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Elbow humerus shoulder fracture

Jennifer Kurowicki, Enesi Momoh, Jonathan C Levy
Periprosthetic humerus fractures are relatively uncommon occurrence that can be difficult to manage nonoperatively. Locking plate technology has enhanced the surgical management of these fractures. However, adequate fixation around the stem remains of some concern. We describe an osteosynthesis technique using a locking plate utilizing eccentrically placed screw holes to place "skive screws" in the proximal end of the plate to achieve fixation around the stem of the implant. A clinical series of 5 consecutive patients treated with this technique is presented with an average follow-up of 29 months (range, 12-48)...
November 2016: Journal of Orthopaedic Trauma
Richard M Hinds, Michael B Gottschalk, Kenneth A Egol, John T Capo
BACKGROUND: The objectives of this investigation were to report temporal trends in resident performed upper extremity fracture procedures and analyze case volume variability. METHODS: Orthopaedic resident case logs from the Accreditation Council for Graduate Medical Education were reviewed for graduating years 2007 to 2014. The mean number of wrist, forearm, elbow, humerus, and shoulder fracture-dislocation procedures performed by residents was analyzed. The median number of procedures reported by the top 30% and bottom 30% of residents (by case volume) was also recorded...
September 2016: Bulletin of the Hospital for Joint Diseases
Mohammed Monem, Mohamad Khalid Iskandarani, Kishan Gokaraju
We discuss the case of an independent 80-year-old Caucasian woman, being treated with new oral anticoagulants for a previous deep vein thrombosis, who had fallen on her right shoulder. She made a delayed presentation to the emergency department with a wrist drop in her right dominant hand. She had right arm bruising with good distal pulses but had a global neurological deficit in the hand. Plain radiographs of the shoulder, humerus, elbow, forearm and wrist demonstrated no fractures. MRI showed a significant right axillary lesion distorting the surrounding soft tissues, including the brachial plexus, and CT with contrast confirmed this to be a large axillary pseudoaneurysm...
2016: BMJ Case Reports
Ying-Chao Chou, Yung-Heng Hsu, Yi-Hsun Yu, Chi-Chuan Wu
BACKGROUND: The purpose of this study was to determine if the triceps-reflecting anconeus pedicle (TRAP) approach combined with the precontoured locking plate can provide acceptable clinical outcomes in the treatment of comminuted distal humerus fracture. METHODS: Between August 2008 and June 2014, 48 patients with Orthopaedic Trauma Association type C (21 with C2, 27 with C3) distal humerus fractures underwent open reduction and internal fixation with orthogonal precontoured locking plate fixation using the TRAP approach...
October 2016: Injury
Sreenivasulu Metikala, Prabhudheer Bhogadi
INTRODUCTION: Nonunion following surgical stabilization of humeral shaft fractures, although infrequent, remains a challenge as limited surgical options are available. The difficulties in re-fixation are due to osteolysis produced by the loose implant components and disuse osteopenia of the entire bone segment. We share our experience in the management of a long standing diaphyseal nonunion of humerus following titanium LCP fixation. CASE REPORT: A 58 years old woman presented with 20 months old nonunion following titanium LCP fixation of her closed humeral shaft fracture, done elsewhere...
October 2015: Journal of Orthopaedic Case Reports
David D Savin, Ina Zamfirova, Joseph Iannotti, Benjamin A Goldberg, Ari R Youderian
PURPOSE: The role of reverse total shoulder arthroplasty (RTSA) for three and four-part proximal humerus fractures is evolving. However, there does not appear to be a clear consensus amongst surgeons. The purpose of this study is to further define the standard of care, assessing surgeon preference and treatment considerations for management of such fractures. METHODS: Orthopaedic surgeons were surveyed on their training, practice setting, and experience regarding management of four-part proximal humerus fractures...
September 2016: International Orthopaedics
Laurent Obert, Rachid Saadnia, François Loisel, Julien Uhring, Antoine Adam, Séverin Rochet, Pascal Clappaz, Tristan Lascar
INTRODUCTION: The purpose of this study was to evaluate the functional and radiological outcomes of a cementless, trauma-specific locked stem for 3- and 4-part proximal humeral fractures. MATERIALS AND METHODS: This study consisted of two parts: a cadaver study with 22 shoulders and a multicenter prospective clinical study of 23 fracture patients evaluated at least 2 years after treatment. In the cadaver study, the locked stem (Humelock(TM), FX Solutions) and its instrumentation were evaluated...
