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proximal humerus fracture

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https://www.readbyqxmd.com/read/28238043/cementless-and-locked-prosthesis-for-the-treatment-of-3-part-and-4-part-proximal-humerus-fractures-prospective-clinical-evaluation-of-hemi-and-reverse-arthroplasty
#1
E Boyer, G Menu, F Loisel, R Saadnia, J Uhring, A Adam, S Rochet, P Clappaz, E Baudouin, T Lascar, R Cermeno, L Obert
INTRODUCTION: Cemented stem remains the gold standard for prosthesis in trauma. The purpose of this study was to evaluate the functional and radiological outcomes of a cementless, trauma-specific locked stem (hemi and reverse) for 3- and 4-part proximal humeral fractures. MATERIALS AND METHODS: One hundred and thirty-four 3- and 4-part fractures have been treated by locked stem, 69 with hemiarthroplasty [mean age 68 years (50-90)] and 65 with reversed [mean age 78 years (66-91)]...
February 25, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28236247/humeral-shaft-non-union-after-intramedullary-nailing
#2
G Campochiaro, P Baudi, M Gialdini, A Corradini, V Duca, M Rebuzzi, F Catani
BACKGROUND: The humerus shaft is one of the sites with the largest probability of developing pseudoarthrosis after fracture. We present the results of nine patients with atrophic pseudoarthrosis of humeral shaft treated with angular stability plate associated with allograft and platelet-rich plasma (PRP), after a first treatment with intramedullary nail to correct the fracture. MATERIAL AND METHODS: From January 2012 to December 2014, nine patients were treated for atrophic pseudoarthrosis (PSA) of humeral shaft treated previously using intramedullary nail; seven humeral diaphysis fractures were located in the middle-proximal third and two in the middle third...
February 24, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28216756/outcome-of-anatomic-locking-plate-in-extraarticular-distal-humeral-shaft-fractures
#3
Deepak Jain, Gurpreet S Goyal, Rajnish Garg, Pankaj Mahindra, Mohammad Yamin, Harpal S Selhi
BACKGROUND: Extraarticular fractures of distal humerus are challenging injuries to treat because of complex anatomy and fracture patterns. Functional bracing may not provide adequate stability in these injuries and operative treatment with intramedullary nails or conventional plates also has the limitation of inadequate fixation in the short distal fragment. The 3.5 mm precontoured single column locking plate (extraarticular distal humerus plate [EADHP]) has been introduced to overcome this problem...
January 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28210775/risk-of-fragility-fracture-among-patients-with-sarcoidosis-a-population-based-study-1976-2013
#4
P Ungprasert, C S Crowson, E L Matteson
: Incidence of fragility fracture of a population-based cohort of 345 patients with sarcoidosis was compared with age and sex-matched comparators. The incidence of fragility fracture was higher among patients with sarcoidosis with hazard ratio (HR) of 2.18. INTRODUCTION: Several chronic inflammatory disorders increase the risk of fragility fracture. However, little is known about the risk of fragility fracture in patients with sarcoidosis. METHODS: This study was conducted using a previously identified population-based cohort of 345 patients with incident sarcoidosis from Olmsted County, Minnesota...
February 16, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28198550/birth-injuries-to-growth-plates-a-sheep-in-wolves-clothing
#5
Jerrin Varghese, Matthew Teng, Mingqian Huang, Dvorah Balsam
Growth plate injuries (Salter-Harris type 1 or physeal fractures) of the long bones in the newborn are easily misdiagnosed as joint fractures with dislocations due to their nonossified epiphyses on plain radiographs. Diagnosis with musculoskeletal ultrasound (US) is advantageous due to its ability to visualize the nonossified epiphysis. We present two cases of humeral growth plate fractures in newborns, one at the shoulder (proximal humerus) and the other at the elbow (distal humerus). These cases emphasize the importance of quick and noninvasive diagnosis with US to avoid unnecessary intervention...
