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https://www.readbyqxmd.com/read/29781910/superior-baseplate-inclination-is-associated-with-instability-after-reverse-total-shoulder-arthroplasty
#1
Robert Z Tashjian, Brook I Martin, Cassandra A Ricketts, Heath B Henninger, Erin K Granger, Peter N Chalmers
BACKGROUND: Instability is the most common complication after reverse total shoulder arthroplasty (rTSA). In the native glenohumeral joint, in addition to full dislocations, more subtle forms of instability exist. However, the incidence of more subtle forms of instability, the factors associated with instability, and the effect of instability on validated outcome scores after rTSA remain poorly understood. QUESTIONS/PURPOSES: (1) After rTSA, what is the risk of instability, including more subtle forms of subjective instability? (2) What are the factors associated with instability? (3) Are more subtle forms of instability associated with lower American Shoulder and Elbow Surgeons (ASES) functional outcome scores than those patients without instability? METHODS: A total of 168 rTSAs were performed during the study period...
May 17, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29778591/complications-of-antibiotic-cement-spacers-used-for-shoulder-infections
#2
Edward G McFarland, Jorge Rojas, Jeremy Smalley, Amrut U Borade, Jacob Joseph
BACKGROUND: Our aim was to evaluate complications related to commercially available antibiotic cement spacers used in the treatment of shoulder infections. METHODS: We performed a retrospective review of commercially available antibiotic spacers implanted in 53 patients (60 spacers) between April 2009 and October 2017 as part of a 2-stage treatment plan for infection at the site of a shoulder arthroplasty (n = 39), other (non-arthroplasty) shoulder surgery (n = 8), or primary shoulder infection without previous surgery (n = 6)...
May 16, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29759905/analysis-of-4063-complications-of-shoulder-arthroplasty-reported-to-the-us-food-and-drug-administration-from-2012-to-2016
#3
Jeremy S Somerson, Jason E Hsu, Moni B Neradilek, Frederick A Matsen
BACKGROUND: Most of the literature on shoulder arthroplasty failure comes from high-volume centers. These reports tend to exclude the experience of community orthopedic surgeons, who perform most of the shoulder joint replacements. METHODS: We analyzed the failure reports mandated by the US Food and Drug Administration for all hospitals. Each reported event from 2012 to 2016 was characterized by implant, failure mode, and year of surgery. RESULTS: For the 1673 anatomic arthroplasties, the most common failure modes were glenoid component failure (20...
May 11, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29717991/survival-to-amputation-in-pre-antibiotic-era-a-case-study-from-a-longobard-necropolis-6th-8th-centuries-ad
#4
Ileana Micarelli, Robert Paine, Caterina Giostra, Mary Anne Tafuri, Antonio Profico, Marco Boggioni, Fabio Di Vincenzo, Danilo Massani, Andrea Papini, Giorgio Manzi
The Longobard necropolis of Povegliano Veronese dates from the 6th to the 8th centuries AD. Among the 164 tombs excavated, the skeleton of an older male shows a well-healed amputated right forearm. The orientation of the forearm fracture suggests an angled cut by a single blow. Reasons why a forearm might be amputated include combat, medical intervention, and judicial punishment. As with other amputation cases reported in literature, this one exhibits both healing and osteoblastic response. We argue that the forelimb stump morphology suggests the use of a prosthesis...
April 10, 2018: Journal of Anthropological Sciences, Rivista di Antropologia: JASS
https://www.readbyqxmd.com/read/29618894/comparative-histomorphometric-evaluation-of-healthy-and-ankylosed-mandibular-condylar-process
#5
Nandakishore Sahoo, Dibyajyoti Boruah, Ankur Thakral, Rahul Kumar, Indranil Deb Roy
Background: Temporomandibular joint (TMJ) ankylosis is one of the most disruptive maladies afflicting the masticatory system. The characteristic feature is the formation of bony mass bridging condyle with glenoid fossa. The exact pathogenesis is, however, not completely understood. Purpose: To investigate and compare histomorphometric features of ankylosed condylar specimen with normal condylar process. Materials and Methods: Group I included 17 post-traumatic unilateral TMJ ankylosis patients managed by excision of ankylosed mass and interpositional arthroplasty...
