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Distal humerous

Yashwant Singh Tanwar, Yatinder Kharbanda, Atin Jaiswal, Vikas Birla, Ramsagar Pandit
INTRODUCTION: Coronal plane distal humeral injuries are relatively rare. Numerous classification systems have been proposed as the complexity of these fractures has been realized. We in the present series of ten patients describe the surgical technique of Open Reduction and Internal Fixation of Coronal plane fractures of the distal humerus with headless compression screws performed using the anterolateral approach. MATERIAL AND METHOD: It was a retrospective study, the data collected from March 2010 to 2015 was analysed and the final outcome was assessed using the DASH score...
2018: SICOT-J
Andy Morris, Kerstin Erles, Thomas W Maddox
A 2-year-old cat was presented with the complaint of acute-onset non-weight-bearing lameness of the right forelimb. When examined, the cat was of short stature and had multiple joint and cartilaginous abnormalities suggestive of chondrodysplasia. The cause of the acute lameness was radiographically identified as a displaced osseous fragment from the medial portion of the right humeral condyle. The features of the osseous fragment were consistent with an ununited medial condylar ossification centre of the distal humerus...
February 2018: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
Rony-Orijit Dey Hazra, Helmut Lill, Gunnar Jensen, Julia Imrecke, Alexander Ellwein
Around one third of humeral fractures and 2-6% of all fractures occur to the distal part of the humerus. There is a bimodal distribution differentiating between young male patients with high-energy and elderly female patients with low-energy trauma related to osteoporosis. The AO classification and Dubberley subclassification are used in daily routine. Most fractures are diagnosed on radiographs. For further evaluation, three-dimensional computed tomography is recommended, especially for comminuted or complex fractures...
2018: Obere Extremität
Ena Nielsen, Lindsay M Andras, David L Skaggs
BACKGROUND: In adults, a relative "safe zone" for lateral approaches to the elbow has been well described in efforts to reduce iatrogenic injury, typically a minimum of 6 cm proximal to the lateral epicondyle. To avoid iatrogenic injury to the radial nerve intraoperatively, we investigated the distance of the nerve from the distal humeral physis in children. METHODS: All patients who had axial and coronal T1-weighted magnetic resonance imagings of the humerus and elbow between 2005 and 2015 were eligible...
March 8, 2018: Journal of Pediatric Orthopedics
Andrew Chia Chen Chou, Ho Yin Kevin Wong, Sumanth Kumar, Arjandas Mahadev
BACKGROUND: Distal humerus physeal separations are rare pediatric elbow fractures that are often misdiagnosed and difficult to treat. Adequate reduction is often technically challenging and up to 71% of children develop postoperative cubitus varus. We propose using the medial and lateral humeral lines as an adjunct to elbow arthrography in order to guide intraoperative fixation of distal humerus physeal separations to reduce the incidence of postoperative cubitus varus. METHODS: From 2009 to 2014, all pediatric patients under the age of 3 diagnosed with a distal humerus physeal separation and treated surgically at our institution were included for analysis...
March 5, 2018: Journal of Pediatric Orthopedics
Andrew S Neviaser, Diana C Patterson, Paul J Cagle, Bradford O Parsons, Evan L Flatow
BACKGROUND: Biceps tenodesis reduces the incidence of Popeye deformity occurring with tenotomy, but pain may occur with tenodesis superior to or within the bicipital groove. Arthroscopic suprapectoral tenodesis is an attractive alternative. The purpose of this study was to establish landmarks for arthroscopic suprapectoral tenodesis and determine the appropriate fixation point to optimize muscle tension. METHODS: Twelve fresh cadaveric shoulders were dissected. Urethane polymer was injected into the axillary artery...
February 27, 2018: Journal of Shoulder and Elbow Surgery
Li-Ming Zhao, Dong-Mu Tian, Yue Wei, Jun-Hui Zhang, Zheng-Lin Di, Zhi-Yong He, Yong-Cheng Hu
OBJECTIVE: To study the biomechanical properties of a novel modular intercalary prosthesis for humeral diaphyseal segmental defect reconstruction, to establish valid finite element humerus and prosthesis models, and to analyze the biomechanical differences in modular intercalary prostheses with or without plate fixation. METHODS: Three groups were set up to compare the performance of the prosthesis: intact humerus, humerus-prosthesis and humerus-prosthesis-plate...
