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https://www.readbyqxmd.com/read/28070676/-upper-extremity-fractures-in-the-elderly
#1
Roland Biber, S Grüninger, H J Bail
Upper extremity fractures in the elderly are very frequent and second only to hip fractures in the group of fragility fractures. Their impact on mobility and functional decline seems to be underestimated especially when they occur in combination with lower extremity fractures. Fractures of the proximal humerus and the distal radius can often be treated conservatively; however, the indications for operative treatment must not be based on fracture morphology alone and due consideration should be given to all concomitant circumstances affecting functional aspects of patients...
January 9, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28063677/the-results-of-tension-band-rotator-cuff-suture-fixation-of-locked-plating-of-displaced-proximal-humerus-fractures
#2
Dave R Shukla, Steven McAnany, Christian Pean, Samuel Overley, Andrew Lovy, Bradford O Parsons
INTRODUCTION: The purpose of this study was to assess 1-year outcomes of patients with displaced proximal humerus fractures who underwent treatment with locked plate fixation with rotator cuff suture augmentation. METHODS: A total of 86 patients who had sustained 2, 3 and 4-part displaced proximal humerus fractures underwent locked plate fixation with multiple sutures placed in the cuff tendons. Clinical outcome variables included active forward elevation (AFE), active external rotation (AER), and Constant and American Shoulder and Elbow Surgeons (ASES) scores...
December 29, 2016: Injury
https://www.readbyqxmd.com/read/28058796/hox-gene-expression-in-the-specialized-limbs-of-the-iberian-mole-talpa-occidentalis
#3
Constanze Bickelmann, Wessel van der Vos, Merijn A G de Bakker, Rafael Jiménez, Saskia Maas, Marcelo R Sánchez-Villagra
Fossorial talpid moles use their limbs predominantly for digging, which explains their highly specialized anatomy. The humerus is particularly short and dorsoventrally rotated, with broadened distal and proximal parts where muscles attach and which facilitate powerful abductive movements. The radius and ulna are exceptionally robust and short. The ulna has an expanded olecranon process. The femur is generalized, but the fused tibia-fibula complex is short and robust. To understand the developmental bases of these specializations, we studied expression patterns of four 5' Hox genes in the fossorial Iberian mole (Talpa occidentalis)...
January 2017: Evolution & Development
https://www.readbyqxmd.com/read/28057631/ultimate-fracture-load-of-cadaver-proximal-humeri-correlates-more-strongly-with-mean-combined-cortical-thickness-than-with-areal-cortical-index-dexa-density-or-canal-to-calcar-ratio
#4
J G Skedros, C S Mears, W Z Burkhead
OBJECTIVES: This investigation sought to advance the work published in our prior biomechanical study (Journal of Orthopaedic Research, 2016). We specifically sought to determine whether there are additional easy-to-measure parameters on plain radiographs of the proximal humerus that correlate more strongly with ultimate fracture load, and whether a parameter resembling the Dorr strength/quality characterisation of proximal femurs can be applied to humeri. MATERIALS AND METHODS: A total of 33 adult humeri were used from a previous study where we quantified bone mineral density of the proximal humerus using radiographs and dual-energy x-ray absorptiometry (DEXA), and regional mean cortical thickness and cortical index using radiographs...
January 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28057011/functional-and-radiological-outcomes-of-a-minimally-invasive-surgical-approach-to-monostotic-fibrous-dysplasia
#5
Mamer S Rosario, Katsuhiro Hayashi, Norio Yamamoto, Akihiko Takeuchi, Shinji Miwa, Yuta Taniguchi, Hiroyuki Tsuchiya
BACKGROUND: Reports showing high recurrence rates for intralesional curettage and bone grafting have made the current treatment principle for fibrous dysplasia controversial. This study aimed to report the postoperative clinical outcomes from three minimally invasive surgical strategies we use for monostotic fibrous dysplasia (MFD). PATIENTS AND METHODS: Twelve patients with MFD presenting with no pathologic fracture or deformity and treated with one of three surgical strategies-plain open biopsy, plain alpha-tricalcium phosphate (ATP) reconstruction, and prophylactic bridge plating-were included...
