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https://www.readbyqxmd.com/read/28637185/a-novel-method-of-open-reduction-and-internal-fixation-of-a-displaced-manubrial-fracture-using-distal-clavicle-locking-plates
#1
Daniel Miller, M Adeel Akhtar, Jonathan Fergusson, James L McVie
A 52-year-old man sustained a sternal fracture after a blunt traumatic chest injury. He was in severe pain in the intensive care unit, which resulted in difficulty breathing and increased analgesic requirement, and a decision was made to stabilize his manubrial fracture. Orthopaedic and thoracic surgeons jointly performed open reduction and internal fixation of the displaced manubrial fracture using 2 distal clavicle locking plates. This resulted in improvement in patient's pain and helped with his subsequent recovery and discharge from the hospital...
June 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28634742/outcomes-of-coronoid-first-repair-in-terrible-triad-injuries-of-the-elbow
#2
Junren Zhang, Mark Tan, Ernest Beng Kee Kwek
BACKGROUND: Clinical outcomes of terrible triad injuries (TTIs) of the elbow are historically poor. To date, it is still debatable whether the coronoid needs to be fixed and if so, how and in which sequence. METHODOLOGY: Between 2010 and 2013, 13 patients were treated surgically for acute TTIs of the elbow at a Tertiary Level 1 Trauma Centre by a single surgeon, using a standardized protocol, which included coronoid-brachialis complex fixation via pull-through trans-osseous sutures, radial head fixation or prosthetic replacement and a repair of the lateral ulnar collateral ligament...
June 20, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28632595/plate-fixation-versus-nonoperative-treatment-for-displaced-midshaft-clavicular-fractures-a-meta-analysis-of-randomized-controlled-trials
#3
Sarah Woltz, Pieta Krijnen, Inger B Schipper
BACKGROUND: The aim was to analyze whether patients with a displaced midshaft clavicular fracture are best managed with plate fixation or nonoperative treatment with respect to nonunion, secondary operations, and functional outcome, by evaluating all available randomized controlled trials (RCTs) on this subject. METHODS: A systematic search of electronic databases (PubMed, MEDLINE, Embase, and Web of Science) was performed to identify RCTs comparing nonoperative treatment with plate fixation for displaced midshaft clavicular fractures...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28630838/a-case-report-of-an-unusual-case-of-tuberculous-osteomyelitis-causing-spontaneous-pathological-fracture-of-humerus-in-a-middle-aged-female
#4
Umesh Birole, Ashish Ranade, Mahesh Mone
INTRODUCTION: Tuberculosis is a major health problem worldwide. Extrapulmonary tuberculosis is often secondary to some primary foci in lungs. There are reports of tuberculous osteomyelitis involving maxilla, ulna, femur, and shoulder joint but none have reported pathological fracture in humeral diaphysis due to tuberculosis osteomyelitis without shoulder joint involvement. We report a case of pathological fracture of humerus diaphysis due to tuberculous osteomyelitis with normal articular space...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28630830/bilateral-humerus-and-right-femur-fracture-in-a-newborn-after-cesarean-section-for-breech-presentation-in-a-twin-pregnancy-a-very-rare-case-report
#5
P Rahul, Amit Rakesh Grover, S M Ajoy
INTRODUCTION: The most common fractures during vaginal delivery occur in the clavicle, humerus, and femur. Cesarean section reduces the chances of a child having a birth injury. However, in some difficult extractions, long bone fractures may occur. Cesarean section further reduces the incidence of birth injuries, especially in a breech delivery. Maneuvers employed during cesarean section, energetic traction, improper uterine incisions, and contracted uterus may cause these injuries. In the medical literature, there are few articles highlighting the occurrence of long bone fractures during cesarean section...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28630753/how-to-deal-with-a-glenoid-fracture
#6
Lars Henrik Frich, Morten Schultz Larsen
The glenoid fossa is involved in approximately 10% of all scapular fractures.Glenoid fossa incongruity is surprisingly well tolerated.Surgery is recommended when 20% or more of the anterior glenoid fossa is involved.Glenoid rim fractures often lead to chronic shoulder instability.Unstable glenoid neck fractures need surgical treatment and stable fractures can be treated conservatively.CT examination with 3D reformations of the glenoid fossa has improved insight into fracture morphology and fracture patterns and is very helpful for clinical decision makers...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28628579/distal-humeral-flexion-osteotomy-for-the-treatment-of-supracondylar-extension-type-malunions-in-children
#7
Sebastian Farr, Rudolf Ganger, Werner Girsch
Distal humeral extension-type malunions may occur as a complication following improper reduction of supracondylar humerus fractures. We evaluated results after distal humeral flexion osteotomies for sagittal realignment of the humeral condyle in children. Medical records and radiographs of all patients younger than 18 years of age, who underwent this procedure because of a clinically relevant lack of elbow flexion, were evaluated. In a cohort of 18 children with a mean age of 8 years at the time of surgery and a mean follow-up duration of 1 year, elbow flexion increased significantly from a mean of 101° preoperatively to 126° at the final follow-up; established radiographic parameters (e...
