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elbow surgery

Young W Kwon, Joseph D Zuckerman
Although total shoulder arthroplasty (TSA) is generally associated with good to excellent outcomes in most patients, the integrity and function of the subscapularis tendon (SSC) is of paramount importance because SSC rupture after TSA can lead to inferior outcomes. Therefore, the efficacy of a SSC-sparing TSA procedure was evaluated through a prospective, double-blinded, randomized study. Patients with end-stage osteoarthritis of the shoulder were randomized into 2 groups. Group 1 patients were treated with TSA in which the prosthesis was inserted entirely through the rotator interval without violating the SSC tendon (SPARING)...
November 13, 2018: Orthopedics
Charles A Thigpen, Ellen Shanley, Amit M Momaya, Michael J Kissenberth, Stefan J Tolan, John M Tokish, Richard J Hawkins
BACKGROUND: There is an ever-increasing demand for widespread implementation of patient-reported outcomes. However, adoption is slow owing to limitations in clinical infrastructure and resources within busy orthopaedic practices. Prior studies showed the single alpha-numeric evaluation (SANE) score to correlate at a single point in time with the American Shoulder and Elbow Surgeons (ASES) score. However, no study has validated the SANE in terms of test-retest reliability, responsiveness, or clinical utility...
November 12, 2018: American Journal of Sports Medicine
E R Wagner, M Hevesi, M T Houdek, R H Cofield, J W Sperling, J Sanchez-Sotelo
AIMS: Patients with a failed reverse shoulder arthroplasty (RSA) have limited salvage options. The aim of this study was to determine the outcome of revision RSA when used as a salvage procedure for a failed primary RSA. PATIENTS AND METHODS: We reviewed all revision RSAs performed for a failed primary RSA between 2006 and 2012, excluding patients with a follow-up of less than two years. A total of 27 revision RSAs were included in the study. The mean age of the patients at the time of revision was 70 years (58 to 82)...
November 2018: Bone & Joint Journal
Yuji Tomori, Mitsuhiko Nanno, Shinro Takai
To compare the clinical outcomes of 2 procedures, closed or mini-open reduction with percutaneous pinning (ORPP), for the treatment of supracondylar fractures of the humerus in children.Patients aged less than 15 years who had undergone surgery for supracondylar fracture of the humerus between 2004 and 2013 were identified. The case records and radiographs from 34 patients were reviewed. Twenty-one patients had undergone closed reduction followed by percutaneous pinning (CRPP), while 13 had undergone mini-open reduction through the anterior approach with percutaneous pinning (mini-ORPP)...
November 2018: Medicine (Baltimore)
Rodolfo Romero Pareja, Rafael Castro Delgado, Fernando Turégano Fuentes, Israel Jhon Thissard-Vasallo, David Sanz Rosa, Pedro Arcos González
BACKGROUND: In mass casualty incidents (MCI), death usually occurs within the first few hours and thus early transfer to a trauma centre can be crucial in selected cases. However, most triage systems designed to prioritize the transfer to hospital of these patients do not assess the need for surgery, in part due to inconclusive evidence regarding the value of such an assessment. Therefore, the aim of the present study was to evaluate the capacity of a new triage system-the Prehospital Advanced Triage Method (META)-to identify victims who could benefit from urgent surgical assessment in case of MCI...
November 7, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Shun-Wun Jhan, Wen-Yi Chou, Kuan-Ting Wu, Ching-Jen Wang, Ya-Ju Yang, Jih-Yang Ko
BACKGROUND: Elbow arthroscopy had good functional outcome for throwing athletes. Returning to sports is a major concern for all athletes, but only a few reports have investigated the clinical factors related to the duration of returning to sports. The present study evaluates the efficacy of elbow arthroscopic surgery on throwing elbows with osteoarthritis and defines the clinical factors related to the duration of the returning to sports. METHODS: This was a retrospective study with fifteen active baseball throwing athletes with elbow osteoarthritis who were treated with elbow arthroscopy...
November 7, 2018: Journal of Orthopaedic Surgery and Research
Olga D Savvidou, Frantzeska Zampeli, George Georgopoulos, Leonidas Dimopoulos, Thekla Antoniadou, Ioannis Papanastassiou, Panayiotis J Papagelopoulos
Malignant tumors of the scapula are rare, and limb salvage surgery after tumor resection is challenging. The authors present a series of 6 patients who were treated by total scapulectomy and reconstruction with a custom-made scapular prosthesis and a constrained reverse shoulder arthroplasty. Postoperative oncologic and functional outcomes were assessed. The mean follow-up was 37 months (range, 9-84 months). Clear surgical margins were achieved in all patients. At the last follow-up, 4 patients showed no evidence of disease and 2 had died of systemic metastatic disease...
