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Humeral Fractures

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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/29779979/intercalary-prosthetic-reconstruction-for-pathologic-diaphyseal-humeral-fractures-due-to-metastatic-tumors-outcomes-and-improvements
#2
Jie Zhao, Xiu-Chun Yu, Ming Xu, Kai Zheng, Yong-Cheng Hu, Feng Wang, Deng-Xing Lun
BACKGROUND: There is a high aseptic loosening rate for intercalary prosthetic reconstruction for malignant tumors. We evaluated outcomes and complications of intercalary prosthetic reconstruction for pathologic diaphyseal humeral fractures and report the application of an extracortical plate that can prevent early loosening. METHODS: We retrospectively analyzed 9 patients who underwent intercalary prosthetic reconstruction for pathologic diaphyseal humeral fractures secondary to metastatic diseases between March 2011 and September 2017...
May 17, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29779978/biomechanical-evaluation-of-cable-and-suture-cerclages-for-tuberosity-reattachment-in-a-4-part-proximal-humeral-fracture-model-treated-with-reverse-shoulder-arthroplasty
#3
Dominik Knierzinger, Christian H Heinrichs, Clemens Hengg, Marko Konschake, Franz Kralinger, Werner Schmoelz
BACKGROUND: Sufficient tuberosity fixation in proximal humeral fractures treated with shoulder arthroplasty is essential to gain a good clinical outcome. This biomechanical study evaluated the strength of the reattached tuberosities in reverse total shoulder arthroplasty fixed with cables or with sutures in a cerclage-like technique. Considering the mechanical advantages of flexible titanium alloy cables compared with conventional sutures for cerclage-like fixations, we hypothesized that titanium alloy cables would achieve higher fixation strengths of the tuberosities compared with heavy nonabsorbable sutures...
May 17, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29778591/complications-of-antibiotic-cement-spacers-used-for-shoulder-infections
#4
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/29777778/anterior-approach-in-humeral-plating-osteosynthesis
#5
Daniel Handy Eone, Prudence Christelle Danielle Ngono, Marie Josée Essi, Gaël Leckpa, Kennedy Olivier Muluem, Farikou Ibrahima, Maurice Aurélien Sosso
CONTEXT: Humeral plating osteosynthesis is controversial, particularly regarding the choice between anterior and lateral approach, data for which in the context of a low-income country are lacking. HYPOTHESIS: The anterior approach is an easy surgical technique, allowing good anatomic reconstruction. We hypothesize that the anterior approach is associated with fewer neurovascular lesions and functional sequelae than the lateral approach. MATERIALS AND METHODS: A retrospective study with assessment update was carried out over a period of 6 years 4 months from January 2010 to June 2016, with consecutive recruitment in the city of Yaoundé, Cameroon...
May 16, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29762342/humeral-stem-loosening-following-reverse-shoulder-arthroplasty-a-systematic-review-and-meta-analysis
#6
Ben Grey, Reitze N Rodseth, Stephen J Roche
BACKGROUND: Aseptic stem loosening following reverse shoulder arthroplasty (RSA) is an uncommon complication. The timing and the factors contributing to aseptic stem loosening remain poorly understood. METHODS: We performed a systematic review that identified 75 articles; 65 of the included articles were case series (Level-IV evidence), 8 were cohort studies (7 Level III, 1 Level II), and 2 were prospective randomized controlled trials (Level I). A meta-analysis of 1,660 cemented and 805 uncemented RSA stems was performed...
