Short-Term Effectiveness of Precut Kinesiology Tape Versus an NSAID as Adjuvant Treatment to Exercise for Subacromial Impingement: A Randomized Controlled Trial.

Objective: To compare the short-term effectiveness of precut kinesiology tape (PCT) to a nonsteroidal anti-inflammatory drug (NSAID) as adjuvant treatment to exercise physiotherapy in improving pain and function in patients with shoulder impingement.

Design: Randomized, controlled assessor-blind parallel-design trial with 3 groups.

Setting: Academic-community hospital.

Outcome of distal clavicle resection in patients with acromioclavicular joint osteoarthritis and full-thickness rotator cuff tear.

Purpose: The purpose of this study was to examine the impact of distal clavicle resection (DCR) on subjective and objective outcome measures in patients with acromioclavicular (AC) joint osteoarthritis (OA) and rotator cuff tear.

Methods: Prospectively collected data of consecutive patients with arthroscopic evidence of OA of the ACJ with complete data at 2 years were used for the data analysis. Patients with moderate-to-severe OA of the AC joint underwent a DCR in conjunction with rotator cuff repair, while patients with mild OA of the ACJ underwent surgery related to concomitant rotator cuff tear without a DCR.

Improving the rapid and reliable diagnosis of complete distal biceps tendon rupture: a nuanced approach to the clinical examination.

Background: Diagnosis of complete distal biceps tendon rupture (DBTR) is frequently missed or delayed on clinical examination. No single clinical test, including MRI, has demonstrated 100% efficacy in assessing the integrity of the distal biceps tendon.

Hypothesis: Combining 3 validated clinical tests for identifying complete rupture can maximize a true-positive diagnosis for complete DBTR without the need for confirmatory soft tissue imaging when performed in concert with other important factors from the history and clinical examination.

The "bicipital aponeurosis flex test": evaluating the integrity of the bicipital aponeurosis and its implications for treatment of distal biceps tendon ruptures.

Background: One mitigating factor in the accurate diagnosis of complete distal biceps tendon ruptures (DBTR) is the integrity of the bicipital aponeurosis (BA). Current orthopedic literature lacks a descriptive means of evaluating the integrity of the BA in the presence of distal biceps injury.

Methods: A consecutive cohort of 17 patients with suspected DBTR was examined.

A systematic review and comprehensive classification of pectoralis major tears.

Background: Reported descriptions of pectoralis major (PM) injury are often inconsistent with the actual musculotendinous morphology. The literature lacks an injury classification system that is consistently applied and accurately reflects surgically relevant anatomic injury patterns, making meaningful comparison of treatment techniques and outcomes difficult.

Materials And Methods: Published cases of PM injury between 1822 and 2010 were analyzed to identify incidence and injury patterns and the extent to which these injuries fit into a classification category.

Bone tunnel fixation for repair of tibialis anterior tendon rupture.

Atraumatic rupture of the tibialis anterior tendon is rare, and due to the mild nature of pain symptoms, affected patients often present weeks or months after rupture. Surgical management is advocated to restore function in active patients, and historically suture anchors have been the preferred method for repairing the ruptured tendon directly to bone. We present a case of acute, atraumatic tibialis anterior tendon rupture that was anatomically repaired using a novel application of a bone tunnel fixation technique.

Management of fall-related injuries in the elderly: a retrospective chart review of patients presenting to the emergency department of a community-based teaching hospital.

Purpose: To identify current practice for elderly individuals who have sustained a fall-related injury and subsequently presented to the emergency department (ED) of a community-based hospital in Toronto, Ontario.

Methods: A retrospective longitudinal chart review was conducted for 300 persons, 65 years of age and older, who presented to the ED of a community-based teaching hospital with a fall from June 2004 through May 2005. Data were collected using a tool created by the investigators (based on information gathered through a literature review) to capture information related to risk factors for falling.

Subacromial morphometric assessment of the clavicle hook plate.

Background: Clavicle hook plates are an effective plate fixation alternative for distal clavicle fractures and severe acromioclavicular joint dislocations. However, post-operative complications associated with the subacromial portion of the hook include acromial osteolysis and subacromial impingement. We examine and quantify the three-dimensional position of the subacromial portion of the hook plate relative to surrounding acromial and subacromial structures in a series of cadaveric shoulders to determine if hook positioning predisposes the shoulder to these noted post-operative complications.

Variability in the surgical management of carpal tunnel syndrome: implications for the effective use of healthcare resources.

Medicine has been said to be as much art as science, where physicians invoke their individual skills and judgment to address the unique aspects of each presenting patient. Yet to what extent should physicians exercise their own discretion in determining the use rates of hospital resources? This article examines the results of a study on surgeon use of surgical setting and anesthetic technique for carpal tunnel release (CTR) surgery - a simple, low-risk surgical procedure that can be performed in either a formal operating room or a minor surgical setting, using local, regional or general anesthetic. The selected combination of surgical setting and anesthetic technique employed by a surgeon has not been standardized and can significantly impact both patient outcomes and administrative healthcare costs for hospital resources, equipment and pharmaceuticals.

The biceps crease interval for diagnosing complete distal biceps tendon ruptures.

Unlabelled: Complete distal biceps tendon ruptures require prompt surgical management for optimal functional and aesthetic outcome. The need exists for a valid and reliable diagnostic tool to expedite surgical referral. We hypothesized complete distal biceps tendon ruptures result in an objectively measurable anatomic landmark (the distance between the antecubital crease of the elbow and the cusp of distal descent of the biceps muscle, or the biceps crease interval), as a result of proximal retraction of the musculotendinous complex.

Evaluating organizational readiness for change: a preliminary mixed-model assessment of an interprofessional rehabilitation hospital.

We conducted a Functional Organizational Readiness for Change Evaluation (FORCE) to assess the characteristics of readiness for change across two programs (N=216 employees) in an interprofessional rehabilitation hospital that was about to undergo strategic changes as part of a planned physical merger within the next two years. The study used a mixed-method approach: a quantitative survey, previously validated in a drug rehabilitation setting, followed by key informant interviews to further enlighten survey findings. Statistical analyses identified correlations between demographic variables (age, education and experience) and readiness for change, as well as the prevalence of specific organizational characteristics (motivation for change, access to resources, staff attributes, organizational climate, and exposure/ use of training opportunities) that facilitate or impede change.