January 5, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28050700/when-is-it-safe-to-reduce-fracture-dislocation-of-shoulder-under-sedation-proposed-treatment-algorithm
#6
Konrad Sebastian Wronka, Abhimanyu Ved, Khitish Mohanty
INTRODUCTION: Shoulder dislocations are common. It is known that incongruent shoulder should be promptly reduced. However, when associated with fracture of the proximal humerus, there is a clinical dilemma if reduction under sedation is a safe option. We wanted to establish when it is safe to attempt reduction of a shoulder fracture dislocation under sedation in emergency room. METHODS: This is a retrospective cohort study assessing consecutive patients presenting with a dislocation of a gleno-humeral joint with an associated fracture of the humerus between 2007 and 2015...
January 3, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28040077/closing-the-gap-a-novel-technique-for-humeral-shaft-nonunions-using-cup-and-cone-reamers
#7
Brian T Nickel, Mitchell R Klement, Marc J Richard, Robert Zura, Grant E Garrigues
INTRODUCTION: Nonunion following closed treatment of humeral shaft fracture is estimated to be 5.5%. Many surgical techniques have been described to address humeral shaft nonunion including: open reduction, internal fixation (ORIF) with compression plating and bone graft, dual plating, cortical strut allograft and autograft, and adding biologic augmentation (BMP). The current standard of care includes ORIF with compression plating and bone grafting, but even this technique has an approximated 10% failure rate...
December 2016: Injury
https://www.readbyqxmd.com/read/28040076/glenohumeral-arthritis-as-a-risk-factor-for-proximal-humerus-nonunion
#8
Mitchell R Klement, Brian T Nickel, Abiram Bala, Colin T Penrose, Robert D Zura, Grant E Garrigues
BACKGROUND: Proximal humerus fractures are common injuries and nonsurgical treatment has proven to yield good to excellent clinical results. A small percentage of these fractures go on to delayed or nonunion and the incidence and risk factors for this complication are poorly understood. We hypothesize that adjacent joint stiffness of the glenohumeral joint might lead to an increased rate of nonunion for proximal humerus fractures. METHODS: A search of the entire Medicare database from 2005 to 2011 was performed to identify 38,754 patients who sustained a proximal humerus fracture including 13,802 with co-existing ipsilateral shoulder osteoarthritis (OA) and 24,952 with co-existing diagnosis of rheumatoid arthritis (RA)...
December 2016: Injury
https://www.readbyqxmd.com/read/28040072/biomechanical-testing-to-evaluate-the-cut-through-resistance-of-intramedullary-nails-for-the-proximal-humerus
#9
Maximilian Wanzl, Peter Foehr, Ulrich Schreiber, Rainer H Burgkart, Andreas Lenich
Intramedullary nailing for stabilization of proximal humeral fractures is well-established. Complications as part of a cut-through, such as backing out of locking screws, loss of reduction, and perforation of the screws into the glenoid, are equally well-known. The test bench presented in this study enables testing of the cut-through behavior of multiple intramedullary implants on a simulated osteoporotic three-part fracture configuration with three different loading circumstances (A, B and C). In situation A, the glenohumeral dynamic force with progressive loadings entered at an angle of 15° to the humeral shaft...
December 2016: Injury
https://www.readbyqxmd.com/read/28040071/proximal-humeral-fractures-non-operative-treatment-versus-intramedullary-nailing-in-2-3-and-4-part-fractures
#10
Mirjam Lange, Daniel Brandt, Thomas Mittlmeier, Georg Gradl
BACKGROUND: Little is known about non-operative treatment of proximal humerus 4-part and severe displaced fractures as those are normally treated operatively. In this study, we present a historical collective of two level I trauma centers, where all humeral head fractures, despite displaced fractures, received non-operative treatment within a 10 years period. Functional and clinical results of 2-, 3- and 4-part fractures were compared to those after fixed angle intramedullary nailing by matched pair analysis...