May 15, 2018: JBJS Reviews
https://www.readbyqxmd.com/read/29762292/a-dedicated-satellite-trauma-orthopaedic-program-operating-room-safely-increases-capacity
#7
Peter M Waters, Brian W Yang, Doreen White, Ellen Barth, Vincent Chiang, Arielle Mizrahi-Arnaud, William Sparks
BACKGROUND: Providing high-value care for urgent orthopaedic trauma patients requires effective and timely treatment. Herein, we describe the implementation of an innovative program utilizing the operating room (OR) capacity of a satellite campus to decrease stress on a pediatric tertiary care center without jeopardizing patient safety. METHODS: In addition to the daily emergency surgical room on the main campus, a dedicated orthopaedic trauma surgery OR was established in a satellite hospital location for 3 days per week in the summer and for 2 days per week for the rest of the year...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
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
#8
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/29755914/supracondylar-humeral-fractures-an-audit-of-the-frequency-of-bi-columnar-fixation-and-intra-articular-wire-placement
#9
Andrew Ker, Claire Murnaghan, James S Huntley
Introduction For supracondylar humeral (SCH) fractures, biomechanical studies suggest the most stable wire configuration achieves bi-columnar fixation. Achieving medial column fixation using lateral-entry-only wires may require an intracapsular entry point. The aim of this study was to identify the rate of bi-columnar fixation achieved in our department when treating SCH fractures with percutaneous wire fixation. A secondary aim was to identify the rate of placement of an intra-articular wire. Further aims were to examine if failure to achieve bi-columnar fixation was associated with an increased loss of fixation and whether the placement of an intra-articular wire resulted in any cases of deep infection or septic arthritis...
March 13, 2018: Curēus
https://www.readbyqxmd.com/read/29735376/operative-versus-nonoperative-treatment-of-proximal-humeral-fractures-a-systematic-review-meta-analysis-and-comparison-of-observational-studies-and-randomized-controlled-trials
#10
REVIEW
Reinier B Beks, Yassine Ochen, Herman Frima, Diederik P J Smeeing, Olivier van der Meijden, Tim K Timmers, Detlef van der Velde, Mark van Heijl, Luke P H Leenen, Rolf H H Groenwold, R Marijn Houwert
BACKGROUND: There is no consensus on the choice of treatment for displaced proximal humeral fractures in older patients (aged > 65 years). The aims of this systematic review and meta-analysis were (1) to compare operative with nonoperative management of displaced proximal humeral fractures and (2) to compare effect estimates obtained from randomized controlled trials (RCTs) and observational studies. METHODS: The databases of MEDLINE, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), and CINAHL (Cumulative Index to Nursing and Allied Health Literature) were searched on September 5, 2017, for studies comparing operative versus nonoperative treatment of proximal humeral fractures; both RCTs and observational studies were included...
May 4, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29735375/which-additional-augmented-fixation-procedure-decreases-surgical-failure-after-proximal-humeral-fracture-with-medial-comminution-fibular-allograft-or-inferomedial-screws
#11
Doo-Sup Kim, Doo-Hyung Lee, Yong-Min Chun, Sang-Jin Shin
BACKGROUND: The purpose of this study was to compare clinical and radiologic results between treatment with locking plate fixation and fibular allograft augmentation (FA) and treatment with locking plate fixation and additional inferomedial screws (IMSs) in 3- or 4-part proximal humeral fractures with medial comminution in geriatric patients. METHODS: We enrolled 164 patients with 3- or 4-part proximal humeral fractures with medial comminution who were treated with locking plates...
May 4, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29735339/distal-medial-tibial-locking-plate-for-fixation-of-extraarticular-distal-humeral-fractures-an-alternative-choice-for-fixation
#12
Ali Cagdas Yorukoglu, Ahmet Fahir Demirkan, Nihal Buker
OBJECTIVE: The aim of this study was to describe an alternative fixation method for distal humeral extra-articular fractures through posterior approach using distal tibia anatomic locking plate; and to evaluate the patient's functional outcome and union condition. METHODS: Eighteen patients (11 men and 7 women; average age of 37.0 ± 17.3 years (range: 18-73 years)) with a distal humeral extra-articular fracture who were treated with distal tibial medial locking plate were included into the study...
May 4, 2018: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/29725515/a-limb-threatening-long-arterial-dissection-caused-by-humerus-neck-fracture-a-case-report
#13
R Kurnaz, M Ikizler, M Ozbayburtlu, T Gunes
Proximal humerus fracture is a common arm trauma and rarely occurs with vascular injury which however is a serious complication. In this case report, we present a long segment dissection of the axillary and brachial arteries as a rare complication due to fragmented proximal humerus fracture and shoulder dislocation. An 80-year old female patient was seen at the emergency department. Radiograph examination has revealed a fragmented proximal humerus fracture besides dislocation of the head of humerus towards the axillary area...