June 16, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28626630/arthroscopic-removal-of-proximal-humerus-plates-in-chronic-post-traumatic-shoulder-stiffness
#8
Deepak N Bhatia
Proximal humerus fracture fixation may be complicated by persistent postsurgical stiffness or implant-related problems. Arthroscopic plate removal is a cosmetic and functionally beneficial procedure; however, the procedure is technically difficult in the presence of severe subdeltoid scarring. The technique described here shows an arthroscopic subdeltoid adhesiolysis and proximal humerus plate removal using systematic access to 5 regions of screw positions on the plate. After initial glenohumeral adhesiolysis, a thorough subacromial and subdeltoid bursectomy is performed...
April 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28625096/surgical-technique-and-early-outcomes-of-intramedullary-nailing-of-displaced-proximal-humeral-fractures-in-an-asian-population-using-a-contemporary-straight-nail-design
#9
Toon Dong Hao, Andy Wee Teck Huat
BACKGROUND: Despite being a common orthopedic injury, the optimal management of proximal humeral fractures remains a topic of debate. Although intramedullary nails have been used to treat these fractures, several complications have been reported with older nail devices. We describe our surgical technique and aim to evaluate the early functional and radiological outcomes of displaced Neer's two- to four-part proximal humeral fractures undergoing fixation with a contemporary straight intramedullary nail...
May 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28622154/operative-treatment-of-two-part-surgical-neck-fracture-of-the-humerus-intramedullary-nail-versus-locking-compression-plate-with-technical-consideration
#10
Wonyong Lee, Jun-Young Park, Yong-Min Chun
OBJECTIVE: To compare the outcomes of patients who underwent either open reduction internal fixation with a locking plate and screws or closed reduction internal fixation with an antegrade intramedullary (IM) nail for displaced surgical neck fracture of the humerus. DESIGN: retrospective comparative study SETTING:: single institute, Level-I academic trauma center PATIENTS AND INTERVENTION:: Sixty-nine patients with two-part surgical neck fracture of the humerus underwent either an IM nail (38 patients Group A) or a locked plate fixation (31 patients Group B)...
May 23, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28619746/informal-regionalization-of-pediatric-fracture-care-in-the-greater-toronto-area-a-retrospective-cross-sectional-study
#11
Daniel Pincus, Steven Morrison, Martin F Gargan, Mark W Camp
BACKGROUND: Operative management of pediatric fractures is an expected competency in the specialty of Orthopedic Surgery. However, specialized pediatric centres may be providing care for increasing numbers of patients with fractures previously treated at community hospitals. The primary objective of this study was to examine trends in presentation of children with fractures to a specialized pediatric centre. METHODS: We performed a detailed chart review to examine trends in presentation of children aged 14 years or less with supracondylar humerus or femur fractures to a specialized pediatric centre (Hospital for Sick Children, Toronto) from anywhere in the Greater Toronto Area between Apr...
June 14, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28614274/corrective-osteotomy-for-symptomatic-clavicle-malunion-using-patient-specific-osteotomy-and-reduction-guides
#12
Mathias Haefeli, Matthias Schenkel, Ralf Schumacher, Karim Eid
Midshaft clavicular fractures are often treated nonoperatively with good reported clinical outcome in a majority of patients. However, malunion with shortening of the affected clavicle is not uncommon. Shortening of the clavicle has been shown to affect shoulder strength and kinematics with alteration of scapular position. Whereas the exact clinical impact of these factors is unknown, the deformity may lead to cosmetic and functional impairment as for example pain with weight-bearing on the shoulder girdle...
June 13, 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28614146/the-effect-of-concomitant-elbow-injuries-on-the-outcomes-of-radial-head-arthroplasty-a-cohort-comparison
#13
Jason A Strelzow, George S Athwal, Joy C MacDermid, Ruby Grewal, Kenneth J Faber, Darren Drosdowech, Graham J W King
OBJECTIVES: To compare physical impairments and patient reported outcomes in patients following simple and complex elbow injuries who were treated with a radial head arthroplasty. DESIGN: Patients with isolated elbow trauma and no prior injury to the elbow were prospectively enrolled following radial head arthroplasty for an acute unreconstructable fracture. Injury patterns were classified as simple or complex based on the presence or absence of associated elbow fractures and/or dislocation...
May 31, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28607872/vascularized-fibula-based-physis-transfer-a-follow-up-study-of-longitudinal-bone-growth-and-complications
#14
Ronnie L Shammas, Yash J Avashia, Alfredo E Farjat, Anthony A Catanzano, L Scott Levin, William C Eward, Brian E Brigman, Detlev Erdmann
BACKGROUND: The vascularized free fibula epiphyseal transfer provides an option for the preservation of limb lengthening after resection of the proximal humerus in pediatric sarcoma patients. The purpose of this study was to provide a long-term follow-up of longitudinal growth patterns and outcomes after free fibula epiphyseal transfer in upper extremity reconstruction. METHODS: A retrospective review of 4 patients who underwent free fibula epiphyseal transfer after oncologic resection of the proximal humerus for osteosarcoma was performed...
