°) or emergence profiles (28.56 ± 12.95°) in the different (anterior, premolar or molar) preparations or crowns. The mean emergence profiles for all crowns was statistically significantly greater (p
    Matched MeSH terms: Shoulder
  5. Labao HC, Faller EM, Bacayo MFD
    Ann Glob Health, 2018 08 31;84(3):474-480.
    PMID: 30835403 DOI: 10.29024/aogh.2331
    BACKGROUND AND PURPOSE: Musculoskeletal disorders (MSDs) are alarmingly high among migrant workers in Malaysia. MSDs are the most prevalent occupational-related conditions in most parts of the world affecting function, productivity and overall health-related quality of life. Therefore, this study aims to determine the profile of Filipino migrant workers in Malaysia and their various musculoskeletal complaints.

    METHOD: This study utilized a quantitative, nonexperimental, cross-sectional research design. A total of 60 subjects were randomly selected after passing the study's sampling criteria. The Nordic Musculoskeletal Questionnaire (NMQ) was to used to determine common MSDs affecting the various regions in the body. The Demographic Pofile Sheet was provided to gather a subject's demographic characteristics.

    RESULTS: Filipino migrant workers mostly complain of pain in the low back area (60%) and shoulder pain (60%), followed by pain in the upper back (48.3%) and neck pain (45%) in the last 12 months. Household workers accounting for 73.3% of the subjects commonly complain of pain in the hips/thighs (78.9%), while workers in the service industry commonly complain of knee pain (39.1%).

    CONCLUSIONS: Results imply that Filipino migrant workers have a higher prevalence of shoulder and lower back pain in the last 12 months. Household workers are more susceptible to hip/thigh pain. Interventions focusing on ergonomics policy implementation, education on posture and lifting techniques and physical function is recommended. Further studies should consider the psychological and psychosocial aspects of migrant employment, which are known risk factors for MSDs.

    Matched MeSH terms: Shoulder; Shoulder Pain
  6. Amin NA, Nordin R, Fatt QK, Noah RM, Oxley J
    PMID: 25852937 DOI: 10.1186/s40557-014-0023-2
    OBJECTIVE: This study examined the relationships between psychosocial work factors and risk of WRMSDs among public hospital nurses in the Klang Valley, Malaysia.

    METHODS: We conducted a cross-sectional study among 660 public hospital nurses. A self-administered questionnaire was used to collect data on the occurrence of WRMSDs according to body regions, socio-demographic profiles, occupational information and psychosocial risk factors. 468 questionnaires were returned (response rate of 71%), and 376 questionnaires qualified for subsequent analysis. Univariate analyses were applied to test for mean and categorical differences across the WRMSDs; multiple logistic regression was applied to predict WRMSDs based on the Job Strain Model's psychosocial risk factors.

    RESULTS: Over two thirds of the sample of nurses experienced discomfort or pain in at least one site of the musculoskeletal system within the last year. The neck was the most prevalent site (48.94%), followed by the feet (47.20%), the upper back (40.69%) and the lower back (35.28%). More than 50% of the nurses complained of having discomfort in region one (neck, shoulders and upperback) and region four (hips, knees, ankles, and feet). The results also revealed that psychological job demands, job strain and iso-strain ratio demonstrated statistically significant mean differences (p shoulders and upper back) and region 4 (hips, knees, ankles, and feet). All demographic variables except for years of employment were statistically and significantly associated with WRMSDs (p

    Matched MeSH terms: Shoulder
  7. Henry LJ, Jafarzadeh Esfehani A, Ramli A, Ishak I, Justine M, Mohan V
    Asia Pac J Public Health, 2015 Mar;27(2):NP1785-92.
    PMID: 23417907 DOI: 10.1177/1010539513475657
    This study investigated the patterns of ongoing work-related musculoskeletal disorders (WRMDs) and exposure risk to musculoskeletal injuries for various body regions among palm plantation workers. Standard Nordic Musculoskeletal Questionnaire (SNMQ) was used to assess the prevalence of musculoskeletal disorders symptoms. The Quick Exposure check (QEC) was used to assess the exposure risk of farmers to WRMDs. The common pattern of WRMDs was back pain (40%), followed by shoulder pain (19%). The QEC revealed high exposure risk for neck (56%), followed by back (45.6%). The results from the SNMQ showed that 58% reported pain in 1 region, followed by 2 regions (10.7%) and 3 regions (3.6%). Back pain and shoulder pain were found to be common among workers in palm plantation occupation. Nevertheless, the neck region appeared to have the highest risk of exposure to injuries.
    Matched MeSH terms: Shoulder Pain/epidemiology
  8. Chiu CK, Tan RL, Gani SMA, Chong JSL, Chung WH, Chan CYW, et al.
    Asian Spine J, 2021 May 07.
    PMID: 33957021 DOI: 10.31616/asj.2020.0649
    Study Design: Retrospective study.

