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Humeral Fractures

Cees de Baat, Paul de Baat, Anneloes E Gerritsen, Karien A Flohil, Gert-Jan van der Putten, Claar D van der Maarel-Wierink
One-third of community-dwelling people older than 65 years of age fall each year, and half of them fall at least twice a year. Older care home residents are approximately three times more likely to fall when compared to community-dwelling older people. Risk indicators for falls are related to the older people's body, environment, behavior, and activities. An important health risk indicator is (orthostatic or postprandial) hypotension, which may induce cerebral hypoperfusion. Although the majority of falls remain without major consequences, 10% to 25% of falls in care homes result in bodily trauma...
October 22, 2016: Special Care in Dentistry
Gareth Davies, Gerald Yeo, Mahendrakumar Meta, David Miller, Erik Hohmann, Kevin Tetsworth
OBJECTIVES: To compare the risk of major complications after either minimally invasive plate osteosynthesis (MIPO) or intramedullary nailing (IMN) of humeral shaft fractures. DESIGN: Retrospective, case-match controlled study. SETTING: A major metropolitan tertiary referral trauma center in Australia. PATIENTS: Thirty patients with fractures of the humeral shaft. INTERVENTION: Either MIPO or IMN were performed on 15 patients each with traumatic humeral shaft fractures...
November 2016: Journal of Orthopaedic Trauma
G Zhao, H N Liu, N Li, L He, X B Wu
Objective: To evaluate the mid-term clinical efficacy of plate and intramedullary nail for humeral shaft fracture. Methods: In this retrospective study a total of 122 patients with humeral shaft fracture were divided into 2 groups according to surgery type from May 2010 to July 2012. There were 63 patients in plate group and 59 patients in intramedullary nail group. The factors related to the operation for each group were compared respectively. The clinical outcome was evaluated by the Neer scores, Myao scores and EuroQol 5 dimensions scores (EQ-5D)...
October 11, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
H H G Handoll, S D Brealey, L Jefferson, A Keding, A J Brooksbank, A J Johnstone, J J Candal-Couto, A Rangan
OBJECTIVES: Accurate characterisation of fractures is essential in fracture management trials. However, this is often hampered by poor inter-observer agreement. This article describes the practicalities of defining the fracture population, based on the Neer classification, within a pragmatic multicentre randomised controlled trial in which surgical treatment was compared with non-surgical treatment in adults with displaced fractures of the proximal humerus involving the surgical neck...
October 2016: Bone & Joint Research
Kiran C Mahabier, Esther M M Van Lieshout, Boyd C Van Der Schaaf, Gert R Roukema, Bas J Punt, Michael H J Verhofstad, Dennis Den Hartog
OBJECTIVES: This study aimed to determine inter-observer reliability and intra-observer reproducibility of the OTA/AO classification for humeral shaft fractures, and to evaluate differences between fracture types, fracture groups, and surgical specializations. METHODS: 30 observers (25 orthopedic trauma surgeons and five general orthopedic surgeons) independently classified 90 humeral shaft fractures according to the OTA/AO classification. Patients of 16 years and older were included...
October 13, 2016: Journal of Orthopaedic Trauma
Eugene T H Ek, Sophia K Paul, Robert N Hotchkiss
BACKGROUND: The role of elbow contracture release in the very young is unclear, with existing studies reporting conflicting results. This study evaluated the long-term results after open elbow contracture release in patients aged younger than 18 years. METHODS: Between 1994 and 2012, 32 patients underwent open elbow contracture release at a mean age of 13.8 years (range, 5-18 years), and their outcomes were reviewed. The primary cause was traumatic in 30 patients (4 radial head/neck fractures, 5 intra-articular distal humeral fractures, 11 extra-articular distal humeral fractures, 10 complex fracture-dislocations), and the mean time from the index injury to contracture release was 16...
October 14, 2016: Journal of Shoulder and Elbow Surgery
Kuang-Ming Liao, Fu-Wen Liang, Chung-Yi Li
Patients with chronic obstructive pulmonary disease (COPD) have a high prevalence of osteoporosis. The clinical sequel of osteoporosis is fracture. Patients with COPD who experience a fracture also have increased morbidity and mortality. Currently, the types of all-cause and site-specific fracture among patients with COPD are unknown. Thus, we elucidated the all-cause and site-specific fractures among patients with COPD.A retrospective, population-based, cohort study was conducted utilizing the Taiwan Longitudinal Health Insurance Database...