October 26, 2018: Orthopedics
Jayme Augusto Bertelli, Francisco Soldado, Alfonso Rodrígues-Baeza, Marcos Flávio Ghizoni
PURPOSE: With ulnar nerve injuries, paralysis of the first dorsal interosseous (FDI) and the adductor pollicis (ADP) muscles weakens pinch. The likelihood that these muscles will be reinnervated following ulnar nerve repair around the elbow is very low. To overcome this obstacle, we propose a more distal repair: transferring the opponens pollicis motor branch (OPB) to the terminal division of the deep branch of the ulnar nerve (TDDBUN). METHODS: We dissected 10 embalmed hands to study the anatomy of the thenar branches of the median nerve and TDDBUN...
October 23, 2018: Journal of Hand Surgery
J Guillou, C Pougès, M Limousin, G Strouck, C Fontaine
Lateral epicondylitis is a condition whose pathophysiology is poorly understood and whose optimal treatment divides physicians. Arthroscopy has proven its worth, with results similar to or better than open surgery. The purpose of this study was to look for prognostic factors for the outcomes of arthroscopic treatment of lateral epicondylitis. This was a retrospective, single-center study involving 39 cases (36 patients). Patients were split into two groups based on the Mayo Elbow Performance score (MEPS). A good result was defined as a score of 75 or better...
October 20, 2018: Hand Surgery and Rehabilitation
Lina Bunketorp Käll, Jan Fridén, Malin Björnsdotter
CONTEXT/OBJECTIVE: Spinal cord injury (SCI) causes atrophy of brain regions linked to motor function. We aimed to estimate cortical thickness in brain regions that control surgically restored limb movement in individuals with tetraplegia. DESIGN: Cross-sectional study. SETTING: Sahlgrenska University hospital, Gothenburg, Sweden. PARTICIPANTS: Six individuals with tetraplegia who had undergone surgical restoration of grip function by surgical transfer of one elbow flexor (brachioradialis), to the paralyzed thumb flexor (flexor pollicis longus)...
October 23, 2018: Journal of Spinal Cord Medicine
Hao-Min Cui, Ya-Ling Yu, Yu He, Ling-Zhi Kong, Cun-Yi Fan
BACKGROUND: The purpose of our study was to evaluate the functional outcomes and oncologic results of elbow salvage surgery using arthrolysis combined with ligament repair and external fixation for reconstruction of the elbow after tumor excision and autografting. METHODS: We retrospectively reviewed 6 patients with elbow dysfunction associated with giant cell tumor of the distal humerus. All patients were treated with our combined protocol. We assessed the Musculoskeletal Tumor Society system score, range of motion, Mayo Elbow Performance Score, recurrence, and complications for each patient...
October 19, 2018: Journal of Shoulder and Elbow Surgery
Christian Spross, Wouter Jak, Roger P van Riet
BACKGROUND: The aim of this study was to analyze indications, outcomes, and complications in patients treated with radiocapitellar arthroplasty. METHODS: This prospective analysis of clinical and radiographic results included 16 elbows in 15 patients. RESULTS: This study included 4 men and 11 women (mean age, 51.9 years; age range, 32-65 years). The mean follow-up period was 3.4 years (range, 2-6 years). The indications were post-traumatic (n = 10) and primary radiohumeral osteoarthritis (n = 6)...
October 19, 2018: Journal of Shoulder and Elbow Surgery
Ryan C Rauck, Ishaan Swarup, Brenda Chang, David M Dines, Russell F Warren, Lawrence V Gulotta, R Frank Henn
BACKGROUND: The purpose of this study was to determine the effect of preoperative expectations on outcomes after reverse shoulder arthroplasty (RSA). We hypothesized that patients with greater expectations would have better outcomes. METHODS: Patients undergoing primary RSA completed the Hospital for Special Surgery's Shoulder Expectations Survey preoperatively. Preoperative and 2-year postoperative clinical outcomes were measured with the American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form, Shoulder Activity Scale (SAS), 36-Item Short Form Health Survey (SF-36), and visual analog scales (VASs)...
