This study is intended to follow immediately upon the previous one, firstly because the same material has been used for both, and secondly because the observations in both studies mutually illustrate one another.The object in the present work has been to find an answer to pathogenic questions through the study of clinical and anatomic material, the main subject of inquiry being: is rupture of the aponeurosis a disease due either to wear or old age, or are one or more distinct traumas the chief cause?From all the literature on the subject the following views may be noted in regard to the pathogenesis of ruptures of the tendon aponeurosis of the shoulder joint and of tendon ruptures in general.CODMAN is of the opinion that one or more traumas cause the rupture, and he has mentioned that an injury leading to subcoracoid luxation is especially likely to produce a rupture of the aponeurosis.When the head of the humerus is displaced downwards the upper portion of the tendon aponeurosis is pressed against the adjacent edge of the glenoid cavity and is stretched a t an angle over it.The part of the aponeurosis thereby affected depends on the rotation position of the arm.CODMAN considers that the capsule and the adjoining layers of tendinous tissue are here subjected to the greatest strain.However, he also states that age has a certain influence, seeing that the cases of rupture occur round about the age of 40 or later.In his histologic examinations CODMAN has found, amongst other signs, degenerative changes in the tendon aponeurosis of older patients, but not of the younger ones, and in very aged people he found in most cases rupture of the tendinous fibers at the synovial reflection.As regards bony changes, CODMAN sometimes found an irregularity of the bone tendon line, ))the blue line)), and, among manual ~~ ~
Copyright remains with the authors and publisher.
This study is intended to follow immediately upon the previous one, firstly because the same material has been used for both, and secondly because the observations in both studies mutually illustrate one another.The object in the present work has been to find an answer to pathogenic questions through the study of clinical and anatomic material, the main subject of inquiry being: is rupture of the aponeurosis a disease due either to wear or old age, or are one or more distinct traumas the chief cause?From all the literature on the subject the following views may be noted in regard to the pathogenesis of ruptures of the tendon aponeurosis of the shoulder joint and of tendon ruptures in general.CODMAN is of the opinion that one or more traumas cause the rupture, and he has mentioned that an injury leading to subcoracoid luxation is especially likely to produce a rupture of the aponeurosis.When the head of the humerus is displaced downwards the upper portion of the tendon aponeurosis is pressed against the adjacent edge of the glenoid cavity and is stretched a t an angle over it.The part of the aponeurosis thereby affected depends on the rotation position of the arm.CODMAN considers that the capsule and the adjoining layers of tendinous tissue are here subjected to the greatest strain.However, he also states that age has a certain influence, seeing that the cases of rupture occur round about the age of 40 or later.In his histologic examinations CODMAN has found, amongst other signs, degenerative changes in the tendon aponeurosis of older patients, but not of the younger ones, and in very aged people he found in most cases rupture of the tendinous fibers at the synovial reflection.As regards bony changes, CODMAN sometimes found an irregularity of the bone tendon line, ))the blue line)), and, among manual ~~ ~
Copyright remains with the authors and publisher.