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https://www.readbyqxmd.com/read/29158650/partial-humeral-replacement-for-peri-prosthetic-fractures-of-the-humerus
#1
Ruben Manohara, Colin R Howie
Introduction: Treating peri-prosthetic fractures of the humerus can be very challenging, especially when there is poor bone stock and in the presence of adjacent joint prostheses. We discuss the option of a partial humeral replacement as a salvage procedure for such cases with some technical comments. Methods: This paper presents a technique which utilises a custom- made cemented connector to incorporate the existing well functioning elbow or shoulder replacement with a commercially available partial humeral replacement (PHR) or to an existing prosthetic humeral stem...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29152005/humeral-head-replacement-and-reverse-shoulder-arthroplasty-for-the-treatment-of-proximal-humerus-fracturesm
#2
REVIEW
Aaron Andrew Frombach, Kendra Brett, Peter Lapner
Acute proximal humeral fractures in the elderly are generally treated non-operatively if alignment is acceptable and in stable fracture patterns. When operative treatment is indicated, surgical fixation is often difficult or impossible to obtain. Hemiarthroplasty has long been the standard of care. However, with its reliance on tuberosity healing, functional outcomes and patient satisfaction are often poor. Reverse shoulder arthroplasty has emerged as a new technology for treating proximal humeral fractures but the indications for its use remain uncertain...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29135565/pediatric-and-adolescent-anterior-shoulder-instability-clinical-management-of-first-time-dislocators
#3
Kenneth M Lin, Evan W James, Elad Spitzer, Peter D Fabricant
PURPOSE OF REVIEW: The purpose of this review is to discuss the epidemiology, pathoanatomy, diagnosis, and clinical management of pediatric and adolescent patients following a first-time shoulder dislocation. RECENT FINDINGS: Shoulder instability is becoming increasingly common as pediatric and adolescent patients engage in earlier organized sports competition. Recommended treatment following a first-time glenohumeral dislocation event in adolescents depends on several factors, but surgical stabilization is becoming more frequently performed...
November 11, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29128375/is-the-pectoralis-major-tendon-a-reliable-reference-for-restoration-of-humeral-length-with-fracture-hemiarthroplasty
#4
Beom-Soo Kim, Du-Han Kim, Kwang-Soon Song, Byung-Woo Min, Ki-Cheor Bae, Chul-Hyun Cho
BACKGROUND: The primary objective was to calculate and to apply the numeric value of the distance from the pectoralis major tendon insertion to the superior aspect of the humeral head (PMTD) without any radiation exposure or equipment through basic data such as age, sex, height, and weight of Asian populations. METHODS: We analyzed shoulder magnetic resonance images of 260 patients (107 men and 153 women; average age, 59.8 years). The superior border of the pectoralis major was identified on the transverse section and cross-referenced with the coronal section...
November 8, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29122116/mipo-of-proximal-humerus-fractures-through-an-anterolateral-acromial-approach-is-the-axillary-nerve-at-risk
#5
Josip Knežević, Mario Mihalj, Fabijan Čukelj, Arsen Ivanišević
PURPOSE: It is known that shoulder surgery may cause iatrogenic injury to the axillary nerve as a serious complication, but there is little evidence to indicate whether the axillary nerve is at risk of injury during an anterolateral acromial approach for minimally-invasive plate osteosynthesis (MIPO) of proximal humerus fractures. We hypothesised that this surgical method is safe for the axillary nerve and would preserve it from iatrogenic injury. MATERIALS AND METHODS: We conducted a prospective follow-up cohort study on 49 consecutive patients with proximal humerus fractures who were managed with MIPO through an anterolateral approach...
November 2017: Injury
https://www.readbyqxmd.com/read/29116358/humeral-head-inferior-subluxation-in-proximal-humerus-fractures
#6
Stefano Carbone, Matteo Papalia, Valerio Arceri, Stefano Placidi, Andrea Carbone, Riccardo Mezzoprete
PURPOSE: The objectives of this study are to propose a reliable radiologic method for detecting static inferior subluxation of humeral head, to calculate the relative intra- and inter-observer reliability, and to evaluate its presence pre- and post-surgery. METHODS: This is a retrospective observational study of patients surgically treated for a fracture of the proximal humerus. Fractures were classified using Codman-Lego criteria (radiographic, CT images), osteoporosis was assessed...
