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Shoulder fractures

Jennifer Kurowicki, Enesi Momoh, Jonathan C Levy
Periprosthetic humerus fractures are relatively uncommon occurrence that can be difficult to manage nonoperatively. Locking plate technology has enhanced the surgical management of these fractures. However, adequate fixation around the stem remains of some concern. We describe an osteosynthesis technique using a locking plate utilizing eccentrically placed screw holes to place "skive screws" in the proximal end of the plate to achieve fixation around the stem of the implant. A clinical series of 5 consecutive patients treated with this technique is presented with an average follow-up of 29 months (range, 12-48)...
November 2016: Journal of Orthopaedic Trauma
Nam Hong Choi, Seok Min Lim, Sang Young Lee, Tae Kang Lim
BACKGROUND: This study was conducted to report loss of reduction and complications after single-tunnel coracoclavicular (CC) ligament reconstruction with autogenous semitendinosus tendon graft for acute acromioclavicular (AC) joint dislocations. METHODS: This retrospective study included patients with acute, unstable AC dislocations (surgery within 6 weeks after trauma). We excluded patients with chronic injury and distal clavicle fractures with CC ligaments disruption...
October 17, 2016: Journal of Shoulder and Elbow Surgery
Markus Rupp, Jendrik Hardes, Michael J Raschke, Adrian Skwara
Hereditary multiple exostosis (HME) is an autosomal dominant disorder characterized by two or more benign growing, cartilage capped tumors of long bones called osteochondromas. If abnormal growth and clinical symptoms of osteochondromas newly appear in adults, malignant transformation of the usually benign growing tumors should be suspected and diagnostic testing should be initiated. Against the background of hypothesized higher malignant transformation of osteochondromas into chondrosarcoma in individuals with shoulder exostoses, we report a case of bilateral scapulothoracic osteochondromas in a patient suffering from HME...
September 19, 2016: Orthopedic Reviews
H H G Handoll, S D Brealey, L Jefferson, A Keding, A J Brooksbank, A J Johnstone, J J Candal-Couto, A Rangan
OBJECTIVES: Accurate characterisation of fractures is essential in fracture management trials. However, this is often hampered by poor inter-observer agreement. This article describes the practicalities of defining the fracture population, based on the Neer classification, within a pragmatic multicentre randomised controlled trial in which surgical treatment was compared with non-surgical treatment in adults with displaced fractures of the proximal humerus involving the surgical neck...
October 2016: Bone & Joint Research
Beigang Fu
OBJECTIVES: The aim of this study was to evaluate clinical results of a new design titanium elastic nail (TEN) for displaced midshaft clavicular fractures. PATIENTS AND METHODS: Between February 2012 and December 2013, a total 36 patients with displaced midshaft clavicular fractures were treated with intramedullary nailing stabilization with our new design TEN. Blood loss, mean times of operation, postoperative complications, hospital stays and time to bone union was recorded...
October 15, 2016: Acta Orthopaedica et Traumatologica Turcica
Kristi Reynolds, Daichi Shimbo, C Barrett Bowling, Luqin Deng, Adam Bress, John Sim, Paul Muntner
OBJECTIVE: To identify risk factors for serious fall injuries following initiation of antihypertensive medication among older adults. DESIGN AND METHOD: We conducted a retrospective cohort study using a 5% random sample of people with Medicare health insurance, a government program for older US adults. The analysis was restricted to patients with a diagnosis of hypertension who initiated antihypertensive medication between 2007 and 2011. Initiation was defined by the first antihypertensive medication fill in this time period preceded by 365 days with no antihypertensive medication fills...
September 2016: Journal of Hypertension
Jonathan J E White, John R Soothill, Marie Morgan, David I Clark, Marius P Espag, Amol A Tambe
BACKGROUND: A large metaphyseal volume shoulder hemiarthroplasty has been in use within our department since 2008; however, no clinical outcome data are available for this prosthesis apart from the designer surgeon series. MATERIALS AND METHODS: During a 5-year period, data were collected for 40 patients (30 women, 10 men) treated consecutively with the Zimmer Anatomical Shoulder Fracture hemiarthroplasty system (Zimmer, Warsaw, IN, USA). RESULTS: The final analysis included 26 patients...