June 2018: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/29600205/open-reduction-and-internal-fixation-of-posterior-fracture-dislocation-of-the-shoulder-made-easy
#6
Waqar Saadat, Puneet Monga
Introduction: Posteriorly dislocated humeral head fracture has a great implication, as it is associated with high risk of avascular necrosis, limited access through the deltopectoral approach, and posterior approach to the posteriorly dislocated humeral fracture increases the risk to the remaining blood supply. Technical Tip: Posteriorly dislocated humeral fracture is approached through deltopectoral approach. Schanz pin is inserted into the humeral head to achieve purchase in the humeral head...
November 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29582118/reverse-total-shoulder-arthroplasty-using-helical-blade-to-optimize-glenoid-fixation-and-bone-preservation-preliminary-results-in-thirty-five-patients-with-minimum-two-year-follow-up
#7
Sebastien Zilber, Eleonora Camana, Peter Lapner, Emil Haritinian, Laurent Nove Josserand
PURPOSE: Glenoid loosening is a common cause of reverse total shoulder arthroplasty (RTSA) failure, and grafting of the glenoid is often required for revision due to bone loss due to the central peg in most glenoid baseplates. Helical blades have been used in the hip to optimize bone fixation in proximal femoral fracture. This study presents the initial results of specifically designed helical blade in the shoulder to optimize glenoid bone fixation and preservation as part of RTSA. METHODS: Thirty-five patients underwent RTSA with glenoid helical blade fixation...
March 26, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29580228/intra-and-interobserver-reliability-of-glenoid-fracture-classifications-by-ideberg-euler-and-ao
#8
F Gilbert, L Eden, R Meffert, F Konietschke, J Lotz, L Bauer, W Staab
BACKGROUND: Representing 3%-5% of shoulder girdle injuries scapula fractures are rare. Furthermore, approximately 1% of scapula fractures are intraarticularfractures of the glenoid fossa. Because of uncertain fracture morphology and limited experience, the treatment of glenoid fossa fractures is difficult. The glenoid fracture classification by Ideberg (1984) and Euler (1996) is still commonly used in literature. In 2013 a new glenoid fracture classification was introduced by the AO. The purpose of this study was to examine the new AO classification in clinical practice in comparison with the classifications by Ideberg and Euler...
March 27, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29541270/early-results-of-the-a-l-p-s-proximal-humerus-locking-plate
#9
Miltiadis Argyropoulos, Matthew Kent
Background: Open reduction internal fixation of displaced 3 and 4-part proximal humerus fractures is an effective treatment modality particularly for the younger age group, but it is not without complications. Fixed angled locking screw plates are the mainstay of fixation. The A.L.P.S. Proximal Humerus Plating System is a new implant that has smooth locking pegs in the place of humeral head screws to help reduce glenoid damage in the event of cut-out and is designed to sit low on the humerus in order to reduce the risk of subacromial impingement...
2018: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29470237/primary-shoulder-hemiarthroplasty-what-can-be-learned-from-359-cases-that-were-surgically-revised
#10
Daniel J Hackett, Jason E Hsu, Frederick A Matsen
BACKGROUND: Primary shoulder hemiarthroplasty is used to address a range of glenohumeral disorders, including fracture, arthritis, avascular necrosis, and capsulorrhaphy arthropathy; some patients with hemiarthroplasties undergo revision surgery for persistent pain or residual shoulder dysfunction. The literature does not clarify the features of the hemiarthroplasties having repeat surgery in a way that can guide surgeons' efforts to minimize the need for revision. To help address this gap, we analyzed the characteristics of patients from our region for whom we performed surgical revision of a prior humeral hemiarthroplasty QUESTIONS/PURPOSES: (1) What are the common characteristics of shoulder hemiarthroplasties having a revision? (2) What are the common characteristics of the subset of revised shoulder hemiarthroplasties that were performed for fracture? (3) What are characteristics of the subset of all revised hemiarthroplasties that were associated with glenoid bone erosion? METHODS: Data for 983 patients for whom we performed a surgical revision of any type of shoulder arthroplasty between January 1991 and January 2017 were identified in our longitudinally maintained institutional arthroplasty revision database...