February 2018: Orthopaedic Surgery
D Schneidmueller, M Kertai, V Bühren, C von Rüden
INTRODUCTION: Kirschner wire osteosynthesis is considered to be the standard technique for surgical fixation of displaced supracondylar humeral and distal radial fractures in children. The Kirschner wires can be left exposed or buried under the skin. Advantages of the epicutaneous technique are, e. g. the efficiency (cost, effort) and the possibility for wire removal without the necessity of a second anesthesia. On the other hand, there is a concern about higher infection rates as well as traumatization of the children due to externally visible wires...
February 20, 2018: Der Unfallchirurg
Logan W Carr, Sebastian M Brooke, T Shane Johnson, Brett F Michelotti
Background: The lateral arm flap is used for composite defects in need of vascularized soft tissue, skin, and bone. From its original description, the distal humeral metaphysis can be included with the flap, supplied by the periosteal extensions of the posterior branch of the radial collateral artery. We sought to reexplore the anatomy of the lateral arm to determine its utility as a donor site for vascularized bone. Methods: Twelve fresh, silicone-injected cadaver dissections were performed...
January 2018: Plastic and Reconstructive Surgery. Global Open
Patrick B Morrissey, Ryan Myers, Daniel Houskamp, Leo T Kroonen
PURPOSE: Ulnohumeral arthroplasty, also known as the Outerbridge-Kashiwagi procedure, was popularized after reports of successful results in 1978, and has long been a means of management for ulnohumeral arthritis. However, there are concerns over the loss of integrity of the distal humerus as a result of fenestration. The purpose of this study was to examine the relationship between the size of fenestration and fracture risk. METHODS: Using a validated fourth-generation sawbones model, load to failure and site of fracture were investigated following incrementally increasing distal humeral fenestration sizes...
February 16, 2018: Journal of Hand Surgery
Yeming Wang, Jian Li, Jianhua Yang, Jingming Dong
BACKGROUND: Incidence of proximal humeral fractures dramatically increased over the last decade due to demographic changes. The goal of this study was to analyze regional characteristics of cortical bone in the humeral head region using cortical bone mapping (CBM) technique. METHODS: The proximal humerus of 103 healthy volunteers was imaged by clinical computed tomography (CT) scans. Three groups of volunteers were identified according to age: group A (20-39 years), group B (40-59 years), and group C (>60 years)...
February 16, 2018: Bone
Mohammadhadi Nouraei, Mehdi Motififar, Morteza Barazandeh
Background: In this study, functional state of patients with Type C distal humerus fractures undergone surgical plating was evaluated 6 and 12 months after the surgery in order to record postsurgical factors such as pain level and job/performance satisfaction. Materials and Methods: In this cross-sectional study, 46 patients with humerus fractures were recruited and their ability to do daily tasks, presence of degenerative changes, stability of elbow joint, and range of motion was evaluated...
2018: Advanced Biomedical Research
Chuan Zhang, Zuo-Jun Zhang, Lei Wang, Zhong-Xiao Chang, Lin-Ping Yang, Ming Zhao, Xing-Xing Li, Rui-Ping Feng, Guo-Jie Wang, Xiao-Bo Duan
OBJECTIVE: To explore the therapeutic effects of distal humeral lateral closing wedge osteotomy followed by modified pinning combined with external tension band fixation in the treatment of cubitus varus deformity in children. METHODS: Total 26 adult patients with cubitus varus deformity were treated by operation from March 2011 to June 2015, 15 patients were boys and the other 11 patients were girls, ranging in age from 4 to 13 years, with an average of 7.8 years...
August 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Samir Mehta, Matthew Chin, Jennifer Sanville, Surena Namdari, Michael W Hast
INTRODUCTION: In locked plate fixation of proximal humerus fractures, the calcar is an important anchor point for screws providing much-needed medial column support. Most locking plate implants utilize a fixed-trajectory locking screw to achieve this goal. Consequently, adjustments of plate location to account for patient-specific anatomy may result in a screw position outside of the calcar. To date, little is known about the consequences of "missing" the calcar during plate positioning...