October 10, 2016: Journal of Shoulder and Elbow Surgery
Kiran C Mahabier, Dennis Den Hartog, Nina Theyskens, Michael H J Verhofstad, Esther M M Van Lieshout
BACKGROUND: The Disabilities of the Arm, Shoulder and Hand (DASH) and Constant-Murley scores are commonly used instruments. The DASH is patient-reported, and the Constant-Murley combines a clinician-reported and a patient-reported part. For patients with a humeral shaft fracture, their validity, reliability, responsiveness, and minimal important change (MIC) have not been published. This study evaluated the measurement properties of these instruments in patients who sustained a humeral shaft fracture...
October 10, 2016: Journal of Shoulder and Elbow Surgery
Erhan Şükür, Yusuf Öztürkmen, Yunus Emre Akman, Mustafa Güngör
OBJECTIVE: The aim of this study was to analyze the clinical and functional results of hook plate fixation in Neer type 2 distal clavicle fractures. METHODS: We retrospectively analyzed 16 patients (11 males, 5 females) who were diagnosed with Neer type 2 distal clavicle fractures and treated with hook plate fixation between 2013 and 2014. Mean age was 38 (range: 27-61), and mean follow-up time was 14.3 (range: 12-18) months. Complications seen on radiographs were implant failure and subacromial osteolysis...
October 11, 2016: Acta Orthopaedica et Traumatologica Turcica
Alex Charles Fox, Daniel R Martin
Inferior dislocation (luxatio erecta) is the most uncommon form of dislocation of the glenohumeral joint. The chance that a person endures the specific direction of forces to dislocate both shoulders simultaneously makes bilateral luxatio erecta even more uncommon. In this article, we report the case of a man who sustained bilateral luxatio erecta when he jumped from a falling scaffold and tried grabbing onto another structure.
September 2016: American Journal of Orthopedics
Thomas Westphal, Stephan Woischnik, Daniela Adolf, Helmut Feistner, Stefan Piatek
BACKGROUND: Axillary nerve injuries after shoulder surgery are rare. In most studies, the frequency of injury is usually determined using clinical examinations, but results from intraoperative neuromonitoring studies have revealed higher than expected rates. Few studies have investigated this topic. Our aim was to determine the frequency of axillary nerve lesions after open reduction and internal fixation of proximal humeral fractures by using electrophysiological assessments and to provide a review of the relevant literature...
October 7, 2016: Journal of Shoulder and Elbow Surgery
Bauke W Kooistra, W Jaap Willems, Eelke Lemmens, Bas P Hartel, Michel P J van den Bekerom, Derek F P van Deurzen
BACKGROUND: Compared with total shoulder arthroplasty (TSA), total shoulder surface replacement (TSSR) may offer the advantage of preservation of bone stock and shorter surgical time, possibly at the expense of glenoid component positioning and increasing lateral glenohumeral offset. We hypothesized that in patients treated for osteoarthritis with a sufficient rotator cuff, TSA and TSSR patients have comparable functional outcome, glenoid component version, and lateral glenohumeral offset...
October 7, 2016: Journal of Shoulder and Elbow Surgery
Jorge Delgado, Diego Jaramillo, Nancy A Chauvin
Increased physical activity in childhood has resulted in a large number of sports-related injuries. Although there is overlap between the sports-related injuries seen in pediatric and adult patients, important differences exist in the injury patterns of pediatric patients. These differences are related to the continuous changes in the developing skeleton and its relationship with adjacent soft tissues. The imbalance in strength between the growing bones and the nearby tendons and ligaments makes the bones prone to acute and chronic injuries...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Laurent Obert, Christelle Peyron, Etienne Boyer, Gauthier Menu, François Loisel, Sébastien Aubry
INTRODUCTION: The shoulder arthroplasty brings satisfaction to patients in terms of quality of life and indolence. However whether anatomic implant or reverse, it does not escape from the loosening of the glenoid component. Moreover, optimal implantation is required to ensure the functional outcome without shortening of the arm. The purpose of this study is obtain CT scan evaluation of the glenoid bone stock in order to optimize glenoid component implantation and obtain a reference to determine optimal humeral component placement in case of humeral proximal fracture...