May 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29457419/-treatment-of-scapular-fractures-with-lateral-incision-and-bridge-combined-internal-fixation-system
#11
Yu-Cheng Zhou, Lin-Xin Yu, Hong Duan, Jie Min, Xiao-Feng Yuan, Peng Yu, Bang-Xu Nie, Jun Hu
OBJECTIVE: To investigate the clinical results of scapula fractures with lateral incision combined with bridge internal fixation system. METHODS: From October 2012 to December 2016, 20 cases of scapular fractures were treated through the lateral incision combined with bridge fixation system, including 15 males and 5 females, with an average age of 31.6 years old(ranged, 21 to 52 years old). Fourteen cases were scapular body fracture, 10 were scapular neck fracture, 6 were scapular fracture, 1 was acromion fracture, 1 was coracoid fracture, 4 were the glenoid rim fracture, 3 were the glenoid fossa fracture...
October 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29444577/classification-of-scapular-body-fractures
#12
J Bartonicek, D Klika, M Tucek
INTRODUCTION: The aim of this study is to present, on the basis of 3D CT reconstructions of 187 of scapular body fractures, a clinically oriented classification respecting the biomechanical architecture of the scapula. METHODS: In a series of 375 scapula fractures we identified 187 body fractures in187 patients (157 men, 30 women) with the mean age of 48 years (range; 16100 years). 3D CT reconstructions were obtainedof all fractures, to allow an objective evaluation of the fracture pattern...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/29430393/arthroscopic-posterior-glenoid-fracture-fixation-using-knotless-suture-anchors
#13
Jonathan A Baxter, James Tyler, Nivander Bhamber, Magnus Arnander, Eyiyemi Pearse, Duncan Tennent
Shoulder instability after a posterior glenoid rim fracture is rare and potentially difficult pathology to treat. Operative techniques often involve a large dissection to view the fragments resulting in local soft tissue injury. Internal fixation is often achieved with interfragmentary screws; however, this may not be possible with small or multifragmentary fracture patterns. We describe an arthroscopic technique for posterior glenoid rim fracture fixation using knotless suture anchors. These anchors can be inserted without cannulas allowing easier access to the posterior glenoid...
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29427200/a-reverse-judet-approach-to-the-scapula
#14
Ruben Manohara, V Prem Kumar
Fractures of the scapular body that extend to involve the neck and glenoid articular surface with a large gap pose a significant problem for surgical exposure. Several surgical approaches for scapula fixation have been described, but all give limited exposure to the entire scapular body, neck and articular surface. Here, we describe our 'Reverse Judet' technique, with cadaveric dissections and discuss a clinical case. We believe this approach gives a wide exposure of the infraspinous scapular body, neck and glenoid articular surface while keeping away from vital neural structures...
May 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29399445/arthroscopic-lateral-border-resection-in-medialized-scapula-neck-fractures
#15
Valentin Rausch, Matthias Königshausen, Thomas A Schildhauer, Dominik Seybold, Jan Gessmann
Scapula neck fractures are rare injuries, leaving several treatment options. Standardized markers for operative treatment are a decreased glenopolar angle ≤22°, lateral border offset (LBO) of the glenoid ≥20 mm, angular deformity ≥45°, or LBO ≥15 mm plus angular deformity ≥35°. If operative treatment is not performed before union, the fracture heals malaligned with possible mechanical complications due to a medialized glenoid and the protruding lateral border. Common operative treatment comprises a corrective osteotomy for the anatomic correction of the malunited fracture, leaving intra-articular pathologies like adhesive capsular stiffness unaddressed...