    Purpose: To report the perioperative and radiological outcomes of single-stage posterior passive correction and fusion (SSPPCF) in adolescent patients who present with congenital scoliosis.

    Overview of Literature: The surgical treatment for congenital scoliosis is complex. There is no definitive guide on surgical options for skeletally matured adolescent patients who have congenital scoliosis.

    Methods: Patients with congenital scoliosis who underwent SSPPCF using a pedicle screw system were reviewed. We identified the following three surgical indications: (1) hemivertebra or wedge vertebra over the thoracic or thoracolumbar region with structural lumbar curves, (2) hemivertebra or wedge vertebra at the lumbar region with significant pelvic obliquity or sacral slanting, and (3) mixed or complex congenital scoliosis. The demographic, perioperative, and radiographic data of these patients were collected.

    Results: Thirty-four patients were reviewed. The mean patient age was 14.6±3.4 years. There were 13 hemivertebrae, three wedged vertebrae, two butterfly vertebrae, three hemivertebrae with butterfly vertebra, eight unsegmented bars, and five multiple complex lesions. The average surgical duration was 219.4±68.8 minutes. The average blood loss was 1,208.4±763.5 mL. Seven patients required allogeneic blood transfusion. The mean hospital stay duration was 6.1±2.5 days. The complication rate was 11.8% (4/34): one patient had severe blood loss, one had rod breakage, and two had distal adding-on. The Cobb angle reduced from 65.9°±17.4° to 36.3°±15.3° (p<0.001) with a correction rate (CR) of 44.8%±17.4%. The regional kyphotic angle decreased from 39.9°±20.5° to 27.5°±13.9° (p=0.001) with a CR of 19.3%±49.6%. Radiographic parameters (radiographic shoulder height, clavicle angle, T1 tilt, cervical axis, pelvic obliquity, coronal balance, and apical vertebral translation) showed significant improvement postoperatively.

    Conclusions: SSPPCF was a feasible option for adolescent patients with congenital scoliosis who were skeletally matured.

    Matched MeSH terms: Shoulder
  9. Chan CYW, Gani SMA, Lim MY, Chiu CK, Kwan MK
    Asian Spine J, 2019 Apr;13(2):216-224.
    PMID: 30472823 DOI: 10.31616/asj.2018.0151
    STUDY DESIGN: Prospective study.

    PURPOSE: To compare patients' and parents' perceptions of physical attributes (PAs) of adolescent idiopathic scoliosis (AIS) patients and to report any correlations between their perceptions and Scoliosis Research Society-22r (SRS-22r) scores.

    OVERVIEW OF LITERATURE: Few studies have looked into the differences between patients' and parents' perceptions of their appearance.

    METHODS: AIS patient-parent pairs (n=170) were recruited. The patients' and parents' perceptions of six PAs were evaluated: waist asymmetry (WA), rib hump (RH), shoulder asymmetry (SA), neck tilt, breast asymmetry (BrA), and chest prominence. These PAs were ranked, and an aggregate PA (Agg-PA) score was derived from a score assigned to the attribute (6 for the most important PA and 1 for the least important). The patients also completed the SRS-22r questionnaire.

    RESULTS: Ninety-nine patients (58.2%) and 71 patients (41.8%) had thoracic and lumbar major curves, respectively. WA was ranked first by 54 patients (31.8%) and 50 parents (29.4%), whereas RH was ranked first by 50 patients (29.4%) and 38 parents (22.4%). The overall Agg-PA scores were similar for patients and parents (p>0.05). However, for thoracic major curves (TMCs) >40°, a significant difference was noted between the Agg-PA scores of patients and parents for SA (3.5±1.6 vs. 4.2±1.6, p=0.041) and BrA (3.0±1.6 vs. 2.2±1.3, p=0.006). For TMCs <40°, a significant difference was found between the Agg-PA scores of patients and parents for WA (3.7±1.6 vs. 4.4±1.5, p=0.050). BrA was negatively correlated with total SRS-22r score.

