Adeline
Cipto Mangunkusumo Hospital, Indonesia
Abstract Title: Severe Scapularthoracic Muscles Atrophy in post Shoulder Hemiarthroplasty Surgery: A Case Report
Biography: Adeline is currently a resident physician in Physical Medicine and Rehabilitation Department at the Faculty of Medicine, University Indonesia. My residency programmes include comprehensive managemnt of patients with physical disabilities, muskuloskeletal conditions, and neurological impariments from geriatric to pediatric patients. Through rotations in CiptoMangunkuskumo National General Hospital and affliated centers, I gain extensive experience in rehabilitation medicine including neurorehabilitation, muskuloskeletal ultrasound, pediatric rehabilitation.
Research Interest: A 69-year-old man came with a limited range of motion of his right shoulder abduction, flexion and extension post hemiarthoplasty surgery due to closed fracture disclocation of right proximal humerus caused by traumatic fall. Prior to the ORIF surgery, the patient has the history of limited right shoulder range of motion due to radiotherapy of his nasopharyngeal cancer, with 90 degree of shoulder flexion and 100 degree of shoulder abduction. On physical examination the patient had excessive scapular protraction along with narrow glenohumeral joint, with hypotrophy of middle and lower trapezius muscle, and right rhomboid muscle. Ultrasonography examination of the right shoulder shows no significant periarticular pathology. Recent electromyography examination shows only denervation in axillary nerve, with 80% of recruitment, suggesting axillary nerve injury that has underwent healing process. Radiologic evaluation shows the implant of right shoulder hemiarthoplasty is in the correct position with increasing number of calus surrounding. Limited range of motion of right shoulder shows no remarkable changes. Integrated rehabilitation exercise programs composing of joint mobilization, flexibiity training, neuromuscular education and strengthening were administered to the patient