December 2016: Injury
https://www.readbyqxmd.com/read/28026728/-influence-of-the-weather-on-the-incidence-of-fractures-in-the-elderly
#11
F Burget, O Foltán, J Kraus, K Kudrna, M Novák, J Ulrych
PURPOSE OF THE STUDY The incidence of geriatric fractures (proximal femur, distal radius, proximal humerus and thoracolumbar spine injuries) in the population increases with ageing. However, the role of weather conditions, such as icy and slippery winter, should not be overlooked. A deeper insight into this relationship may bring about a better understanding of the fracture aetiology and thus allow for improvement in the prevention of fractures in elderly people. MATERIAL AND METHODS This prospective study included 676 patients (469 women and 207 men) aged 65 and over...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28018682/bent-metal-in-a-bone-a-rare-complication-of-an-emergent-procedure-or-a-deficiency-in-skill-set
#12
Mridula Krishnan, Katherine Lester, Amber Johnson, Kaye Bardeloza, Peter Edemekong, Ilya Berim
Intraosseous (IO) access is an important consideration in patients with difficult intravenous (IV) access in emergent situations. IO access in adults has become more popular due to the ease of placement and high success rates. The most common sites of access include the proximal tibia and the humeral head. The complications associated are rare but can be catastrophic: subsequent amputation of a limb has been described in the literature. We report a 25-year-old female presenting with diabetic ketoacidosis (DKA) in whom emergent IO access was complicated by needle bending inside the humerus...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28005168/peek-versus-titanium-locking-plates-for-proximal-humerus-fracture-fixation-a-comparative-biomechanical-study-in-two-and-three-part-fractures
#13
Benedikt Schliemann, Robert Seifert, Christina Theisen, Dominic Gehweiler, Dirk Wähnert, Martin Schulze, Michael J Raschke, Andre Weimann
INTRODUCTION: The high rigidity of metal implants may be a cause of failure after fixation of proximal humerus fractures. Carbon fiber-reinforced polyetheretherketone (PEEK) plates with a modulus similar to human cortical bone may help to overcome this problem. The present study assesses the biomechanical behavior of a PEEK plate compared with a titanium locking plate. MATERIALS AND METHODS: Unstable two- and three-part fractures were simulated in 12 pairs of cadaveric humeri and were fixed with either a PEEK or a titanium locking plate using a pairwise comparison...
December 22, 2016: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28002370/distinct-proximal-humeral-geometry-in-chinese-population-and-clinical-relevance
#14
Qiang Zhang, Lewis L Shi, Krishna C Ravella, Jason L Koh, Shaobai Wang, Cailong Liu, Guoan Li, Jianhua Wang
BACKGROUND: Replicating humeral anatomy during shoulder arthroplasty is important for good patient outcomes. The proximal humeral geometry of the Chinese population has been rarely reported. We analyzed the geometry of the proximal part of the humerus in Chinese subjects and compared it with that of Western populations and the dimensions of available prostheses. METHODS: Eighty healthy Chinese subjects underwent computed tomography (CT)-arthrography. Three-dimensional (3D) digital humeral and glenoid models were reconstructed, and geometric parameters were measured...
December 21, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27977497/internal-rotation-stress-testing-improves-radiographic-outcomes-of-type-3-supracondylar-humerus-fractures
#15
Jennifer M Bauer, Christopher M Stutz, Jonathan G Schoenecker, Steven A Lovejoy, Gregory A Mencio, Jeffrey E Martus
BACKGROUND: The purpose of this study was to determine if routine use of an intraoperative internal rotation stress test (IRST) for type 3 supracondylar humerus fractures will safely improve maintenance of reduction. METHODS: An intraoperative protocol for type 3 supracondylar humerus fractures was adopted at our institution, consisting of fracture reduction, placement of 2 laterally based divergent pins, and then an IRST to determine the need for additional fixation with a medial column pin placed through a small open approach...