    CONCLUSIONS: There were no significant differences between patients and parents in their ranking of the most important PAs. For TMCs >40°, there were significant differences in the Agg-PA for SA and BrA. Pa¬tients were more concerned about BrA and parents were more concerned about SA. Patients' perception of the six PAs had weak correlation with SRS-22r scores.

    Matched MeSH terms: Shoulder
  10. Das B
    Biomed Imaging Interv J, 2007 Oct;3(4):e45.
    PMID: 21614297 DOI: 10.2349/biij.3.4.e45
    Radiosynovectomy is a novel method of treatment for several acute and chronic inflammatory joint disorders. A small amount of a beta-emitting radionuclide is injected into the affected joint delivering a radiation dose of 70 to 100 Gy to the synovia. The proliferative tissue is destroyed, secretion of fluid and accumulation of inflammation causing cellular compounds stops and the joint surfaces become fibrosed, providing long term symptom relief. The radionuclides are injected in colloidal form so that they remain in the synovium and are not transported by lymphatic vessels causing radiation exposure to other organs. Complete reduction of knee joint swelling has been seen in above 40% and pain relief in 88% of patients. Wrist, elbow, shoulder, ankle and hip joints showed significant improvement in 50-60% and restoration of normal function and long term pain relief has been achieved in about 70% of small finger joints. In hemophilic arthropathies complete cessation of bleeding in about 60% and improved mobility in 75% of patients has been reported.

    Matched MeSH terms: Shoulder
  11. Mohd Shaffid Md Shariff, Hanizah Ngadiron, Firdaus Hayati, Nornazirah Azizan, Affirul Chairil Ariffin
    MyJurnal
    Fracture is common after trauma. Proximal humeral fracture can occur in the elderly after fall and in youngsters after motor vehicle accidents (MVA) and sport injuries. A 37-year-old man was admitted with a fracture of his left proximal humerus following an MVA. He sustained a 3-part fracture and treated surgically using a PHILOS plate. There are few options in managing proximal humerus fracture ranging from conservative to surgical intervention based on its severity. We reminiscent the usage of PHILOS plate as a mode of treatment of such fracture.
    Matched MeSH terms: Shoulder Fractures
  12. Loh SY, Musa AN
    PMID: 25792854 DOI: 10.2147/BCTT.S47012
    CONTEXT: Breast cancer is the most prevalent cancer amongst women but it has the highest survival rates amongst all cancer. Rehabilitation therapy of post-treatment effects from cancer and its treatment is needed to improve functioning and quality of life. This review investigated the range of methods for improving physical, psychosocial, occupational, and social wellbeing in women with breast cancer after receiving breast cancer surgery.
    METHOD: A search for articles published in English between the years 2009 and 2014 was carried out using The Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, PubMed, and ScienceDirect. Search terms included: 'breast cancer', 'breast carcinoma', 'surgery', 'mastectomy', 'lumpectomy', 'breast conservation', 'axillary lymph node dissection', 'rehabilitation', 'therapy', 'physiotherapy', 'occupational therapy', 'psychological', 'psychosocial', 'psychotherapy', 'exercise', 'physical activity', 'cognitive', 'occupational', 'alternative', 'complementary', and 'systematic review'.
    STUDY SELECTION: Systematic reviews on the effectiveness of rehabilitation methods in improving post-operative physical, and psychological outcomes for breast cancer were selected. Sixteen articles met all the eligibility criteria and were included in the review.
    DATA EXTRACTION: Included review year, study aim, total number of participants included, and results.
    DATA SYNTHESIS: Evidence for exercise rehabilitation is predominantly in the improvement of shoulder mobility and limb strength. Inconclusive results exist for a range of rehabilitation methods (physical, psycho-education, nutritional, alternative-complementary methods) for addressing the domains of psychosocial, cognitive, and occupational outcomes.
    CONCLUSION: There is good evidence for narrowly-focused exercise rehabilitation in improving physical outcome particularly for shoulder mobility and lymphedema. There were inconclusive results for methods to improve psychosocial, cognitive, and occupational outcomes. There were no reviews on broader performance areas and lifestyle factors to enable effective living after treatment. The review suggests that comprehensiveness and effectiveness of post-operative breast cancer rehabilitation should consider patients' self-management approaches towards lifestyle redesign, and incorporate health promotion aspects, in light of the fact that breast cancer is now taking the form of a chronic illness with longer survivorship years.
    KEYWORDS: breast cancer surgery; lifestyle redesign; quality of life; rehabilitation methods; self-management; symptom-management
    Matched MeSH terms: Shoulder
  13. Kwan MK, Chiu CK, Goh SH, Ng SJ, Tan PH, Chian XH, et al.
    Clin Spine Surg, 2019 Jul;32(6):256-262.
    PMID: 30640749 DOI: 10.1097/BSD.0000000000000769
    STUDY DESIGN: Retrospective study.