October 2016: Medicine (Baltimore)
H Naouli, B Benfor, H Jiber, A Bouarhroum
Axillary artery injury from humeral neck fracture is an uncommon event. Vascular damage due to these injuries may threaten limb loss. In some cases, the signs of ischemia may not be evident just after the injury and may only appear later on. Therefore, a high index of suspicion is essential. It is important to bear this association in mind, so as to make an early diagnosis and avoid serious complications. We are describing the case of a young patient involved in a motor vehicle crash with an axillary artery trauma due to the surgical neck of humerus fracture...
October 13, 2016: Journal des Maladies Vasculaires
Kiran C Mahabier, Dennis Den Hartog, Nina Theyskens, Michael H J Verhofstad, Esther M M Van Lieshout
BACKGROUND: The Disabilities of the Arm, Shoulder and Hand (DASH) and Constant-Murley scores are commonly used instruments. The DASH is patient-reported, and the Constant-Murley combines a clinician-reported and a patient-reported part. For patients with a humeral shaft fracture, their validity, reliability, responsiveness, and minimal important change (MIC) have not been published. This study evaluated the measurement properties of these instruments in patients who sustained a humeral shaft fracture...
October 10, 2016: Journal of Shoulder and Elbow Surgery
Elizabeth B Gausden, Alexander B Christ, Stephen J Warner, Ashley Levack, Andrew Nellestein, Dean G Lorich
INTRODUCTION: The optimal treatment of humeral shaft fractures continues to be debated. In the current investigation, we sought to determine the clinical and radiographic outcomes following the plate fixation of humeral shaft fractures utilizing the triceps-sparing posterior approach. MATERIALS AND METHODS: A retrospective review identified a consecutive series of 66 humeral shaft fractures (OTA 12-A, 12-B, or 12-C) treated with dual plate fixation via a posterior, triceps-sparing approach between 2005 and 2014 by a single surgeon...
October 15, 2016: Archives of Orthopaedic and Trauma Surgery
Derrick M Knapik, Cameron L Fausett, Allison Gilmore, Raymond W Liu
BACKGROUND: Medial epicondyle fractures may occur in isolation or with associated elbow dislocation. In the absence of open fracture or fragment incarceration, nonoperative management with immobilization has been shown to result in generally successfully outcomes comparable with those reported after surgical fixation. However, no comparative investigation has assessed outcomes after nonoperative treatment based on the presence or absence of elbow dislocation. METHODS: A systematic review was conducted investigating all studies in the literature reporting nonoperative outcomes for isolated medial epicondyle fractures and fracture-dislocations...
October 12, 2016: Journal of Pediatric Orthopedics
Anshuman Singh, Michael Padilla, Eric M Nyberg, Mary Chocas, Oke Anakwenze, Raffy Mirzayan, Edward H Yian, Ronald A Navarro
BACKGROUND: Tuberosity healing correlates with clinical outcomes after hemiarthroplasty for 4-part proximal humeral fractures (4PHFs). We seek to examine variables that affect tuberosity healing. METHODS: This was a retrospective comparative study. At 1 year postoperatively, patients who underwent hemiarthroplasty for 4PHFs were divided into 2 groups: those with anatomically healed tuberosities and those with tuberosity nonunion. The primary variables included time between injury and surgery, prosthesis fenestration, cement mantle classification, and both vertical and horizontal tuberosity reduction...
October 7, 2016: Journal of Shoulder and Elbow Surgery
Thomas Westphal, Stephan Woischnik, Daniela Adolf, Helmut Feistner, Stefan Piatek
BACKGROUND: Axillary nerve injuries after shoulder surgery are rare. In most studies, the frequency of injury is usually determined using clinical examinations, but results from intraoperative neuromonitoring studies have revealed higher than expected rates. Few studies have investigated this topic. Our aim was to determine the frequency of axillary nerve lesions after open reduction and internal fixation of proximal humeral fractures by using electrophysiological assessments and to provide a review of the relevant literature...
