florencechaverneff, Author at Clinical Pain Advisor

florencechaverneff

All articles by florencechaverneff

Managing the Failed Rotator Cuff Repair

The Problem Rotator cuff repair results in predictable pain relief and a variable return of function in the majority of patients. However, it may take up to a year to achieve maximum improvement in shoulder strength and function. In certain cases patients may continue to experience pain and weakness in the shoulder following rotator cuff…

Chronic Glenohumeral Dislocation: Anterior and Posterior

The Problem Chronic glenohumeral dislocations represent a therapeutic challenge for the orthopaedic surgeon. Patients with a chronic glenohumeral dislocation often present with a complex combination of pathologic findings, all of which impact the treatment strategy and ultimate prognosis. These include injuries to the humeral head articular surface, the glenoid, the rotator cuff, and the capsulolabral…

Management of Recurrent Anterior Shoulder Instability

The Problem Recurrent shoulder instability is a difficult problem arising from a destabilizing injury to the static and dynamic anterior restraints of the glenohumeral joint. The most common lesion found in anterior instability is an avulsion of the anteroinferior capsulolabral structures from the glenoid rim (Bankart lesion). Recurrent shoulder dislocation events may also result in…

Back pain

Back pain I. Problem / Condition. Back pain is a challenging condition for hospitalists to treat given the usual chronicity of the disease and the episodic nature of care that is inherent with our specialty. Further, while back pain is extremely common, it rarely is a diagnosis that warrants hospitalization. However, the practitioner must recognize…

Subarachnoid hemorrhage

Hemorrhagic strokes comprise 10-15% of all strokes. Subarachnoid hemorrhage (SAH) accounts for about 50% of hemorrhagic strokes. A thunderclap headache (TCH), which is a sudden and severe headache with maximal intensity at onset is a common presenting feature of SAH. About 80% of cases of non-traumatic SAH are due to the rupture of a saccular…

Evaluation and Management of Complex Elbow Dislocations

The Problem Complex elbow dislocations are characterized by instability of the elbow with associated fractures. These are difficult injuries to treat with relatively poor outcomes when compared to simple elbow dislocations. The extent of injury can vary greatly from minor fractures to severe injuries with multiple fractures and soft tissue damage. The term “terrible triad”…

Elbow Problems in the Throwing Athlete

The Problem Overhead throwing athletes place extraordinary demands on their elbow to generate and withstand substantial forces on a repetitive basis. Although the ‘throwing athlete’ encompasses many sports, it has been best studied in baseball pitchers. Professional pitchers place enormous valgus force across their elbow, generating torques as high as 64 N/m and angular velocities…

Cubital Tunnel Syndrome

The Problem The ulnar nerve passes in a subcutaneous position posterior to the medial epicondyle in the elbow. Cubital tunnel syndrome (CuTS) is defined as the compression of the ulnar nerve in this anatomic region. It is the second most common compressive neuropathy of the upper extremity after carpal tunnel syndrome with an incidence reported…

Management of Shoulder Injuries in the Throwing Athlete

The Problem Shoulder injuries in the throwing athlete present a unique challenge. The act of throwing itself subjects the shoulder to extremes of motion and stress. This can be amplified even further in high lever throwing athletes. The drive to succeed for many throwing athletes causes them to push their shoulders to near failure on…

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