    OBJECTIVE: This study looked into whether crossbar can reliably measure Upper Instrumend Vertebra (UIV) tilt angle intraoperatively and accurately predict the UIV tilt angle postoperatively and at final follow-up.

    SUMMARY OF BACKGROUND DATA: Postoperative shoulder imbalance is a common cause of poor cosmetic appearance leading to patient dissatisfaction. There were no reports describing the technique or method in measuring the UIV tilt angle intraoperatively. Therefore, this study was designed to look into the reliability and accuracy of the usage of intraoperative crossbar in measuring the UIV tilt angle intraoperatively.

    METHODS: Lenke 1 and 2 Adolescent Idiopathic Scoliosis patients who underwent instrumented Posterior Spinal Fusion using pedicle screw constructs with minimum follow-up of 24 months were recruited for this study. After surgical correction, intraoperative UIV tilt angle was measured using a crossbar. Immediate postoperative and final follow up UIV tilt angle was measured on the standing anteroposterior radiographs.

    RESULTS: A total of 100 patients were included into this study. The reliability of the intraoperative crossbar to measure the optimal UIV tilt angle intraoperatively was determined by repeated measurements by assessors and measurement by different assessors. We found that the intra observer and inter observer reliability was very good with intraclass correlation coefficient values of >0.9. The accuracy of the intraoperative crossbar to measure the optimal UIV tilt angle intraoperatively was determined by comparing this measurement with the postoperative UIV tilt angle. We found that there was no significant difference (P>0.05) between intraoperative, immediate postoperative, and follow-up UIV tilt angle.

    CONCLUSIONS: The crossbar can be used to measure the intraoperative UIV tilt angle consistently and was able to predict the postoperative UIV tilt angle. It was a cheap, simple, reliable, and accurate instrument to measure the intraoperative UIV tilt angle.

    Matched MeSH terms: Shoulder
  14. Bajuri MY, Maidin S, Rauf A, Baharuddin M, Harjeet S
    Clinics (Sao Paulo), 2011;66(4):635-9.
    PMID: 21655759
    OBJECTIVE: The main aim of the study was to analyze the outcomes of clavicle fractures in adults treated non-surgically and to evaluate the clinical effects of displacement, fracture patterns, fracture location, fracture comminution, shortening and fracture union on shoulder function.

    METHODS: Seventy clavicle fractures were non-surgically treated in the Orthopedics Department at the Tuanku Ja'afar General Hospital, a tertiary care hospital in Seremban, Malaysia, an average of six months after injury. The clavicle fractures were treated conservatively with an arm sling and a figure-eight splint for three weeks. No attempt was made to reduce displaced fractures, and the patients were allowed immediate free-shoulder mobilization, as tolerated. They were prospectively evaluated clinically and radiographically. Shoulder function was evaluated using the Constant scoring technique.

    RESULTS: There were statistically significant functional outcome impairments in non-surgically treated clavicle fractures that correlated with the fracture type (comminution), the fracture displacement (21 mm or more), shortening (15 mm or more) and the fracture union (malunion).

    CONCLUSION: This article reveals the need for surgical intervention to treat clavicle fractures and improve shoulder functional outcomes.