November 7, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29103059/fatty-degeneration-of-the-deltoid-muscle-associated-with-displaced-proximal-humerus-fractures
#7
M Panzica, J Brandes, U Schmiddem, A Karch, N Hawi, C Krettek, R Meller
INTRODUCTION: The use of reverse shoulder arthroplasty (RSA) has increased dramatically over the last two decades, with many surgeons now indicating RSA for the acute management of displaced proximal humerus fractures (PHF) in the elderly. RSA relies on adequate deltoid muscle function to obtain a good outcome, yet no literature to date exists which discusses preoperative assessment of deltoid structure prior to RSA. The purpose of this study was to assess for preoperative fatty deltoid-degeneration in patients with displaced PHF...
October 23, 2017: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/29102769/a-scale-space-curvature-matching-algorithm-for-the-reconstruction-of-complex-proximal-humeral-fractures
#8
Lazaros Vlachopoulos, Gábor Székely, Christian Gerber, Philipp Fürnstahl
The optimal surgical treatment of complex fractures of the proximal humerus is controversial. It is proven that best results are obtained if an anatomical reduction of the fragments is achieved and, therefore, computer-assisted methods have been proposed for the reconstruction of the fractures. However, complex fractures of the proximal humerus are commonly accompanied with a relevant displacement of the fragments and, therefore, algorithms relying on the initial position of the fragments might fail. The state-of-the-art algorithm for complex fractures of the proximal humerus requires the acquisition of a CT scan of the (healthy) contralateral anatomy as a reconstruction template to address the displacement of the fragments...
October 27, 2017: Medical Image Analysis
https://www.readbyqxmd.com/read/29098354/-total-elbow-arthroplasty-in-traumatic-and-post-traumatic-bone-defects
#9
REVIEW
M Hackl, L P Müller, T Leschinger, K Wegmann
Total elbow arthroplasty is currently most commonly carried out due to acute trauma or post-traumatic conditions. Bone defects are often present and must be considered in the (pre-)operative workup. The use of semi-constrained prostheses with a systematic cementing technique through a triceps-on approach leads to satisfying clinical results, however, the outcome is worse when compared with rheumatic patients.Primary total elbow arthroplasty for complex distal humerus fractures in the elderly patient or secondary implantation following failed conservative treatment or osteosynthesis represent possible indications for (post‑)traumatic joint replacement...
November 2, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/29066532/impact-of-the-profher-trial-findings-on-surgeons-clinical-practice-an-online-questionnaire-survey
#10
L Jefferson, S Brealey, H Handoll, A Keding, L Kottam, I Sbizzera, A Rangan
OBJECTIVES: To explore whether orthopaedic surgeons have adopted the Proximal Fracture of the Humerus: Evaluation by Randomisation (PROFHER) trial results routinely into clinical practice. METHODS: A questionnaire was piloted with six orthopaedic surgeons using a 'think aloud' process. The final questionnaire contained 29 items and was distributed online to surgeon members of the British Orthopaedic Association and British Elbow and Shoulder Society. Descriptive statistics summarised the sample characteristics and fracture treatment of respondents overall, and grouped them by whether they changed practice based on PROFHER trial findings...
October 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/29054991/the-influence-of-bone-mineral-density-and-cortical-index-on-the-complexity-of-fractures-of-the-proximal-humerus
#11
J W A M den Teuling, B S Pauwels, L Janssen, C E Wyers, H M J Janzing, J P W van den Bergh, J W Morrenhof
OBJECTIVES: The goal of this study is to investigate the relation between indicators of osteoporosis (i.e., bone mineral density (BMD), and Cortical Index (CI)) and the complexity of a fracture of the proximal humerus as a result of a low-energy trauma. METHODS: A retrospective chart review of 168 patients (mean age 67.2 years, range 51 to 88.7) with a fracture of the proximal humerus between 2007 and 2011, whose BMD was assessed at the Fracture Liaison Service with Dual Energy X-ray Absorptiometry (DXA) measurements of the hip, femoral neck (FN) and/or lumbar spine (LS), and whose CI and complexity of fracture were assessed on plain anteroposterior radiographs of the proximal humerus...