2016: SICOT-J
Saurabh Sharma, Mukesh Tiwari, Hemant Chaturvedi
OBJECTIVE: To evaluate the functional outcome and extensor apparatus of operative management of intra-articular fractures of distal humerus using modification of the Triceps Tongue Flap approach. METHODS: This prospective study was conducted between June, 2012 to April,2014 in NIMS Medical College and Hospital, Jaipur, Rajasthan(India). We included 23 patients with intraarticular fractures of distal humerus that were managed surgically. Modification of Triceps Tongue Flap approach with Triceps flap in inverted 'V' shape was used...
October 2015: Bull Emerg Trauma
İbrahim Azboy, Mehmet Bulut, Cahit Ancar, Abdullah Demirtaş, Emin Özkul, Mehmet Gem, Hilmi Karadeniz, Hüseyin Arslan
BACKGROUND: This study aimed to evaluate the functional outcomes of patients with intra-articular distal humerus fractures treated with triceps-reflecting anconeus pedicle (TRAP) and olecranon osteotomy. METHODS: Forty patients with intra-articular distal humerus fractures were retrospectively analyzed. TRAP approach was used in 22 patients (12 males, 10 females; mean age 37.8 years, range 17-70), and olecranon osteotomy in 18 patients (11 males, 7 females; mean age 35...
January 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Shun Lu, Junwei Wu, Shihong Xu, Baisheng Fu, Jinlei Dong, Yongliang Yang, Guodong Wang, Maoyuan Xin, Qinghu Li, Tong-Chuan He, Fu Wang, Dongsheng Zhou
BACKGROUND: Plate fixation is the gold standard for diaphyseal fracture management, and the anterolateral approach is widely used by reconstructive surgeons. However, the outcomes of humeral shaft fracture fixation using a medial approach are rarely reported. The aim of this study is to explore the management and outcomes of humeral mid-shaft fractures fixed through a medial incision. METHODS: Thirty-four patients who sustained a humeral mid-shaft fracture and underwent an open-reduction internal fixation (ORIF) in our department between January 2010 and January 2013 were included in this study...
2016: Journal of Orthopaedic Surgery and Research
H Chen, X Ji, Y Gao, L Zhang, Q Zhang, X Liang, P Tang
OBJECTIVES: To compare the outcomes of intramedullary fibular allograft (IFA) with locking compression plates (LCPs) versus shoulder hemi-arthroplasty (HA) in osteoporotic four-part proximal humeral fracture (PHF). METHODS: Between January 2010 and December 2012, totally 60 cases with osteoporotic four-part PHF were enrolled in this study and were randomly separated into IFA and LCPs group and HA group (n=30). Additionally, surgery indexes for patients in the two groups, such as Constant-Murley score (CMS), the Disability of Arm, Shoulder and Hand (DASH) score, individual subject evaluation of the outcomes, plain X-ray, and computer tomography (CT) scanning were evaluated and compared...
May 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Sung-Weon Jung, Seung-Hoon Kang, Min Jeong, Hae-Seong Lim
BACKGROUND: Distal humerus intercondylar fractures are intra-articular and comminuted fractures involving soft tissue injury. As distal humerus is triangle-shaped, parallel plating coupled with articular fixation would be suitable for bicolumn restoration in treatment of distal humerus intercondylar fracture. METHODS: This study included 38 patients (15 males and 23 females) who underwent olecranon osteotomy, open reduction and internal fixation with the triangle-shaped cannulated screw and parallel locking plates (triangular fixation technique)...
March 2016: Clinics in Orthopedic Surgery
Bobby Dezfuli, Joseph J King, Kevin W Farmer, Aimee M Struk, Thomas W Wright
BACKGROUND: Reverse total shoulder arthroplasty (RTSA) has been shown to be an effective treatment for proximal humerus fracture (PHF). This study evaluates outcomes of all patients with PHF treated with RTSA as a primary procedure for acute PHF, a delayed primary procedure for symptomatic PHF malunion or nonunion, a revision procedure for failed PHF hemiarthroplasty (HA), or a revision procedure for failed open reduction and internal fixation (ORIF). METHODS: Patients who underwent RTSA for PHF were evaluated for active range of motion and Shoulder Pain and Disability Index (SPADI), Simple Shoulder Test-12, American Shoulder and Elbow Surgeons (ASES), University of California-Los Angeles (UCLA) shoulder rating scale, Constant, and 12-Item Short Form Health Survey scores...