    Matched MeSH terms: Shoulder/physiopathology*
  15. Mohamad Isa MZ, Mohamed-Yassin MS, Abdul Kadir RF
    Clin Pract, 2020 Mar 31;10(1):1218.
    PMID: 32373307 DOI: 10.4081/cp.2020.1218
    Necrotizing fasciitis is a severe and progressive infection of deep soft tissues which results in destruction of the fascia and overlying subcutaneous fat. We report a case of a 45-year-old diabetic gentleman who initially presented with left shoulder pain, which was treated symptomatically. Upon representation, he had fever and the pain extended to his left upper back. There was a warm, firm and mildly tender purplish swelling on his mid to the left upper back. Blood tests revealed significantly elevated white cell counts and C-reactive protein. A CT thorax showed extensive soft tissue gas within the deep and superficial fascial layers of his left upper back. Necrotizing fasciitis was confirmed intraoperatively. The diagnosis of this condition is often difficult as early symptoms can be mild and nonspecific. A high Laboratory Risk Indicator for NECrotizing fasciitis (LRINEC) score may be helpful to rule in this diagnosis and guide further management.
    Matched MeSH terms: Shoulder Pain
  16. Wahab AHA, Saad APM, Syahrom A, Kadir MRA
    Comput Methods Biomech Biomed Engin, 2020 Apr;23(5):182-190.
    PMID: 31910663 DOI: 10.1080/10255842.2019.1709828
    Glenoid perforation is not the intended consequence of the surgery and must be avoided. The analysis on biomechanical aspect of glenoid vault perforation remains unknown. The purpose of this study is to determine the impact of glenoid perforation towards stress distribution and micromotion at the interfaces. Eight glenoid implant models had been constructed with various size, number and type of fixation. A load of 750 N was applied to centre, superior-anterior and superior-posterior area. Implant perforation had minimal impact on stress distribution and micromotion at the interfaces. However, cement survival rate for implant without perforation was the highest with a difference of up to 37% compared to other perforated models. Besides that, implant fixation and high stresses at the implant had more of an impact on implant instability than implant perforation. As a conclusion, glenoid perforation did not influence the stress distribution and micromotion, but, it reduced cement survival rate and increase the stress critical volume.
    Matched MeSH terms: Shoulder Joint/surgery*; Arthroplasty, Replacement, Shoulder*
  17. Abd Hamid MH, Abdullah S, Ahmad AA, Narin Singh PSG, Soh EZF, Liu CY, et al.
    Cureus, 2021 Jan 23;13(1):e12876.
    PMID: 33633905 DOI: 10.7759/cureus.12876
    INTRODUCTION: Distal end radius fractures are common fractures commonly treated with an option of open reduction and plating. Traditionally, plating is performed under general anesthesia (GA) or regional block. Recently, a new technique of plating under wide-awake local anesthesia with no tourniquet (WALANT) has been introduced. We aim to compare the preoperative anxiety level, intraoperative pain scores, post-operative pain scores, operating time, blood loss and clinical outcome of distal end radius plating with WALANT versus GA with tourniquet.

    METHODS: We conducted a randomized controlled study on patients with closed fracture of the distal end of the radius requiring open reduction and plating from January 2019 till April 2020. We recruited 65 patients (33 patients in the WALANT group and 32 patients in the GA group). Randomization was done via block randomization. Data were collected to evaluate preoperative anxiety using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) score, intraoperative pain score during injection (baseline) (V1), 10 minutes after injection (V2), during incision (V3), during gentle manipulation (V4), during aggressive manipulation (V5) and during first drilling of screw (V6), blood loss, duration of surgery and post-operative pain score. Additionally, intraoperative visual analog scale (VAS) score was obtained in the WALANT group. At three weeks, six weeks, three months and six months after operation, the Quick Disabilities of Arm, Shoulder and Hand (QuickDASH) scores and range of motion (ROM) of the wrists were obtained.

    RESULTS: The average age in the WALANT group was 47.19 (range, 36-64) years and GA group was 49.48 (range, 38-60) years. The mean APAIS score obtained was 7.78 (WALANT group) and 7.36 (GA group) with no statistical difference. For intraoperative VAS, only during V4 and V5 were the scores 1/10; otherwise at all other phases, the VAS score was 0. The average time for surgery was statistically longer in the WALANT group (61.22 minutes) compared to the GA group (55.33 minutes) (p = 0.003). There was no statistical difference in mean blood loss in both groups. The average post-operative VAS showed statistical significance only at 1 hour and 12 hours post-operation with no statistical difference at 2 and 24 hours post-operation. There was no difference in the post-operative ROM including wrist flexion, extension, supination and pronation for both groups up to six months' follow-up.

    CONCLUSION: There was no statistically significant difference in terms of preoperative anxiety level, intraoperative and post-operative VAS score, amount of blood loss and clinical outcome in both groups for plating of the distal end radius. However, the operating time was slightly longer in the WALANT group. We conclude that distal radius plating under WALANT has similar outcomes to GA. In centres with limited resources, WALANT offers a safe, reliable and cheaper option, reserving GA time for head, abdominal and thoracic surgery.

