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Humeral Fractures

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https://www.readbyqxmd.com/read/28926381/total-elbow-arthroplasty-for-distal-humeral-fractures-a-ten-year-minimum-follow-up-study
#1
Raul Barco, Philipp N Streubel, Bernard F Morrey, Joaquin Sanchez-Sotelo
BACKGROUND: Total elbow arthroplasty is commonly considered for elderly patients with comminuted distal humeral fractures. Satisfactory short-term outcomes have been reported, but long-term outcomes are unknown. Our purpose was to assess the long-term outcomes of total elbow arthroplasty after distal humeral fracture and to determine differences between elbows with or without inflammatory arthritis at the time of fracture. METHODS: Forty-four total elbow arthroplasties were performed after distal humeral fracture; those patients were followed for a minimum of 10 years and were evaluated with regard to pain, motion, Mayo Elbow Performance Scores, complications, and reoperations...
September 20, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28916133/a-modified-deltoid-splitting-approach-with-axillary-nerve-bundle-mobilization-for-proximal-humeral-fracture-fixation
#2
Young Ho Shin, Young Ho Lee, Ho Sung Choi, Min Bom Kim, Sung Hee Pyo, Goo Hyun Baek
INTRODUCTION: The deltopectoral and the deltoid splitting approach are commonly used for the treatment of proximal humeral fractures. While the deltopectoral approach requires massive soft tissue devascularization, the deltoid splitting approach needs an additional skipped incision to avoid axillary nerve injury. The purpose of this study was to describe a modified anterolateral deltoid splitting approach with axillary nerve bundle mobilization in the treatment of proximal humeral fractures and to assess its radiologic and clinical outcomes...
September 8, 2017: Injury
https://www.readbyqxmd.com/read/28890408/interventions-for-treating-3-or-4-part-proximal-humeral-fractures-in-elderly-patient-a-network-meta-analysis-of-randomized-controlled-trials
#3
REVIEW
Shaolong Du, Jiahao Ye, Haolong Chen, Xishan Li, Qiang Lin
BACKGROUND: The fractures of proximal humerus have a high incidence in elderly patients, especially 3- or 4-part fracture. There are 4 main treatments including nonoperation, open reduction and internal fixation(ORIF), hemiarthroplasty(HA) and reverse shoulder arthroplasty(RSA). However, which one is the optimal choice remains a controversial topic. METHODS: Through the search of three electronic databases (PubMed, Embase, and Cochrane), the randomized controlled trials of 3- or 4-part proximal humeral fracture, until the end of July 2017, which is concerned with the elderly patients, were identified...
September 7, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28885384/a-new-stem-guide-and-a-tuberosity-anchoring-lasso-system-for-shoulder-hemiarthroplasty-in-the-treatment-of-complex-proximal-humerus-fractures
#4
Philippe Valenti, Davide Aliani, Charbel Maroun, Jean-David Werthel
Hemiarthroplasty implantation for proximal humerus fracture is challenging. In case of young demanding patients with functional rotator cuff, humeral head replacement is an option if open reduction internal fixation is not a viable solution. The criteria for success in terms of clinical outcomes and longevity are anatomic healing of the tuberosities and stem positioning (restoring correct height, version, and axis). The purpose of this article is to describe a technique including a new stem guide and a tuberosity anchor "lasso" system for the implantation of hemiarthroplasty in complex proximal humerus fractures...
September 6, 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28878539/unusual-association-of-elbow-dislocation-with-humeral-biepicondylar-fracture-in-a-child-a-case-report-and-review-of-literature
#5
Prabhat Agrawal, Saubhik Das, Vikas Gupta, Sumit Arora
Humeral biepicondylar fracture with elbow dislocation is an unusual pattern of injury encountered in paediatric population. We reported a case of humeral biepicondylar fracture-dislocation of elbow in a 11-year-old boy, who presented with tender, swollen, and deformed left elbow following fall on his outstretched hand. Roentgenographic and CT evaluation confirmed the diagnosis, and also showed incarcerated medial epicondylar fragment. Closed reduction was unsuccessful; open reduction and internal fixation was performed with headless screws...