October 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/29052827/primary-exploration-for-radial-nerve-palsy-associated-with-unstable-closed-humeral-shaft-fracture
#12
Soo Hong Han, In Tae Hong, Ho Jae Lee, Sang June Lee, Uk Kim, Dong Won Kim
BACKGROUND: The treatment of radial nerve palsy caused by closed humeral shaft fracture is a matter of debate. The purpose of this study is to evaluate the outcome of early surgical management of radial nerve palsy in patients with unstable closed humeral shaft fractures and to determine whether patients with this injury should be surgically explored. METHODS: Medical records of 15 consecutive patients who had undergone open reduction and internal fixation for unstable closed humeral shaft fractures were reviewed...
September 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29051871/bilateral-divergent-shoulder-s-fracture-dislocation-case-in-an-ischemic-stroke-patient
#13
Atchi Walla, Faré Gnandi-Piou, Pilakimwé Egbohou, Komi Assogba, Mawuko Quacoe
INTRODUCTION: The literature review revealed that nowadays only about 15 cases of bilateral shoulder dislocation associated with the fracture of the upper end of the humerus have been published. The triad of lesional mechanism designated by the triple syndrome E composed of epilepsy, electrocution, and external trauma was the circumstances noted in which these fractures dislocations occur with migration of the two humeral heads either forward or backward. CASE REPORT: An architect of 36-year-old, right-handed, was admitted in emergency department for loss of knowledge of progressive installation...
May 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29025611/carbon-fiber-reinforced-intramedullary-nailing-in-musculoskeletal-tumor-surgery-a-national-multicentric-experience-of-the-italian-orthopaedic-society-siot-bone-metastasis-study-group
#14
Andrea Piccioli, Raimondo Piana, Michele Lisanti, Alberto Di Martino, Barbara Rossi, Francesco Camnasio, Marco Gatti, Pietro Maniscalco, Franco Gherlinzoni, Maria Silvia Spinelli, Davide Maria Donati, Roberto Biagini, Rodolfo Capanna, Vincenzo Denaro
INTRODUCTION: Carbon fiber reinforced (CFR) implants have been proposed for the treatment of fractures or impending fractures of the long bones in the oncology patient. Aim of this study is to present the largest cohort of oncology patients operated by CFR nailing by the Italian Orthopaedic Society (SIOT) Bone Metastasis Study Group. METHODS: 53 adult oncology patients were operated on with a CFR-PEEK nail. All the data from adjuvants therapies were collected. Bone callus formation, response to radiotherapy, relapse or progression of the osteolysis were recorded...
October 2017: Injury
https://www.readbyqxmd.com/read/28988333/primary-screw-perforation-or-subsequent-screw-cut-out-following-proximal-humerus-fracture-fixation-using-locking-plates-a-review-of-causative-factors-and-proposed-solutions
#15
REVIEW
Tristan E McMillan, Alan J Johnstone
The surgical treatment of proximal humerus fractures remains controversial primarily due to the high complication rate associated with the available fixation methods. In an attempt to reduce the incidence of serious complications and subsequent poor clinical outcomes, proximal humerus locking plates have become popular but even these implants cannot overcome the risk of complications, especially those associated with loss of fracture reduction and screw cut-out/migration through the humeral head. In an attempt to address these issues, we have reviewed the literature, investigating the most likely causes for these predominantly mechanical complications and propose technical solutions...