    Matched MeSH terms: Shoulder
  18. Mansor A, Arumugam K, Omar SZ
    Eur J Obstet Gynecol Reprod Biol, 2010 Mar;149(1):44-6.
    PMID: 20042263 DOI: 10.1016/j.ejogrb.2009.12.003
    To determine if shoulder dystocia can be predicted in babies born weighing 3.5 kg or more.
    Matched MeSH terms: Shoulder*
  19. Kwan MK, Chan CY
    Eur Spine J, 2016 10;25(10):3065-3074.
    PMID: 27021616
    PURPOSE: To investigate whether an optimal upper instrumented vertebra (UIV) tilt angle would prevent 'lateral' shoulder imbalance or neck tilt (with 'medial' shoulder imbalance) post-operatively.

    METHODS: The mean follow-up for 60 AIS (Lenke 1 and Lenke 2) patients was 49.3 ± 8.4 months. Optimal UIV tilt angle was calculated from the cervical supine side bending radiographs. Lateral shoulder imbalance was graded using the clinical shoulder grading. The clinical neck tilt grading was as follows: Grade 0: no neck tilt, Grade 1: actively correctable neck tilt, Grade 2: neck tilt that cannot be corrected by active contraction and Grade 3: severe neck tilt with trapezial asymmetry >1 cm. T1 tilt, clavicle angle and cervical axis were measured. UIVDiff (difference between post-operative UIV tilt and pre-operative Optimal UIV tilt) and the reserve motion of the UIV were correlated with the outcome measures. Patients were assessed at 6 weeks and at final follow-up with a minimum follow-up duration of 24 months.

    RESULTS: Among patients with grade 0 neck tilt, 88.2 % of patients had the UIV tilt angle within the reserve motion range. This percentage dropped to 75.0 % in patients with grade 1 neck tilt whereas in patients with grade 2 and grade 3 neck tilt, the percentage dropped further to 22.2 and 20.0 % (p = 0.000). The occurrence of grade 2 and 3 neck tilt when UIVDiff was <5°, 5-10° and >10° was 9.5, 50.0 and 100.0 %, respectively (p = 0.005). UIVDiff and T1 tilt had a positive and strong correlation (r2 = 0.618). However, UIVDiff had poor correlation with clavicle angle and the lateral shoulder imbalance.

    CONCLUSION: An optimal UIV tilt might prevent neck tilt with 'medial' shoulder imbalance due to trapezial prominence and but not 'lateral' shoulder imbalance.

    Matched MeSH terms: Shoulder/physiopathology*
  20. Kwan MK, Wong KA, Lee CK, Chan CY
    Eur Spine J, 2016 Feb;25(2):401-8.
    PMID: 25962815 DOI: 10.1007/s00586-015-4016-9
    PURPOSE: To introduce a new clinical neck tilt grading and to investigate clinically and radiologically whether neck tilt and shoulder imbalance is the same phenomenon in AIS patients.

    METHODS: 89 AIS Lenke 1 and 2 cases were assessed prospectively using the new clinical neck tilt grading. Shoulder imbalance and neck tilt were correlated with coracoid height difference (CHD), clavicle\rib intersection distance (CRID), clavicle angle (CA), radiographic shoulder height (RSH), T1 tilt and cervical axis.

    RESULTS: Mean age was 17.2 ± 3.8 years old. 66.3 % were Lenke type 1 and 33.7 % were type 2 curves. Strong intraobserver (0.79) and interobserver (0.75) agreement of the clinical neck tilt grading was noted. No significant correlation was observed between clinical neck tilt and shoulder imbalance (0.936). 56.3 % of grade 3 neck tilt, 50.0 % grade 2 neck tilt patients had grade 0 shoulder imbalance. In patients with grade 2 shoulder imbalance, 42.9 % had grade 0, 35.7 % grade 1, 14.3 % grade 2 and only 7.1 % had grade 3 neck tilt. CHD, CRID, CA and RSH correlated with shoulder imbalance. T1 tilt and cervical axis measurements correlated with neck tilt.

    CONCLUSIONS: In conclusion, neck tilt is distinct from shoulder imbalance. Clinical neck tilt has poor correlation with clinical shoulder imbalance. Clinical neck tilt grading correlated with cervical axis and T1 tilt whereas clinical shoulder grading correlated with CHD, RSH CRID and CA.

    Matched MeSH terms: Shoulder/physiopathology*
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