February 15, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28185130/frequency-of-shoulder-corticosteroid-injections-for-pain-and-stiffness-after-shoulder-surgery-and-their-potential-to-enhance-outcomes-with-physiotherapy-a-retrospective-study
#6
John G Skedros, Micheal G Adondakis, Alex N Knight, Michael B Pilkington
INTRODUCTION: What is the rate of injecting patients with shoulder corticosteroid injections to alleviate excessive stiffness and pain within 6 months after shoulder surgery? METHODS: Retrospective 10-year review of a shoulder surgeon's practice. Participants included 754 patients who had 945 non-arthroplasty shoulder surgeries. Outcome measures included the rate of injections, diagnoses, patient characteristics, and efficacy via questionnaire. RESULTS: Approximately one in five patients received a subacromial and/or glenohumeral corticosteroid injection...
February 9, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/28164060/a-case-report-about-early-major-postoperative-ossifications-of-the-shoulder
#7
Maurice Kouame, Moctar Traore, Armand Yepie, Michel Anoumou
INTRODUCTION: Ossifications after osteosynthesis of the proximal humerus are poorly described. We report a case of major and early ossifications after synthesis of a fracture dislocation of the shoulder. CASE REPORT: A 57-year-old man, right-handed, bipolar schizophrenic, presented after a fall, a fracture of the head and metaphysis of the humerus from the anterior notch of posterior dislocation of the right humerus. An osteosynthesis was performed after reduction on the tenth posttraumatic day...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28162882/reverse-shoulder-arthroplasty-for-four-part-proximal-humerus-fracture-in-elderly-patients-can-a-healed-tuberosity-improve-the-functional-outcomes
#8
Yong-Min Chun, Doo-Sup Kim, Doo-Hyung Lee, Sang-Jin Shin
BACKGROUND: The purpose of this study was to investigate whether healed tuberosities yield better rotational range of motion (ROM) and functional outcomes compared with unhealed tuberosities after reverse shoulder arthroplasty in elderly patients with comminuted proximal humerus fractures. METHODS: This study included 38 patients who underwent reverse arthroplasty because of 4-part proximal humerus fractures; 14 patients had healed tuberosities (group A) and 24 patients had unhealed tuberosities (group B)...
February 2, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28162172/-radiographic-and-clinical-assessment-of-supracondylar-humeral-fractures-resulted-from-sports-in-children
#9
Z J Liu, S N Pan, L J Zhang
Objective: To investigate the radiographic and clinical assessment for supracondylar humeral fractures resulted from sports in children. Methods: The medical records of 166 patients with displaced supracondylar humerus fractures treated in Shengjing Hospital of China Medical University from January 2015 to December 2015 were reviewed.The etiology of 56 of 166 cases was relevant to the sports.Medical records of 56 of 166 patients were reviewed, incluidng gender, the mean age of patient at the time of surgery, the mean duration of injury, radiographic assessment based on the anteroposterior (AP) and lateral radiographs of the elbow, neurologic injury, the Mayo Elbow Performance Score (MEPS) and the criteria of Flynn...
January 17, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28128005/isolated-metaphyseal-injury-influences-unrelated-bones
#10
Love Tätting, Olof Sandberg, Magnus Bernhardsson, Jan Ernerudh, Per Aspenberg
Background and purpose - Fracture healing involves different inflammatory cells, some of which are not part of the traditional bone field, such as B-cells and cytotoxic T-cells. We wanted to characterize bone healing by flow cytometry using 15 different inflammatory cell markers in a mouse model of metaphyseal injury, and incidentally discovered a previously unknown general skeletal reaction to trauma. Material and methods - A bent needle was inserted and twisted to traumatize the cancellous bone in the proximal tibia of C57/Bl6 female mice...
January 27, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28124187/national-trends-in-proximal-humerus-fracture-treatment-patterns
#11
Vani J Sabesan, Daniel Lombardo, Graysen Petersen-Fitts, Martin Weisman, Kyle Ramthun, James Whaley
BACKGROUND: The treatment of proximal humerus fractures (PHF) is largely surgeon dependent with no clear guidelines for selecting the optimal method of treatment. AIMS: The aim of this study was to evaluate trends and variations in treatment methods of PHF in the United States from 2004 to 2012 and to determine the regional differences in treatment. METHODS: The National Inpatient Sample was used to identify all patient discharges with diagnosis codes for PHF and the data were classified based on ICD-9 procedure codes...