2016: SICOT-J
Lisa K Schroder, Erich M Gauger, Jeffrey A Gilbertson, Peter A Cole
BACKGROUND: This study's purpose was to assess patient-based functional outcomes following open reduction and internal fixation (ORIF) of displaced scapular body and glenoid neck fractures. This series represents a 9-year experience at a level-I trauma center and referral destination for this injury. METHODS: A database was established to record surgical and functional outcomes of scapular fractures treated with ORIF. For this report, the cases of all patients who had a glenoid neck or scapular body fracture (AO/OTA 14-A3 or 14-C1) without intra-articular involvement were reviewed...
October 5, 2016: Journal of Bone and Joint Surgery. American Volume
Won-Taek Oh, Yun-Rak Choi, Ho-Jung Kang, Il-Hyun Koh, Kyung-Han Lim
PURPOSE: To compare union rates and clinical and radiological outcomes of arthroscopic-assisted reduction and fixation with those of open reduction and fixation in patients with trans-scaphoid perilunate fracture dislocations. METHODS: This retrospective study included consecutive patients with trans-scaphoid PLFDs who underwent arthroscopic-assisted reduction and fixation (group A) or open reduction and fixation (group O), and who were followed up for a minimum of 2 years between May 2005 and March 2013...
October 1, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Tejas Upasani, Abhinav Bhatnagar, Sonu Mehta
INTRODUCTION: Shoulder dislocations are a very common entity in routine orthopaedic practice. Chronic unreduced anterior dislocations of the shoulder are not very common. Neurological and vascular complications may occur as a result of an acute anterior dislocation of the shoulder or after a while in chronic unreduced shoulder dislocation. Open reduction is indicated for most chronic shoulder dislocations. We report a case of neglected bilateral anterior shoulder dislocation with bilateral displaced greater tuberosity fracture...
April 2016: Journal of Orthopaedic Case Reports
Naveen Sharma, Avinash Mandloi, Ashish Agrawal, Shailendra Singh
INTRODUCTION: The clavicle, humerus and acromioclavicular (AC) joint separately are very commonly involved in traumatic injuries around the shoulder. Acromioclavicular joint dislocation with distal clavicle fracture is a well recognized entity in clinical practice. AC joint dislocation with mid shaft clavicle fracture is uncommon and only few cases have been reported in literature. However, to the best of our knowledge, this is the first case report to describe an acromioclavicular dislocation with ipsilateral mid shaft clavicle, mid shaft humerus and coracoid process fracture...
April 2016: Journal of Orthopaedic Case Reports
Michael E Steinhaus, David M Dare, Lawrence V Gulotta
The treatment of displaced proximal humerus fractures is challenging and complex, as its success is predicated on multiple factors. While it is clear that a majority of proximal humerus fractures may be treated nonoperatively, it is less clear which patients benefit from surgical management. The PROFHER trial, a randomized controlled study, used patient-reported outcomes to compare surgical to nonsurgical management of displaced proximal humerus fractures. The purpose of this review is to highlight the strengths and weaknesses of the PROFHER trial and to assess the validity of its conclusion in the context of existing literature...
October 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Yasuhiro Yamauchi, Hideo Yasunaga, Yukiyo Sakamoto, Wakae Hasegawa, Hideyuki Takeshima, Hirokazu Urushiyama, Taisuke Jo, Hiroki Matsui, Kiyohide Fushimi, Takahide Nagase
BACKGROUND AND OBJECTIVE: COPD is well known to frequently coexist with osteoporosis. Bone fractures often occur and may affect mortality in COPD patients. However, in-hospital mortality related to bone fractures in COPD patients has been poorly studied. This retrospective study investigated in-hospital mortality of COPD patients with bone fractures using a national inpatient database in Japan. METHODS: Data of COPD patients admitted with bone fractures, including hip, vertebra, shoulder, and forearm fractures to 1,165 hospitals in Japan between July 2010 and March 2013, were extracted from the Diagnosis Procedure Combination database...
2016: International Journal of Chronic Obstructive Pulmonary Disease
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