tailieunhanh - Cách tiếp cận để quản lý một phần nước mắt

Cách tiếp cận để quản lý một phần nước mắt rotator cuff-độ dày tốt nhất là thực hiện với sự hiểu biết các Đó Đây không phải là một điều kiện đơn lẻ. Thay vào đó, nước mắt Đại diện một phần kết quả chung của một giống của những lời lăng mạ với rotator cuff. Trao đổi thoái hóa do tuổi tác, | Partial-Thickness Tears of the Rotator Cuff Evaluation and Management Owen R. McConville MD and Joseph P. lannotti MD PhD Abstract The approach to management of a partial-thickness rotator cuff tear is best made with the understanding that this is not a singular condition. Rather partial tears represent the common outcome of a variety of insults to the rotator cuff. Degenerative changes due to aging anatomic impingement and trauma may all be etiologic agents. Overhead athletes may develop tears due to repetitive microtrauma or internal impingement. Outlet radiographs and magnetic resonance imaging are recommended for routine preoperative evaluation. A nonoperative treatment program for rotator cuff strengthening and stretching is appropriate as initial treatment modification of activities and anti-inflammatory medication are often used as well. Operative management may be considered when nonoperative treatment fails. Arthroscopic evaluation is required to determine the true extent of the cuff lesion. Arthroscopic subacromial decompression is recommended when outlet impingement is present. Rotator cuff debridement or formal cuff repair is dependent on the size of the cuff defect and the age and activity level of the patient. The importance of recognizing the different causes of partial-thickness rotator cuff tears is emphasized in this review of pathogenesis clinical diagnosis imaging and treatment. J Am Acad Orthop Surg 1999 7 32-43 Partial-thickness rotator cuff tears PTRCTs have long been recognized as an often asymptomatic consequence of the aging process as well as a potential source of shoulder dysfunction. Other possible etiologic factors include anatomic impingement and trauma including repetitive microtrauma . In the past the difficulty in accurately diagnosing and characterizing the elements contributing to PTRCTs has compromised the ability to understand the natural history of this condition. More recently magnetic resonance MR imaging and arthroscopic .