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Open Surgery

Some operations can only be carried out through "open" incisions as it is not possible to perform them arthroscopically.

Fractures of the proximal humerus (ball) account for 5-15 % of all fractures. Majority of these occur in elderly individuals with osteoporosis, and are a cause of major morbidity. In younger individuals, these fractures occur after high-velocity trauma.

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The subscapularis is a most important muscle at the anterior (front) of the shoulder joint. It is often mentioned separately from the rest of the rotator cuff (supraspinatus, infraspinatus and teres minor) but is essentially part of this group of muscles.

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The shoulder consists of a ball (humeral head) and socket (glenoid). The ball is stabilized in the socket by a cartilage rim (“labrum”, which means “lip”) and the ligaments, which attach to the labrum.

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Shoulder dislocations occur when the ball (humeral head) of the shoulder is forced out of the socket (glenoid). Separation or dislocation can also occur of the smaller joint on top of the shoulder known as the AC joint (acromio-clavicular).

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The pectoralis major (large pectoral) is a large muscle on the front of the upper chest and arm.

There are 2 “heads” – the clavicular and sterno-costal.

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Shoulder joint replacement procedures are mostly done for osteo-arthritis of joints. In the normal joint, cartilage covers both bony surfaces of the ball and socket.

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The acromio-clavicular joint is between the clavicle (collar bone) and the acromion (shoulder bone). This injury usually results from a fall onto the tip of the shoulder or on to the back of the shoulder.

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This is the small joint on the top of the shoulder. It connects the tip of the clavicle (collar bone) to the acromion (shoulder bone). It is held together by ligaments between the two bones as well as strong ligaments between the collar bone and the coracoid (a protrusion from the shoulder blade).

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The clavicle is prone to fracture because of its very superficial localisation. A fall onto the arm, a lateral blow or a direct impact over the clavicle can cause a fracture.

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Suprascapular nerve injuries have become increasingly recognized as a cause of shoulder pain and dysfunction1. Recent advances in diagnostic and surgical techniques have simplified the management of injuries of this nerve

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The thoracic outlet is the upper aperture of the chest, between the collar bone and the first rib.This narrow passageway is crowded with blood vessels that run out of the chest to the arm (subclavian vein and artery), as well as the nerves that exit the spine in the neck to supply the arm.

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