November 2018: Journal of Shoulder and Elbow Surgery
M A Verdano, D Aliani, C Galavotti, C Maroun, E Vaienti, F Ceccarelli
PURPOSE: The aim of this study is to retrospectively compare clinical and radiographic outcomes of patients treated with non-lateralizing reverse shoulder arthroplasty (RSA) and with humeral lateralizing RSA after proximal humerus fracture (PHF). METHODS: In total, 32 patients (8 men and 24 women), with a mean age of 77.4 (67-92), have been reevaluated (follow-up of 14.3 months) and divided into Grammont group (G-group-16 patients, 2 men and 14 women, mean age 82...
October 2018: Musculoskeletal Surgery
M Bartoli, L A Pederzini, G Severini, F Serafini, M Prandini
PURPOSE: This study aims to clinically evaluate, at mid-term follow-up, a group of patients treated by the senior author in the last 6 years with our anatomical double-bundle reconstruction surgical technique for the medial ulnar collateral ligament (M-UCL) insufficiency. METHODS: In this study, we included only patients affected by chronic valgus elbow instability, diagnosed with an accurate clinical evaluation combined with an MRI, without associated fractures that had been surgically treated in the past and without additional instability detected during the first checkup and in the preoperative evaluation under anesthesia...
October 2018: Musculoskeletal Surgery
M Le Hanneur, A Cambon-Binder, Z Belkheyar
Our aims were to study the anatomical feasibility of triceps brachii long head (TBLH) transfer to the extensor digitorum communis (EDC) and extensor pollicis longus (EPL) tendons through a medial route, and to report on its first clinical application. Dissections were conducted on 10 fresh-frozen cadaver specimens. Using a posteromedial approach, the TBLH was separated from the remaining triceps and extended distally with a fascia lata strip. This strip was then tunneled through a medial route and secured distally to the EDC and EPL tendons...
October 18, 2018: Hand Surgery and Rehabilitation
Jens Nestorson, Hans Rahme, Lars Adolfsson
BACKGROUND: Primary prosthetic replacement has become an accepted method for the treatment of complex distal humeral fractures. The present study investigated implant survival and adverse events related to this procedure based on available Swedish registries and examined the completeness of the Swedish Elbow Arthroplasty register. MATERIALS AND METHODS: Patients treated in Sweden with a primary elbow replacement due to a distal humeral fracture between 1999 and 2014 were identified through 3 different registries: The Swedish Elbow Arthroplasty Register, National Board of Health and Welfare inpatient register, and local registries of all orthopedic departments...
October 17, 2018: Journal of Shoulder and Elbow Surgery
R J Molenaars, B J A Schoolmeesters, J Viveen, B The, D Eygendaal
PURPOSE: Allografts play an important role in tendon, ligament, and bone reconstruction surgery, particularly when suitable available autologous tissue is limited. Enthusiasm for the use of allografts in reconstructive orthopedic surgery has increased over the past decade, with an increase in allograft use in a variety of procedures. The purpose of this review is to provide an overview of the various applications and indications for the use of allografts in reconstructive surgical procedures of the elbow and forearm...
October 19, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Marie Caroline Merlet, Anthony M Vaichinger, Akin Cil, Shawn W O'Driscoll
BACKGROUND: Patients missing the distal humeral condyles are prone to premature bushing wear after total elbow arthroplasty. A midterm study has demonstrated that a custom triflange outrigger ulnar component was successful in preventing this. The aim of this study was to determine whether these results remained stable over time. MATERIALS AND METHODS: The outcomes of 6 patients who underwent revision of a loose ulnar component using a custom triflange outrigger component were reviewed in this retrospective case study...
November 2018: Journal of Shoulder and Elbow Surgery
Weijuan Zhu, Riyong Zhou, Lulu Chen, Yuanqing Chen, Lvdan Huang, Yun Xia, Thomas J Papadimos, Xuzhong Xu
BACKGROUND: Proximal brachial plexus blocks can lead to an extended period of motor paralysis and delay the return of motor function. This could influence patient satisfaction, and extend hospitalizations. The aim of the study is to compare a selective distal nerve block of the arm to a proximal axillary block, both ultrasound-guided, in terms of their motor block intensity of the elbow. Our hypothesis is that a selective nerve block of the arm would result in a different motor block of the elbow, compared to the axillary block...
October 19, 2018: BMC Anesthesiology
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