February 11, 2018: Injury
Bill Oxley
OBJECTIVE: To report the use of a 3-dimensional (3D)-printed patient-specific reduction guide system to facilitate minimally invasive plate osteosynthesis (MIPO) of a humeral fracture in a cat. STUDY DESIGN: Case report. ANIMALS: A 9-year-old male neutered domestic short hair cat weighing 4.4 kg. METHODS: A 9-year-old male domestic short hair cat was presented with a comminuted, mid-diaphyseal left humeral fracture. Computed tomographic data were processed to yield 3D mesh representations of both humeri and subsequently manipulated in computer-aided design software...
February 15, 2018: Veterinary Surgery: VS
Thomas Amouyel, Yves-Pierre Le Moulec, Nicolas Tarissi, Mo Saffarini, Olivier Courage
Arthroscopic repair of the long head of the biceps (LHB) is performed to treat various biceps pathologies yet the choice between tenotomy or tenodesis remains controversial. Although tenotomy is simpler and quicker, tenodesis results in fewer complications, and there are several techniques available using various fixation devices and sites. This Technical Note describes an all-arthroscopic, suprapectoral tenodesis technique using a bioresorbable interference screw, without motorized devices to create the humeral tunnel in the bicipital groove...
October 2017: Arthroscopy Techniques
Carissa L Leischner, Michael Crouch, Kari L Allen, Damiano Marchi, Francisco Pastor, Adam Hartstone-Rose
It has been previously proposed that distal humerus morphology may reflect the locomotor pattern and substrate preferred by different primates. However, relationships between these behaviors and the morphological capabilities of muscles originating on these osteological structures have not been fully explored. Here, we present data about forearm muscle architecture in a sample of 44 primate species (N = 55 specimens): 9 strepsirrhines, 15 platyrrhines, and 20 catarrhines. The sample includes all major locomotor and substrate use groups...
March 2018: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
Anaïs Delgove, Romain Weigert, Vincent Casoli
BACKGROUND: The medial triceps brachii is vascularized by the middle collateral artery and the arterial circle of the elbow. This vascularization allows a distal pedicled use to cover soft tissue defects of the elbow. We report our experience using this flap to cover traumatic and postsurgical wounds. METHODS: Patients who underwent a pedicled medial triceps brachii flap procedure between 2008 and 2015 were included. Data concerning characteristics of the patients, wound size, surgical technique, and complications were retrospectively reviewed...
January 29, 2018: Journal of Shoulder and Elbow Surgery
Hiroshi Sasai, Daisuke Fujita, Eiko Seto, Yuki Denda, Yutaro Imai, Kanako Okamoto, Kensaku Okamura, Masaru Furuya, Hiroyuki Tani, Kazumi Sasai
OBJECTIVE To evaluate outcome of limb fracture repair in rabbits. DESIGN Retrospective case series. ANIMALS 139 client-owned rabbits with limb fractures treated between 2007 and 2015. PROCEDURES Medical records were reviewed for information on fracture location, fracture treatment, and time to fracture healing. RESULTS 25 rabbits had fractures involving the distal aspects of the limbs (ie, metacarpal or metatarsal bones, phalanges, and calcaneus or talus). Fractures were treated in 23 of these 25 rabbits (external coaptation, n = 17; external skeletal fixation, 4; and intramedullary pinning, 2) and healed in all 23, with a median healing time of 28 days (range, 20 to 45 days)...
February 15, 2018: Journal of the American Veterinary Medical Association
Selim Şanel, Yalçın Turhan, Nurullah Ermiş, Korhan Özkan, Ender Uğutmen
OBJECTIVES: Long head of the biceps tendon (LHB) is an obstacle to closed reduction in two-part fracture of the humeral surgical neck if the distal humeral shaft is displaced into the axilla in anteroposterior X-ray examination. METHODS AND MATERIAL: Among 36 proximal humeral fractures, 10 two-part humeral surgical neck fractures which were displaced into the axilla in anteroposterior X-ray views and classified as 11-A3.2 were included in this study. In all of these fractures, closed reduction attempts were unsuccessful...
January 23, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
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