July 2016: Journal of Shoulder and Elbow Surgery
Jan Gessmann, Matthias Königshausen, Marlon Osman Coulibaly, Thomas Armin Schildhauer, Dominik Seybold
INTRODUCTION: Humeral shaft nonunion after intramedullary nailing is a rare but serious complication. Treatment options include implant removal, open plating, exchange nailing and external fixation. The objective of this retrospective study was to determine whether augmentation plating without nail removal is feasible for treating a humeral shaft nonunion. MATERIALS AND METHODS: Between 2002 and 2014, 37 patients (mean age 51, range 20-84 years) with aseptic humeral shaft nonunions prior to intramedullary nailing were treated with augmentation plating...
May 2016: Archives of Orthopaedic and Trauma Surgery
Mostafa A Ayoub, Ayman E Khalil, Osama A Seleem
BACKGROUND: Distal humerus fracture nonunion and associated elbow stiffness are two intermingled orthopaedic challenges for working adults. This prospective study aimed to evaluate the short-term results of the triple tension band and Lambda plate in managing both problems. METHODS: The study included fourteen cases. The mean age was 35.7 ± 8.5 years (range 25-49). Eight cases were males. Initial management was conservative in three cases. Three cases had a history of infected nonunion...
March 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Arvind Von Keudell, Amir R Kachooei, Ali Moradi, Jesse B Jupiter
OBJECTIVE: The purpose of this study was to report the long-term outcome and complications of surgically fixated lateral unicondylar distal humerus fractures. DESIGN: Retrospective Review. SETTING: Two level 1 Trauma Centers, Massachusetts General Hospital and Brigham and Women's Hospital. PATIENTS/PARTICIPANTS: Between 2002 and 2014, 24 patients treated with open reduction and internal fixation for lateral unicondylar distal humerus fractures (OTA/AO type B1 fractures) were retrospectively reviewed...
May 2016: Journal of Orthopaedic Trauma
Eduardo A Malavolta, Jorge H Assunção, Raphaella A Pagotto, Rafael L Avelino, Mauro E C Gracitelli, Cesar A M Pereira, Alfredo L Jacomo, Arnaldo A Ferreira Neto
BACKGROUND: The head-shaft angle is used to plan osteotomies and arthroplasties and to assess the radiographic outcomes of surgical treatment for proximal humerus fractures. There are no published data showing whether different degrees of arm rotation interfere with the evaluation of this angle. METHODS: Eighteen humeri from adult cadavers were used. Radiographs were taken with the specimens initially placed in a true anteroposterior position and then subsequently positioned with internal and external rotations of 10°, 20°, and 30°...
April 2016: Journal of Shoulder and Elbow Surgery
K Koca, T Ege, M Kurklu, S Ekinci, S Bilgic
OBJECTIVE: Humerus shaft fractures are frequent injuries in orthopedic practice and generally occurs with direct and indirect traumas. While the most of these fractures can be managed with conservative methods, in some situations surgery is needed. The aim of this study is to define a different mechanism and treatment result of  humerus spiral fractures with medial butterfly fragment (AO-12-B1). PATIENTS AND METHODS: Between 2010 and 2013, 11 patients who had undergone surgery for spiral humerus shaft fracture with medial large butterfly fragment (AO type 12-B1) resulting from a motor vehicle accident were enrolled to the study...
December 2015: European Review for Medical and Pharmacological Sciences
Ahmet Köse, Ali Aydin, Naci Ezirmik, Ömer Selim Yildirim
OBJECTIVE: To evaluate the results of treatment of an osteotomy of the olecranon and an ulnar diaphyseal fracture with a single nail, in cases with an ipsilateral ulnar diaphyseal fracture and a comminuted fracture of the distal humerus. DESIGN: Retrospective clinical study. SETTING: University-affiliated teaching hospital. PATIENTS: Eight patients with comminuted fractures of the distal humerus and ipsilateral ulnar diaphyseal fractures were included...
May 2016: Journal of Orthopaedic Trauma
Mandeep S Virk, Gregory P Nicholson
The long head of biceps tendon (LHBT) is a well-recognized cause of anterior shoulder pain. Tenotomy or tenodesis of the LHBT is an effective surgical solution for relieving pain arising from the LHBT. Cosmetic deformity of the arm, cramping or soreness in the biceps muscle, and strength deficits in elbow flexion and supination are the three most common adverse events associated with tenotomy of the LHBT. Complications associated with tenodesis of the LHBT include loss of fixation resulting in cosmetic deformity, residual groove pain, pain or soreness in the biceps muscle, infection, stiffness, hematoma, neurologic injury, vascular injury, proximal humerus fracture, and reflex sympathetic dystrophy...
January 2016: Clinics in Sports Medicine
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