Main description:

The "shoulder-hand syndrome" or pain in the shoulder or arm is an extremely vital subject for the multi-disciplinary approach and usually re quires more than one speciality for complete evaluation. The proceedings of this symposium - organized by the department of general surgery of the University of Limburg - cover the field thoroughly with contributions from outstanding specialists from all over the world. Rheumatological, neuro surgical, orthopedic, and traumatological aspects are covered. Vascular surgeons considering both venous and arterial problems entwine with thoracic surgeons to review the thoracic outlet problem. Establishing a diagnosis in this multi-disciplinary field is extremely important and encom passes a combination of disciplines including neurology, orthopedics, sur gery, and physical medicine. Likewise, the role of each contributing factor must be assessed when multiple sources were responsible for pain. In addition to adequate diagnosis, it is important to institute the appropriate therapy and to establish the proper priority and timing of such therapies. The follow-up techniques particularly regarding thoracic outlet syndrome are extremely important to provide an objective basis for evaluation. Although many advances have been made in the field of objective diagnosis and therapy, there still is a great deal of overlap and confusion which has to be clarified. Professor Greep and his organizing committee have done a wonderful job in composing a program covering all aspects of this field. They are to be congratulated on bringing us a "timely current status" report on pain in the shoulder and arm.

Contents:

I. Investigation and Diagnosis.- 1. Examination of the shoulder and treatment of the shoulder pain.- 2. Arthrography of the shoulder: technique, results, indications.- 3. Angiography of the upper extremity.- 4. Neurophysiological investigation of the arm.- 5. Brachialgia A differential diagnosis.- II. Causes of Pain in Shoulder and Arm.- 6. Shoulder pain as a rheumatologic problem.- 7. Radiological changes of the shoulder joint in rheumatoid arthritis and humero-scapular periarthritis.- 8. Orthopedic diagnosis in shoulder and arm pain.- 9. Traumatology of the shoulder region.- 10. Thrombosis of the axillary-subclavian vein.- 11. Primary axillary-subclavian vein thrombosis.- 12. Surgical therapy and results in arterial occlusive disease of the upper extremities.- III. Thoracic Outlet Syndrome.- 13. The diagnosis of thoracic outlet syndrome.- 14. The technique of measuring conduction velocity for thoracic outlet syndrome.- 15. The classical neurological syndrome associated with a cervical rib and band.- 16. Costo-clavicular compression: A review.- 17. New concepts in the etiology, diagnosis and surgical treatment of thoracic outlet syndrome.- 18. Diagnosis and management of arterial lesions in relation to the outlet compression syndrome.- 19. Costo-clavicular compression and dying digits.- IV. Treatment of Pain in Shoulder and Arm.- 20. The treatment of shoulder pain.- 21. Prostheses and alternatives of shoulder and elbow joints.- 22. Sympathectomy for the upper extremities anatomy, indications and technics.- 23. Thoracodorsal sympathectomy en bloc.- 24. Complete reconstruction of the subclavian vein following thrombotic occlusion at the costo-clavicular level.- 25. Lesions of the subclavian artery: reconstructive procedures.- 26. Operative management of vascular injuries of the thoracic outlet.- Index of subjects.