Introduction. Many literatures regarding more specific tests to diagnose the supraspinatus tendon injuries and the best rehabilitation methods to strengthen the supraspinatus have been published. However, conflicting results have been reported. 2-deoxy-2-[18F] fluoro-D-glucose (FDG) positron emission tomography (PET) has been recently used to assess skeletal muscle activities in various fields. Purpose. To evaluate & compare the metabolic activities of deltoid & rotator cuff muscles after the full-can & empty-can exercises using PET-CT. Materials and Methods. Ten healthy volunteers (age 27–34/mean 29.8 ± 2.7) with no history of shoulder pain and diabetes mellitus participated in this study. After FDG injection, both arms were maintained in the position of empty can and full can for ten minutes respectively. PET-CT was performed at forty minutes after the injection. The maximum standardized uptake value (SUV) was measured in the anterior, middle and posterior deltoid, supraspinatus, subacapularis and infraspinauts on the entire axial images. Results. The middle deltoid and subscapularis showed significantly greater activity during the empty-can exercise than during the full-can exercise (P=.006 and P=.003 respectively). The muscular activity of the supraspinatus also increased during the empty-can exercise than during the full-can exercise, although no statistical difference existed between two exercises. Six cases of eight cases who had increased activity of the subscapularis had increased activity in superior one half of the subscapularis than in lower one half of it, although there is no significant difference between two portions. Conclusion. The Empty-can exercise requires more strength of the middle deltoid, subscapularis and supraspinatus to keep the arm in internal rotation. The increased activity of the middle deltoid and subscapularis muscles after the empty-can exercise can make the empty-can test less specific to the supraspinatus muscle. The empty-can test can induce pain and weakness due to the subscapularis pathology. The full-can test can be used to test the function of the supraspinatus with the least amount of surrounding middle deltoid and subacapularis muslce activity

We describe a series of 20 patients with ununited fractures of the femoral neck following neglected trauma or failed primary internal fixation who were seen at a mean of 7.5 months (2 to 18) following injury. Open reduction and internal fixation of the fracture was performed in all patients, together with a myoperiosteal flap on the quadratus femoris muscle pedicle.

Union occurred at a mean of 4.9 months (2 to 10) in all patients. The mean follow-up was for 70 months (14 to 144). There was no further progression in six of seven patients with pre-operative radiological evidence of osteonecrosis of the femoral head. One patient had delayed collapse and flattening of the femoral head ten years after union of the fracture, but remained asymptomatic.

This study demonstrates the orthopaedic application of myoperiosteal grafting for inducing osteogenesis in a difficult clinical situation.