August 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28877198/correlation-between-classification-and-secondary-screw-penetration-in-proximal-humeral-fractures
#6
Qiuke Wang, Yu Zhu, Yifei Liu, Lei Wang, Yunfeng Chen
OBJECTIVES: In this study, we investigated the correlation between fracture classification and secondary screw penetration. METHODS: We retrospectively identified 189 patients with displaced proximal humeral fractures treated by ORIF at our hospital between June 2006 and June 2013. All fractures were classified radiographically before surgery and follow-up for least 2 years after surgery was recommended. At each follow-up, radiographs were taken in three orthogonal views to evaluate secondary screw penetration...
2017: PloS One
https://www.readbyqxmd.com/read/28872538/making-the-unfamiliar-more-familiar-good-for-patients-and-hospitals-alike-commentary-on-an-article-by-kelly-flynn-et-al-flexion-type-supracondylar-humeral-fractures-ulnar-nerve-injury-increases-risk-of-open-reduction
#7
https://www.readbyqxmd.com/read/28872531/flexion-type-supracondylar-humeral-fractures-ulnar-nerve-injury-increases-risk-of-open-reduction
#8
Kelly Flynn, Apurva S Shah, Christopher M Brusalis, Kelly Leddy, John M Flynn
BACKGROUND: The vast majority of displaced pediatric supracondylar humeral fractures can be treated successfully with closed reduction and percutaneous pinning. The need for open reduction is difficult to determine a priori and is typically due to the failure of closed reduction attempts or persistent limb ischemia. The aims of this study were to determine the prevalence of flexion-type supracondylar humeral fractures, the rate of open reduction for flexion-type fractures, and the predictive impact of ulnar nerve injury on the need for open reduction for flexion-type supracondylar humeral fractures...
September 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28861208/retrograde-intramedullary-nailing-for-humerus-fracture-in-a-supine-position-performing-an-unfamiliar-procedure-in-a-familiar-position
#9
Jin Woong Yi, Jae Sin Lee, Hyung Jun Cho
Intramedullary (IM) nailing for humeral shaft fracture has provided excellent outcomes in terms of fracture biology and cosmetic appearance because of the relatively small incision involved. However, antegrade nailing causes issues such as iatrogenic rotator cuff injury. Retrograde nail fixation method could avoid cuff injury, but has shortcomings such as the need for the prone or lateral decubitus position during surgery. We report that the retrograde IM nail fixation technique performed in a supine position and some ancillary techniques for minimizing scars or complications can provide the advantages of both retrograde nailing and supine position during surgery...