May 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28607788/a-case-of-fracture-redislocation-of-the-hip-caused-by-a-depressed-fracture-of-the-femoral-head-similar-to-a-hill-sachs-lesion
#15
Yoshihiko Okudera, Hiroaki Kijima, Shin Yamada, Natsuo Konishi, Hitoshi Kubota, Hiroshi Tazawa, Takayuki Tani, Norio Suzuki, Keiji Kamo, Ken Sasaki, Tetsuya Kawano, Yosuke Iwamoto, Naohisa Miyakoshi, Yoichi Shimada
The present case shows a case of fracture-redislocation of the hip caused by a depressed fracture of the femoral head similar to a Hill-Sachs lesion. A 59-year-old man fell from a roof and his left hip joint was dislocated posteriorly. He was admitted to a nearby hospital, and he was referred to our hospital more than 24 hours after injury. Computed tomography (CT) suggested a bone chip from the posterior wall of the acetabulum roof and a depressed femoral head that cut into the posterior margin of the acetabulum roof...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28606638/retrospective-cohort-study-on-radial-head-replacements-comparing-results-between-smooth-and-porous-stem-designs
#16
Mélissa Laflamme, Pierre-Philippe Grenier-Gauthier, Alexandre Leclerc, Stéphanie Antoniades, Anne-Marie Bédard
BACKGROUND: When necessary, radial head integrity after a fracture can be re-created by the use of a radial head arthroplasty if the radial head is judged irreparable. The purpose of this study was to compare the clinical and radiographic outcomes of metal modular radial head replacements with a smooth vs. a porous stem. METHODS: A retrospective cohort study of radial head replacements performed in the first 4 weeks after a trauma in an adult patient at our institution between 2000 and 2014 was completed...
June 9, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28606433/plate-osteosynthesis-of-proximal-ulna%C3%A2-fractures-a-biomechanical-micromotion-analysis
#17
Michael Hackl, Katharina Mayer, Mareike Weber, Manfred Staat, Roger van Riet, Klaus Josef Burkhart, Lars Peter Müller, Kilian Wegmann
PURPOSE: Double plating has been promoted, in recent years, as an alternative treatment method for proximal ulna fractures. This study aimed to compare the biomechanical properties of double-plate osteosynthesis with posterior plate fixation using a novel investigational design utilizing a 3-dimensional camera system to analyze fracture micromotion. METHODS: Fourteen fresh-frozen specimens were available for this study. Mayo type IIA fractures of the olecranon were created and internal fixation was performed with either an angular stable posterior plate or angular stable double plates...
June 9, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28601491/a-validation-of-the-nottingham-clavicle-score-a-clavicle-acromioclavicular-joint-and-sternoclavicular-joint-specific-patient-reported-outcome-measure
#18
Edmund R Charles, Vinod Kumar, James Blacknall, Kimberley Edwards, John M Geoghegan, Paul A Manning, W Angus Wallace
BACKGROUND: Patients with acromioclavicular joint (ACJ) and sternoclavicular joint (SCJ) injuries and with clavicle fractures are typically younger and more active than those with other shoulder pathologies. We developed the Nottingham Clavicle Score (NCS) specifically for this group of patients to improve sensitivity for assessing the outcomes of treatment of these conditions compared with the more commonly used Constant Score (CS) and Oxford Shoulder Score (OSS). MATERIALS AND METHODS: This was a cohort study in which the preoperative and 6-month postoperative NCS evaluations of outcome in 90 patients were compared with the CS, OSS, Imatani Score (IS), and the EQ-5D scores...
June 7, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28601085/validity-of-humerus-fracture-classification-in-the-swedish-fracture-register
#19
David Wennergren, Stina Stjernström, Michael Möller, Mikael Sundfeldt, Carl Ekholm
BACKGROUND: The ability to correctly classify fractures is of importance for choosing the appropriate treatment and for providing appropriate data for research and quality registers. In the Swedish Fracture Register (SFR) fractures of all types are registered by the attending physician, often a junior doctor. For the majority of fractures, a modified AO/OTA classification is used. This study aimed to validate the accuracy of classification of humerus fractures in the SFR and also at providing insight into inherent classification uncertainties...
June 10, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28594497/arthroplasty-for-unreconstructable-acute-fractures-and-failed-fracture-fixation-about-the-hip-and-knee-in-the-active-elderly-a-new-paradigm
#20
Richard F Kyle, Paul J Duwelius, George J Haidukewych, Andrew H Schmidt
The techniques, materials, and designs for total joint arthroplasty underwent major improvements in the past 30 years. During this time, trauma surgeons classified the severity of fractures as well as identified certain articular fractures that do not have good outcomes and have a high rate of failure after internal fixation. Advanced improvements in arthroplasty have increased its reliability and longevity. Total joint arthroplasty is becoming a standard of care for some acute articular fractures, particularly displaced femoral neck fractures in the active elderly...
February 15, 2017: Instructional Course Lectures
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