October 7, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28984686/intraobserver-and-interobserver-reliability-of-radiographic-analysis-of-proximal-humerus-fractures-in-adolescents
#16
Michelle C Burke, Christopher Minnock, Christopher B Robbins, Matthew D Abbott, Michelle S Caird, Frances A Farley, Jacob Kirsch, Jared Thomas, Ying Li
BACKGROUND: Multiple studies have shown low intrarater and interrater agreement of radiographic classification systems for proximal humerus fractures (PHFs) in adults. There is no standardized method of measuring angulation of pediatric PHFs, nor is there consensus as to the amount of angulation and displacement that require operative fixation of adolescent PHFs. We propose a new standardized method to measure fracture angulation that is similar to the method used to measure the epiphyseal-shaft angle for slipped capital femoral epiphysis...
October 3, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28976598/soluble-inflammatory-markers-and-risk-of-incident-fractures-in-older-adults-the-cardiovascular-health-study
#17
Danijela Stojanović, Petra Bůžková, Kenneth J Mukamal, Susan R Heckbert, Bruce M Psaty, Howard A Fink, Jane A Cauley, Erin Wallace, Lesley H Curtis, Calvin Hirsch, Matthew Budoff, Dong Li, Rebekah Young, Diana Jalal, Joseph Ac Delaney
Several in vitro and animal studies have showed that inflammatory markers play a role in bone remodeling and pathogenesis of osteoporosis. Additionally, some human longitudinal studies showed suggestive associations between elevated inflammatory markers and increased risk of nontraumatic fractures. We examined several inflammatory markers and multiple fracture types in a single study of older individuals with extensive follow-up. We assessed the association of four inflammatory markers with the risk of incident hip fractures among 5265 participants of the Cardiovascular Health Study (CHS) and a composite endpoint of incident fractures of the hip, pelvis, humerus, or proximal forearm in 4477 participants...
October 4, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28975397/traumatic-inferior-shoulder-dislocation-a-review-of-management-and-outcome
#18
REVIEW
M Nambiar, D Owen, P Moore, A Carr, M Thomas
INTRODUCTION: Traumatic inferior shoulder dislocation (ISD) is rare, estimated to occur in 0.5% of all shoulder dislocations. We describe the demographics, natural history and outcome of this injury. HYPOTHESIS/AIM: The aim of the study is to provide a summary of the demographics, clinical presentation, management and outcome of patients who suffer ISD METHODS: We conducted a systematic review of the English language literature on ISD using PubMed, Medline, CINHAL, Cochrane Database and Evidence-Based Medicine Reviews...
October 3, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28970985/fluoroscopic-technique-for-open-reduction-and-internal-fixation-of-proximal-humeral-fracture-using-the-proximal-humeral-locking-plate-proposal-of-plate-and-screw-views
#19
Wichan Kanchanatawan, Sunikom Suppauksorn, Worawit Densiri-Aksorn, Piyabuth Kittithamvongs, Warongporn Pongpinyopap
Proximal humeral fractures are common injuries with increasing incidence, particularly in the aging population. Nondisplaced or minimally displaced fractures can be treated conservatively whereas surgical fixation is usually indicated in the cases of displaced fractures. Various surgical options have been used for treatment of these fractures. Good outcomes have been reported with use of the Proximal Humeral Internal Locking System (PHILOS plate; Synthes, Zuchwil, Switzerland) as the implant of choice. However many complications have been reported, including varus malalignment, excessive retroversion of the articular part of the humerus, penetration of screws, and avascular necrosis of the humeral head...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28968474/increasing-use-of-reverse-total-shoulder-arthroplasty-for-proximal-humerus-fractures-in-elderly-patients
#20
Sean S Rajaee, Dheeraj Yalamanchili, Naudereh Noori, Eytan Debbi, James Mirocha, Carol A Lin, Charles N Moon
This study described surgical treatment patterns for proximal humerus fractures among elderly patients, focusing on reverse total shoulder arthroplasty (TSA), and evaluated how the type of fixation affects inpatient factors (cost, length of stay), transfusion rates, and patient disposition (home vs skilled nursing facility). With Nationwide Inpatient Sample data from 2011 to 2013, the authors identified patients 65 years and older who had proximal humerus fractures and divided them into 3 groups: (1) open reduction and internal fixation (ORIF); (2) hemiarthroplasty; and (3) reverse TSA...
October 2, 2017: Orthopedics
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