September 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28852352/closed-and-open-reduction-of-displaced-pediatric-lateral-condyle-humeral-fractures-a-study-of-short-term-complications-and-postoperative-protocols
#10
Caitlin Justus, Lee S Haruno, Mary K Riordan, Lisa Wilsford, Tyler Smith, Shannon Antekeier, Scott D McKay
BACKGROUND: Displaced lateral condyle humeral fractures in children are treated operatively to maximize function and growth of the elbow. Traditionally an open approach is used for reduction of the fracture, but recent series have shown promising results with closed reduction. Percutaneous pins are typically used for fixation, no matter the reduction method. This retrospective review compares our experience with early complications after open and closed reduction of these fractures. METHODS: We retrospectively reviewed charts and radiographs of operatively treated lateral condyle fractures...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28852335/proximal-humerus-fracture-dislocation-with-laceration-of-the-axillary-artery-a-case-report
#11
Steven J Cotman, Thai Q Trinh, Stephen Vincent, Jeffrey R Backes
BACKGROUND: Proximal humerus fractures account for approximately 4-6% of all fractures. While the majority of these fractures are treated non-operatively, the amount of fracture displacement, concomitant injuries, and patient factors often result in the need for surgical stabilization. Although concomitant neurovascular injury in the setting of low-energy trauma is rare, injury to the surrounding neurovascular structures have previously been reported. METHODS: We report a case of a 79-year-old male who sustained a low energy fall resulting in a two-part fracture dislocation of the proximal humerus with an associated brachial plexopathy and axillary artery laceration...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28852327/dynamic-fixation-of-humeral-shaft-fractures-using-active-locking-plates-a-prospective-observational-study
#12
Steven M Madey, Stanley Tsai, Daniel C Fitzpatrick, Kathleen Earley, Michael Lutsch, Michael Bottlang
BACKGROUND: Rigid locked plating constructs can suppress fracture healing by inhibiting interfragmentary motion required to stimulate natural bone healing by callus formation. Dynamic fixation with active locking plates reduces construct stiffness, enables controlled interfragmentary motion, and has been shown to induce faster and stronger bone healing in vivo compared to rigid locking plates. This prospective observational study represents the first clinical use of active locking plates...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28844418/early-results-of-latitude-primary-total-elbow-replacement-with-a-minimum-follow-up-of-2-years
#13
Saurabh S Mehta, Adam C Watts, Sumedh C Talwalkar, Ann Birch, David Nuttall, Ian A Trail
BACKGROUND: The aim of this study was to present outcomes of primary Latitude total elbow replacement (TER) with a minimum follow-up of 2 years. METHODS: A retrospective cohort study was undertaken with prospective outcome data collection for the latest outcome. Included were 63 consecutive primary Latitude TERs in 58 patients performed during a period of 5 years at a specialist orthopedic hospital. RESULTS: The mean age of the patients was 62 years (33-85 years)...
August 22, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28834878/unburied-versus-buried-wires-for-fixation-of-pediatric-lateral-condyle-distal-humeral-fractures-a-meta-analysis
#14
Ya-Fei Qin, Zhi-Jun Li, Cheng-Kai Li, Shu-Cai Bai, Hui Li
Open reduction and internal fixation with Kirschner (K) wires has been reported as an efficient and convenient technique for pediatric lateral condyle distal humeral fractures. However, no single study has been large enough to definitively determine whether the K-wires should be buried or unburied. Therefore, we performed a meta-analysis pooling the results from several clinical trials to compare the outcome of using buried versus unburied K-wires. Potential academic articles were identified from the Cochrane Library, Medline (1966-2017...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28831589/functional-and-quality-of-life-outcome-after-non-operatively-managed-proximal-humeral-fractures
#15
Ronnart N Kruithof, Henk A Formijne Jonkers, Denise J C van der Ven, Ger D J van Olden, Tim K Timmers
BACKGROUND: Fractures of the proximal humerus are common and most often treated non-operatively. However, long-term follow-up studies focusing on functional results and quality of life in patients after this type of fracture are scarce. The primary aim of this study is to report the long-term functional and quality of life outcome in patients with a proximal humeral fracture. MATERIALS AND METHODS: A retrospective analysis of all consecutive patients undergoing non-operative treatment for a proximal humeral fracture in a level 2 trauma centre between January 2000 and December 2013 was performed...
August 22, 2017: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/28828634/potential-risk-factors-for-birth-fractures-a-case-control-study
#16
Thanase Ariyawatkul, Kitti Worawuthangkul, Chatupon Chotigavanichaya, Kamolporn Kaewpornsawan, Ornusa Chalayon, Perajit Eamsobhana
INTRODUCTION AND HYPOTHESIS: Birth fractures are uncommon but remain a concern among obstetricians. Although such fractures usually heal without long-term sequelae, some are associated with lifelong disabilities, such as brachial plexus injuries. The purpose of this study was primarily to investigate risk factors related to birth fractures. METHODS: This study comprised newborns delivered at our institute between 2003 and 2013. All 46 birth fractures were reviewed and compared with 223 randomly selected normal neonates...
