By Andrea De Vita MD, W. Ben Kibler MD, FACSM (auth.), Giovanni Di Giacomo, Nicole Pouliart, Alberto Costantini, Andrea De Vita (eds.)
The objective of this Atlas is to concentration the reader's realization on a chain of bone, ligament, muscle and tendon constructions and ultrastructures that experience now not to date been mentioned other than within the most up-to-date overseas literature and in expert journals. This Atlas additionally offers super high-definition photos of "targeted" sections received from cadavers preserved utilizing state of the art techniques.
The authors' goal is to offer the shoulder anatomy in a brand new and unique means and, utilizing an easy yet committed descriptive language, to aid the reader comprehend the complexity of clinical learn, highlighting the significance of integrating anatomical, biomechanical and neurophysiological knowledge.
The textual content is meant as a supplement to the latest and present anatomical experiences in medical study, bringing out the significance of these miniscule constructions to which particular and transparent mechanical and neurological roles are actually being attributed.
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Extra info for Atlas of Functional Shoulder Anatomy
Corteen and Teitge propose a minimal resection of both the distal clavicle and the distal acromion, in preference to excision of the clavicle alone, in order to avoid damage to the trapezoid and conoid ligaments. This may be beneficial clinically, although it has not been tested extensively. Another common surgical procedure performed near the AC joint is subacromial decompression (Fig. 10a, b). Although this procedure successfully attenuates or eliminates pain associated with arm elevation, one report  notes increased radiographic AC joint instability and tenderness in patients who have undergone arthroscopic subacromial decompression.
The fibrocartilaginous character of the entheses suggests that the insertion sites of the ligament are subject to both compressive and tensile loading and are regions of stress concentration. This probably reflects the complex shape of the scapula and the presence of a conspicuous indentation (the suprascapular notch) near the ligament. The loading patterns may reflect either the attachment of muscles and/or the forces transmitted to the suprascapular ligament from the neighbouring coracoclavicular ligament .
The result, then, of a downward force applied to the superior aspect of the acromion is either a lesion of the AC and coracoclavicular ligaments or clavicle fracture. There may be an additional anteroposterior direction to the force. AC joint injuries vary along a continuum of ligament injuries, beginning with a mild sprain of the AC ligaments and progressing through AC ligament tears, followed by stresses on the coracoclavicular ligament; and finally, if the downward force continues, tears of the deltoid and trapezius muscle attachments occur from the clavicle, as do ruptures of the coracoclavicular ligament (Fig.