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29397295/glenoid-neck-hounsfield-units-on-computed-tomography-can-accurately-identify-patients-with-low-bone-mineral-density
#16
Kyle E Nappo, Daniel L Christensen, Jared A Wolfe, Scott M Tintle
BACKGROUND: Osteoporosis is a costly and morbid disease with the first presentation often with a fragility fracture. The purpose of this study was to assess whether Hounsfield unit (HU) measurements on shoulder computed tomography could identify patients at risk of osteoporosis and aid in its diagnosis. METHODS: We identified patients who had both a computed tomography scan of the glenoid and a dual-energy x-ray absorptiometry scan. Dual-energy x-ray absorptiometry results and HU measurements of the patients' glenoid were recorded...
January 31, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29396694/feasibility-of-using-an-inversion-recovery-ultrashort-echo-time-ute-sequence-for-quantification-of-glenoid-bone-loss
#17
Ya-Jun Ma, Justin West, Amin Nazaran, Xin Cheng, Heinz Hoenecke, Jiang Du, Eric Y Chang
OBJECTIVE: To utilize the 3D inversion recovery prepared ultrashort echo time with cones readout (IR-UTE-Cones) MRI technique for direct imaging of lamellar bone with comparison to the gold standard of computed tomography (CT). MATERIALS AND METHODS: CT and MRI was performed on 11 shoulder specimens and three patients. Five specimens had imaging performed before and after glenoid fracture (osteotomy). 2D and 3D volume-rendered CT images were reconstructed and conventional T1-weighted and 3D IR-UTE-Cones MRI techniques were performed...
February 2, 2018: Skeletal Radiology
https://www.readbyqxmd.com/read/29337029/arthroscopic-latarjet-procedure-with-double-button-fixation-short-term-complications-and-learning-curve-analysis
#18
Nicolas Bonnevialle, Charles Edouard Thélu, Yves Bouju, Jérôme Vogels, Charles Agout, Pauline Duriez, Vadim Azoulay
BACKGROUND: The arthroscopic Latarjet with double-button fixation is a guided procedure recently proposed to treat anterior shoulder instability with glenoid bone loss. The goal of this study was to report intraoperative and early postoperative complications and to analyze the learning curve. METHODS: This was a prospective, nonrandomized study that included 88 patients. Intraoperative or postoperative complications as well as adverse events and operative time were recorded...
January 12, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29332226/monocortical-fixation-of-the-coracoid-in-the-latarjet-procedure-is-significantly-weaker-than-bicortical-fixation
#19
Uli Schmiddem, Nael Hawi, Emmanouil Liodakis, Antonios Dratzidis, Manuel Kraemer, Christof Hurschler, Richard Page, Rupert Meller
PURPOSE: A crucial step of the Latarjet procedure is the fixation of the coracoid process onto the glenoid. Multiple problems associated with the fixation have been described, including lesions of the suprascapular nerve due to prominence of the screw or bicortical drilling. The purpose of the present study was to evaluate whether monocortical fixation, without perforating the posterior glenoid cortex, would provide sufficient graft stability. METHODS: Coracoid transfer was performed in 14 scapula models (Sawbones® , Composite Scapula, 4th generation)...
January 13, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29322888/epidemiology-of-scapular-fractures
#20
M Tuček, A Chochola, D Klika, J Bartoníček
The aim of the study has been to acquire basic epidemiological data based on a representative group of patients with scapular fractures treated in one centre. The study analyses group of 250 patients. Diagnostics was based on CT examinations, in 227 cases with 3D reconstructions, in 97 cases compared with operative findings. Fractures were classified according to the modified anatomical classification of Tscherne and Christ. The analysed groups of patients include only the fracture lines whose existence has been verified by 3D CT reconstructions and intraoperative findings...
March 2017: Acta Orthopaedica Belgica
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