August 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28819468/paediatric-fractures-in-a-sub-saharan-tertiary-care-center-a-cohort-analysis-of-demographic-characteristics-clinical-presentation-therapeutic-patterns-and-outcomes
#17
Marc Leroy Guifo, Joel Noutakdie Tochie, Blondel Nana Oumarou, Jean Roger Moulion Tapouh, Aristide Guy Bang, Aurelien Ndoumbe, Bonaventure Jemea, Maurice Aurelien Sosso
INTRODUCTION: Paediatric fractures are often of good prognosis due to auto-correction of insufficient fracture reduction by bone remodeling. In sub-Saharan Africa, traditional healers are renowned for managing fractures and there is a neglect for specialized pediatric fracture care. We aimed to determine the demographic characteristics, clinical presentation, treatment patterns and outcomes of paediatric fractures in a tertiary health care centre in Yaoundé. METHODS: We conducted a prospective cohort study of all consenting consecutive cases of fractures in patients younger than 16 years managed between January 2011 and June 2015 at the University Teaching Hospital, Cameroon...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28817161/biomechanical-evaluation-of-unicortical-stress-risers-of-the-proximal-humerus-associated-with-pectoralis-major-repair
#18
David J Wilson, Brian P Milam, William F Scully, Todd P Balog, Kyong S Min, Christopher S Chen, Bryant G Marchant, Edward D Arrington
Proximal humerus fracture after pectoralis major tendon repair has been recently reported. Although this complication is rare, it may be possible to decrease such risk using newer techniques for myotenodesis. This study was designed to evaluate various unicortical stress risers created at the proximal humeral metadiaphysis during myotenodesis for repair of pectoralis major ruptures. A simulated pectoralis major myotenodesis was performed using fourth-generation Sawbones (N=30). Using previously described anatomic landmarks for the tendinous insertion, 3 repair techniques were compared: bone trough, tenodesis screws, and suture anchors (N=10 each)...
August 17, 2017: Orthopedics
https://www.readbyqxmd.com/read/28811060/isolated-osteochondral-fracture-of-the-trochlea-in-the-coronal-plane-in-a-child-before-ossification-of-the-trochlea-a-case-report-and-literature-review
#19
Koichi Yano, Yasunori Kaneshiro, Hideki Sakanaka
Isolated coronal shear fracture of the trochlea is a rare injury. Isolated fractures of the humeral trochlea have all been reported in adults. We present the case of a 7-year-old boy with pain and swelling of the elbow joint. Magnetic resonance imaging and arthrogram revealed an isolated osteochondral fracture of the trochlea in the coronal plane. Ossification of the trochlea had not yet occurred. An anterior approach was used for reduction and fixation of the fragment. A good clinical outcome was achieved with no signs of bony or chondral necrosis of the fragment 1 year after surgery...
August 12, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28802426/comparison-between-antegrade-intramedullary-nailing-imn-open-reduction-plate-osteosynthesis-orpo-and-minimally-invasive-plate-osteosynthesis-mipo-in-treatment-of-humerus-diaphyseal-fractures
#20
Vidisha Sunil Kulkarni, Madhura Sujay Kulkarni, Govind Shivram Kulkarni, Vaibhav Goyal, Milind Govind Kulkarni
INTRODUCTION: The three currently used methods of treatment: namely open reduction plate osteosynthesis (ORPO), Minimally invasive plate osteosynthesis (MIPO), antegrade intramedullary nailing(IMN) are all reported as satisfactory procedures for treatment of humeral shaft fractures. However none of the published reports have a comparison of superiority of one procedure over the other. We evaluated the clinical, radiological and functional outcome of the three procedures. MATERIALS AND METHODS: We studied adult patients with humerus shaft fractures over a period of 2 years from May 2014 to May 2016 in a level 1 trauma center...
August 2017: Injury
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