October 7, 2016: Journal of Shoulder and Elbow Surgery
Bauke W Kooistra, W Jaap Willems, Eelke Lemmens, Bas P Hartel, Michel P J van den Bekerom, Derek F P van Deurzen
BACKGROUND: Compared with total shoulder arthroplasty (TSA), total shoulder surface replacement (TSSR) may offer the advantage of preservation of bone stock and shorter surgical time, possibly at the expense of glenoid component positioning and increasing lateral glenohumeral offset. We hypothesized that in patients treated for osteoarthritis with a sufficient rotator cuff, TSA and TSSR patients have comparable functional outcome, glenoid component version, and lateral glenohumeral offset...
October 7, 2016: Journal of Shoulder and Elbow Surgery
Jorge Delgado, Diego Jaramillo, Nancy A Chauvin
Increased physical activity in childhood has resulted in a large number of sports-related injuries. Although there is overlap between the sports-related injuries seen in pediatric and adult patients, important differences exist in the injury patterns of pediatric patients. These differences are related to the continuous changes in the developing skeleton and its relationship with adjacent soft tissues. The imbalance in strength between the growing bones and the nearby tendons and ligaments makes the bones prone to acute and chronic injuries...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Laurent Obert, Christelle Peyron, Etienne Boyer, Gauthier Menu, François Loisel, Sébastien Aubry
INTRODUCTION: The shoulder arthroplasty brings satisfaction to patients in terms of quality of life and indolence. However whether anatomic implant or reverse, it does not escape from the loosening of the glenoid component. Moreover, optimal implantation is required to ensure the functional outcome without shortening of the arm. The purpose of this study is obtain CT scan evaluation of the glenoid bone stock in order to optimize glenoid component implantation and obtain a reference to determine optimal humeral component placement in case of humeral proximal fracture...
2016: SICOT-J
Denty Paul Vaughn, Jason Alan Syrcle, John E Ball, Steven H Elder, Jennifer Michele Gambino, Russell L Griffin, Ronald M McLaughlin
OBJECTIVE: Monocortical screws are commonly employed in locking plate fixation, but specific recommendations for their placement are lacking and use of short monocortical screws in metaphyseal bone may be contraindicated. Objectives of this study were to evaluate axial pullout strength of two different lengths of monocortical screws placed in various regions of the canine humerus compared to bicortical screws and to derive cortical thickness and bone density values for those regions using quantitative computed tomography analysis (QCT)...
October 6, 2016: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
Raju Vaishya, Vipul Vijay, Ram Sagar Pandit, Amit K Agarwal
INTRODUCTION: Fractures of the distal humerus are a rare entity accounting for approximately 2% of the humeral fractures. Non union of the distal humerus is further rare and poses a major challenge. These fractures usually respond to open reduction and bone grafting but some may fail multiple surgical attempts at union and hence are labelled as "resistant" non union. We report a case of resistant non union of the distal humerus which was managed by total elbow arthroplasty. CASE PRESENTATION: A 49-year-old male presented to the out patient department with history of a compound comminuted fracture of the distal end of the humerus approximately 25 years back...
April 2016: Journal of Orthopaedic Case Reports
J-J Sinikumpu, S Victorzon, T Pokka, E-L Lindholm, T Peljo, W Serlo
AIMS: We present the clinical and radiographic outcome of 81 children with Gartland type I to III supracondylar humeral fractures at a minimum follow-up of ten years (mean 12.1 years; 10.3 to 16.1) following injury. PATIENTS AND METHODS: The clinical and functional outcomes are compared with normal age- and gender-matched individuals. The population-based study setting was first identified from the institutional registries; the rate of participation was 76%. Controls were randomly selected from Finnish National Population Registry...
October 2016: Bone & Joint Journal
C D Smith, S J Booker, H S Uppal, J Kitson, T D Bunker
AIMS: Despite the expansion of arthroscopic surgery of the shoulder, the open deltopectoral approach is increasingly used for the fixation of fractures and arthroplasty of the shoulder. The anatomy of the terminal branches of the posterior circumflex humeral artery (PCHA) has not been described before. We undertook an investigation to correct this omission. PATIENTS AND METHODS: The vascular anatomy encountered during 100 consecutive elective deltopectoral approaches was recorded, and the common variants of the terminal branches of the PCHA are described...
October 2016: Bone & Joint Journal
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