The Journal of Bone and Joint Surgery, Vol 69, Issue 5 676-678, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
The weight-bearing shoulder. The impingement syndrome in paraplegics
JC Bayley, TP Cochran and CB Sledge
The cases of ninety-four patients who had complete paraplegia were studied
to determine whether they had complaints about the shoulder during transfer
activities. Thirty-one patients reported pain on transferring, and
twenty-three of these patients were found to have a chronic impingement
syndrome with subacromial bursitis. Arthrography of the shoulder was done
for each of these twenty-three patients, and fifteen were found to have a
tear of the rotator cuff. Five of the thirty-one patients were found to
have aseptic necrosis of the head of the humerus. We also measured the
intra-articular pressure in the shoulder in five patients during different
activities, including transfer from wheelchair to bed, and found that this
pressure exceeded the arterial pressure by two and one-half times. We
believe that this high pressure, in conjunction with abnormal distribution
of stress transmitted across the subacromial area during transfer or
propulsion of a wheelchair, contributes to the high rate of problems about
the shoulder in paraplegics.
CiteULike 
Connotea 
Del.icio.us 
Technorati What's this?
