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https://www.readbyqxmd.com/read/28094193/factors-associated-with-infection-after-reconstructive-shoulder-surgery-for-proximal-humerus-tumors
#1
Sjoerd Th Meijer, Nuno R Paulino Pereira, Sjoerd P F Th Nota, Marco L Ferrone, Joseph H Schwab, Santiago A Lozano Calderón
BACKGROUND: The main reconstruction techniques for proximal humerus tumors include osteoarticular allografts (OAs), endoprostheses (EPs), or allograft prosthetic composites (APCs). A common complication is infection, and constructs involving the use of allografts are believed to be at a higher risk of infection. Literature comparing infection rates between different modalities of reconstruction is scarce and underpowered. The study purposes were (1) to determine and compare the prevalence of infection in patients who underwent reconstruction of the proximal humerus including OAs, EPs, and APCs; (2) to identify preoperative, perioperative, and postoperative predictors of infection that might be modifiable; and (3) to present our protocol of treatment in patients with superficial and deep infections...
January 13, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28094189/medicaid-payer-status-is-linked-to-increased-rates-of-complications-after-treatment-of-proximal-humerus-fractures
#2
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/28087165/radiographic-comparison-of-adolescent-athletes-with-elbow-osteochondritis-dissecans-to-ulnar-collateral-ligament-injuries-and-controls
#3
Brian C Lau, Nirav K Pandya
BACKGROUND: There are excellent data supporting recommendations to prevent elbow injuries (osteochondritis dissecans [OCD] and ulnar collateral ligament [UCL] injuries), such as pitch count and pitch type in baseball, but anatomic risk factors have not been thoroughly examined. This study aimed to evaluate radiographic measurements in adolescents with elbow OCD lesions or UCL injuries and controls. METHODS: We retrospectively identified adolescent patients between 2011 and 2016 with isolated capitellum OCD, UCL tear, or normal elbows based on magnetic resonance imaging...
January 10, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28079807/a-case-report-distal-humeral-diaphyseal-fracture-in-a-child
#4
Yuji Tomori, Takuya Sawaizumi, Mitsuhiko Nanno, Shinro Takai
RATIONALE: Distal humeral diaphyseal fractures are much less common than supracondylar humeral fractures. The triangular shape and thinner periosteum in the diaphyseal region than in the supracondylar region of the distal diaphysis makes the treatment of diaphyseal fractures difficult. Nonoperative treatment for this fracture is challenging and troublesome; thus, open reduction and internal fixation (OR/IF) is generally recommended. PATIENT CONCERNS: We herein report a distal humeral diaphyseal fracture in a child...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28077774/tropical-ancient-dna-reveals-relationships-of-the-extinct-bahamian-giant-tortoise-chelonoidis-alburyorum
#5
Christian Kehlmaier, Axel Barlow, Alexander K Hastings, Melita Vamberger, Johanna L A Paijmans, David W Steadman, Nancy A Albury, Richard Franz, Michael Hofreiter, Uwe Fritz
Ancient DNA of extinct species from the Pleistocene and Holocene has provided valuable evolutionary insights. However, these are largely restricted to mammals and high latitudes because DNA preservation in warm climates is typically poor. In the tropics and subtropics, non-avian reptiles constitute a significant part of the fauna and little is known about the genetics of the many extinct reptiles from tropical islands. We have reconstructed the near-complete mitochondrial genome of an extinct giant tortoise from the Bahamas (Chelonoidis alburyorum) using an approximately 1 000-year-old humerus from a water-filled sinkhole (blue hole) on Great Abaco Island...
January 11, 2017: Proceedings. Biological Sciences
https://www.readbyqxmd.com/read/28070676/-upper-extremity-fractures-in-the-elderly
#6
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/28065645/mandibular-reconstruction-with-vascularised-bone-flaps-a-systematic-review-over-25-years
#7
REVIEW
J S Brown, D Lowe, A Kanatas, A Schache
To explore the techniques for mandibular reconstruction with composite free flaps and their outcomes, we systematically reviewed reports published between 1990 and 2015. A total of 9499 mandibular defects were reconstructed with 6178 fibular, 1380 iliac crest, 1127 composite radial, 709 scapular, 63 serratus anterior and rib, 32 metatarsal, and 10 lateral arm flaps including humerus. The failure rate was higher for the iliac crest (6.2%, 66/1059) than for fibular, radial, and scapular flaps combined (3.4%, 202/6018) (p<0...
January 5, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28063677/the-results-of-tension-band-rotator-cuff-suture-fixation-of-locked-plating-of-displaced-proximal-humerus-fractures
#8
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
#9
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
#10
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
#11
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/28053378/reverse-v-osteotomy-and-treatment-of-cubitus-varus-deformity-results-and-experience
#12
Pankaj Kumar Mishra, Ajay Kumar Verma, Rishi Dwivedi, Satya Prakash Singh, Suresh Chandra Gaur
INTRODUCTION: Cubitus varus is a most common repercussion of malunited supracondylar fracture of humerus in paediatric age group. Initially, valgus osteotomies were in trend, but due to higher rate of complications, these procedures are not in trends today, as they were earlier. Here, we are sharing our experience and results of reverse V osteotomy done for cubitus varus. MATERIAL AND METHOD: Reverse V osteotomy was done on 20 patients of cubitus varus (due to malunited supracondylar fracture of humerus)...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28050700/when-is-it-safe-to-reduce-fracture-dislocation-of-shoulder-under-sedation-proposed-treatment-algorithm
#13
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/28047394/su-f-j-06-optimized-patient-inclusion-for-naf-pet-response-based-biopsies
#14
A Roth, S Harmon, T Perk, R Jeraj
PURPOSE: A method to guide mid-treatment biopsies using quantitative [F-18]NaF PET/CT response is being investigated in a clinical trial. This study aims to develop methodology to identify patients amenable to mid-treatment biopsy based on pre-treatment imaging characteristics. METHODS: 35 metastatic prostate cancer patients had NaF PET/CT scans taken prior to the start of treatment and 9-12 weeks into treatment. For mid-treatment biopsy targeting, lesions must be at least 1...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28040077/closing-the-gap-a-novel-technique-for-humeral-shaft-nonunions-using-cup-and-cone-reamers
#15
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
#16
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
#17
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
#18
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/28033242/brachial-plexus-palsy-in-young-infants-harboring-osteomyelitis-of-the-humerus-case-report-and-review-of-the-literature
#19
Petra Zimmermann, Nigel Curtis
We present an infant with brachial plexus palsy who had osteomyelitis of the humerus, and summarize previously reported cases. Although Staphylococcus aureus is the most common pathogen in osteomyelitis in infants, group B streptococcus is responsible for 40% of humeral osteomyelitis. Early diagnosis is critical to prevent long-term sequalae, but is hampered by infants frequently being well and afebrile at presentation.
December 28, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28032029/evaluation-and-treatment-of-internal-impingement-of-the-shoulder-in-overhead-athletes
#20
REVIEW
Keith T Corpus, Christopher L Camp, David M Dines, David W Altchek, Joshua S Dines
One of the most common pathologic processes seen in overhead throwing athletes is posterior shoulder pain resulting from internal impingement. "Internal impingement" is a term used to describe a constellation of symptoms which result from the greater tuberosity of the humerus and the articular surface of the rotator cuff abutting the posterosuperior glenoid when the shoulder is in an abducted and externally rotated position. The pathophysiology in symptomatic internal impingement is multifactorial, involving physiologic shoulder remodeling, posterior capsular contracture, and scapular dyskinesis...
December 18, 2016: World Journal of Orthopedics
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