[A strong man with a weak shoulder].

A 47-year-old former olympic athlete had pain and weakness of his left shoulder. There was no prior trauma. He had full range-of-motion and a scapular dyskinesia.

Bony avulsion of the supraspinatus origin from the scapular spine.

We describe a case of an avulsion of the scapular spine at the origin of the supraspinatus muscle, with successful conservative treatment. An isolated avulsion is rare, as most avulsions occur in combination with other (more severe) injuries such as fractures of the scapula body or neck, coracoid process, glenoid or humerus. These injuries are mostly seen in high-energy trauma cases and need their own specific treatment.

Injection of dexamethasone versus placebo for lateral elbow pain: a prospective, double-blind, randomized clinical trial.

Purpose: We tested the hypothesis that there is no difference in disability, pain, and grip strength 1 and 6 months after corticosteroid and lidocaine injection compared with lidocaine injection alone (placebo).

Methods: Sixty-four patients were randomly assigned to dexamethasone (n = 31) or placebo (n = 33) injection. At enrollment, disability (Disabilities of the Arm, Shoulder, and Hand [DASH] questionnaire), pain on a visual analog scale, grip strength, depression (the Center for Epidemiologic Studies Depression Scale; CESD), and ineffective coping skills (the Pain Catastrophizing Scale; PCS) were comparable between treatment groups.

Elbow dislocation with intra-articular fracture: the results of operative treatment without repair of the medial collateral ligament.

Purpose: To determine the effectiveness of a protocol for the treatment of fracture-dislocations of the elbow based on the concept that, if dislocation of the elbow with associated fractures can be made to resemble a simple elbow dislocation by repairing or reconstructing the fractured structures, repair of the medial collateral ligament (MCL) will not be necessary.

Methods: Over a 5-year period, a single surgeon operated on 34 patients with a posterior dislocation of the elbow associated with one or more intra-articular fractures. The mean age of these 19 men and 15 women was 48 years.

A comparison of proximal radioulnar synostosis excision after trauma and distal biceps reattachment.

We tested the hypothesis that the results of operative resection of a proximal radioulnar synostosis are better when the synostosis is due to a distal biceps reattachment (11 patients) than when it occurs after trauma (13 patients). Two patients in the trauma cohort had recurrence of the synostosis, and 1 had repeat resection. Two patients in the trauma cohort and 1 in the biceps cohort had substantial loss of forearm rotation due to regrowth of heterotopic ossification without synostosis, and 2 patients were addressed with subsequent surgeries.