December 13, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27966104/the-impact-of-the-new-national-bone-health-alliance-nbha-diagnostic-criteria-on-the-prevalence-of-osteoporosis-in-the-usa
#16
N C Wright, K G Saag, B Dawson-Hughes, S Khosla, E S Siris
: We evaluated the prevalence of osteoporosis using the osteoporosis diagnostic criteria developed by the National Bone Health Alliance (NBHA), which includes qualified fractures, FRAX score in addition to bone mineral density (BMD). The expanded definition increases the prevalence compared to BMD alone definitions; however, it may better identify those at elevated fracture risk. PURPOSE: The purpose of this paper is to estimate the prevalence of osteoporosis in US adults ≥50 years using the NBHA osteoporosis diagnostic criteria...
December 13, 2016: Osteoporosis International
https://www.readbyqxmd.com/read/27965047/biomechanical-comparison-of-orthogonal-versus-parallel-double-plating-systems-in-intraarticular-distal-humerus-fractures
#17
Ata C Atalar, Onur Tunalı, Ali Erşen, Mehmet Kapıcıoğlu, Yavuz Sağlam, Mehmet S Demirhan
OBJECTIVES: In intraarticular distal humerus fractures, internal fixation with double plates is the gold standard treatment. However the optimal plate configuration is not clear in the literature. The aim of this study was to compare the biomechanical stability of the parallel and the orthogonal anatomical locking plating systems in intraarticular distal humerus fractures in artificial humerus models. METHODS: Intraarticular distal humerus fracture (AO13-C2) with 5 mm metaphyseal defect was created in sixteen artificial humeral models...
December 10, 2016: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/27942979/use-of-dual-energy-computed-tomography-to-measure-skeletal-wide-marrow-composition-and-cancellous-bone-mineral-density
#18
Luke Arentsen, Karen E Hansen, Masashi Yagi, Yutaka Takahashi, Ryan Shanley, Angela McArthur, Patrick Bolan, Taiki Magome, Douglas Yee, Jerry Froelich, Susanta K Hui
Temporal and spatial variations in bone marrow adipose tissue (MAT) can be indicative of several pathologies and confound current methods of assessing immediate changes in bone mineral remodeling. We present a novel dual-energy computed tomography (DECT) method to monitor MAT and marrow-corrected volumetric BMD (mcvBMD) throughout the body. Twenty-three cancellous skeletal sites in 20 adult female cadavers aged 40-80 years old were measured using DECT (80 and 140 kVp). vBMD was simultaneous recorded using QCT...
December 9, 2016: Journal of Bone and Mineral Metabolism
https://www.readbyqxmd.com/read/27926680/humeral-retroversion-in-children-with-shoulder-internal-rotation-contractures-secondary-to-upper-trunk-neonatal-brachial-plexus-palsy
#19
Michael L Pearl, Michael Batech, Fabian van de Bunt
BACKGROUND: The most common sequela of neonatal brachial plexus palsy is an internal rotation contracture of the shoulder that impairs function and leads to skeletal deformation of the glenohumeral joint. Treatment options include release, transfers, and humeral osteotomy, all ultimately striving for better function through increased external rotation. Prior studies have shown that neonatal brachial plexus palsy alters humeral retroversion but with conflicting findings. We studied retroversion in children with internal rotation contractures from neonatal brachial plexus palsy to clarify its effect on version and surgical planning...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27914842/treatment-of-comminuted-proximal-humeral-fractures-using-locking-plate-with-strut-allograft
#20
Hongeun Cha, Ki-Beom Park, Seungbae Oh, Jinyoung Jeong
BACKGROUND: This study compared the radiologic outcome of fixation using locking plate only with fixation using locking plate with an endosteal strut allograft in the treatment of comminuted proximal humeral fracture. METHODS: Among 52 patients with comminuted proximal humeral fracture, 32 patients underwent fixation with locking plate only, and 20 patients underwent fixation using locking plate with an endosteal strut allograft. The strut allograft was inserted into the intramedullary cavity of the humerus to support the humeral head and fixed with the locking plate...
November 30, 2016: Journal of Shoulder and Elbow Surgery
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