January 25, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28120098/analysis-of-four-fragment-fractures-of-the-proximal-humerus-the-interest-of-2d-and-3d-imagery-and-inter-and-intra-observer-reproducibility
#12
X Ohl, P Mangin, C Barbe, V Brun, C Nerot, F Sirveaux
The treatment of the four-part fractures of the proximal humerus remains a therapeutic challenge. The decision-making is based on preoperative criteria concerning the displacement of the fracture, the stability of the fracture and the risk of avascular necrosis of the humeral head. The aim of this study was to analyse the inter- and intra-observer reproducibility of those criteria previously described by Hertel. Three observers analysed three times 20 radiologic files comprising 2D X-rays, 2D CT scan and 3D reconstructions for the intra-observer study, and an expert committee was used to assess the inter-observer reproducibility...
January 24, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28120001/numerical-investigation-of-fracture-impaction-in-proximal-humeral-fracture-fixation-with-locking-plate-and-intramedullary-nail
#13
Yen-Nien Chen, Chih-Wei Chang, Chia-Wei Lin, Chih-Wei Wang, Yao-Te Peng, Chih-Han Chang, Chun-Ting Li
INTRODUCTION: Fracture impaction is a surgical technique used to support the fractured humerus with locking plate or intramedullary nail when treating proximal humeral fractures. However, few studies have investigated the mechanical difference between fracture impaction with locking plate and with intramedullary nail. The mechanism of fracture impaction to increase stability is still unclear. The aim of this study was to use numerical methods to compare the biomechanical effect of treating proximal humeral fracture...
January 24, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28111180/computed-tomography-based-prediction-of-the-straight-antegrade-humeral-nail-s-entry-point-and-exposure-of-critical-types-truth-or-fiction
#14
Simon A Euler, Clemens Hengg, Matthias Boos, Grant J Dornan, Travis Lee Turnbull, Markus Wambacher, Franz S Kralinger, Peter J Millett, Maximilian Petri
BACKGROUND: Straight antegrade intramedullary nailing of proximal humerus fractures has shown promising clinical results. However, up to 36% of all humeri seem to be "critical types" in terms of the potential violation of the supraspinatus (SSP) tendon footprint by the nail's insertion zone. The aims of this study were to evaluate if a computed tomography (CT) scan could reliably predict the nail's entry point on the humeral head and if it would be possible to preoperatively estimate the individual risk of iatrogenic violation of the SSP tendon footprint by evaluating the uninjured contralateral humerus...
January 19, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28109556/minimally-invasive-lateral-plate-placement-for-metadiaphyseal-fractures-of-the-humerus-and-its-implications-for-the-distal-deltoid-insertion-it-is-not-only-about-the-radial-nerve-a-cadaveric-study
#15
Emanuel Benninger, Christoph Meier
INTRODUCTION: Minimally invasive lateral placement of plates on the humerus may be associated with a risk of injury to the radial nerve. Whereas this potential complication has been investigated in several studies, there is no data regarding potential injuries to the distal insertion of the deltoid muscle when the plates are passed distally in a submuscular tunnel. METHODS: Minimally invasive plate placement was performed on eight arms in fresh cadavers. A lateral deltoid split approach was made and the plates were introduced in an antegrade submuscular manner from proximal to distal...
January 13, 2017: Injury
https://www.readbyqxmd.com/read/28094189/medicaid-payer-status-is-linked-to-increased-rates-of-complications-after-treatment-of-proximal-humerus-fractures
#16
Vani J Sabesan, Graysen Petersen-Fitts, Daniel Lombardo, Daniel Briggs, James Whaley
BACKGROUND: Low socioeconomic status and Medicaid insurance as a primary payer have been associated with major disparities in resource utilization and risk-adjusted outcomes for patients undergoing total joint arthroplasty. With the expansion of Medicaid through the Affordable Care Act in 2014, examination of these disparities has become increasingly relevant for the treatment of proximal humerus fracture (PHF). METHODS: The Healthcare Cost and Utilization Project Nationwide Inpatient Sample database was used to identify patients who were treated for PHF from 2002 to 2012...
January 13, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28070676/-upper-extremity-fractures-in-the-elderly
#17
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 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
#18
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...
February 2017: Injury
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
#19
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
#20
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
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