March 2018: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29719747/the-influence-of-resident-level-of-training-on-fluoroscopy-time-in-pediatric-supracondylar-humeral-fractures-treated-with-closed-reduction-and-percutaneous-pinning
#14
Önder Kalenderer, Ali Turgut, Emre Bilgin, Serkan Erkus, Fikri B İpci, Tunc P Edizsoy
Objective The purpose of this study was to evaluate the effect of resident level of training on fluoroscopy duration in pediatric supracondylar humeral fractures treated with closed reduction and percutaneous pinning (CRPP). Methods After classifying the surgeons according to their seniorities, the duration of fluoroscopy time of 80 patients with extension type III supracondylar fractures during reduction and pinning was recorded. Results The time duration of reduction procedures was similar in all groups with respect to the surgical experience; however, time durations of percutaneous pinning procedures were found statistically different between groups (p=0...
February 28, 2018: Curēus
https://www.readbyqxmd.com/read/29717991/survival-to-amputation-in-pre-antibiotic-era-a-case-study-from-a-longobard-necropolis-6th-8th-centuries-ad
#15
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/29708571/reliability-of-the-anterior-humeral-line-index-compared-with-the-gartland-classification-for-posteriorly-hinged-supracondylar-humerus-fractures
#16
Margaret Siobhan Murphy-Zane, Laura Pyle
The Gartland classification of pediatric supracondylar humerus (SCH) fractures is commonly used but inconsistently defined regarding type 1 and type 2 (posteriorly hinged) SCH fractures. This study examined the reliability of the anterior humeral line (AHL) index compared with the Gartland classification. Fifty consecutive SCH fractures on anteroposterior and lateral elbow radiographs in pediatric patients (age range, 18 months to 15 years) were classified by 11 observers (9 attendings and 2 residents) according to the Gartland classification (types 1, 2, and 3) and the AHL index (AHL0, AHL passes anterior to the capitellum; AHL1, anterior one-third capitellum; and AHL2, middle one-third capitellum), with recommendations for treatment (cast immobilization vs surgery)...
April 27, 2018: Orthopedics
https://www.readbyqxmd.com/read/29703075/thrower-s-fracture-of-the-humerus-a-case-report
#17
Michael G Prucha
Humeral fractures typically occur as the result of direct, external trauma. Here however, we describe the case of a young, amateur athlete presenting with acute right, upper arm pain after throwing a ball. Examination showed right upper arm deformity and tenderness to palpation, without any distal neurovascular deficits. X-ray demonstrated a spiral fracture of the humerus. The patient had operative repair of the injury several days later, with no complications noted on outpatient visits up to 3 months later...
May 1, 2018: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/29698079/the-use-of-lead-isotope-analysis-to-identify-potential-sources-of-lead-toxicosis-in-a-juvenile-bald-eagle-haliaeetus-leucocephalus-with-ventricular-foreign-bodies
#18
Dana Franzen-Klein, David McRuer, Vincent A Slabe, Todd Katzner
A male juvenile bald eagle ( Haliaeetus leucocephalus) was admitted to the Wildlife Center of Virginia with a left humeral fracture a large quantity of anthropogenic debris in the ventriculus, a blood lead level of 0.616 ppm, and clinical signs consistent with chronic lead toxicosis. Because of the poor prognosis for recovery and release, the eagle was euthanatized. Lead isotope analysis was performed to identify potential anthropogenic sources of lead in this bird. The lead isotope ratios in the eagle's femur (0...
March 2018: Journal of Avian Medicine and Surgery
https://www.readbyqxmd.com/read/29693239/cadaveric-study-of-the-anatomical-reference-points-for-proximal-humeral-plate-positioning
#19
Kittikun Thienthong, Manusak Boonard, Artit Boonrod, Kowit Chaisiwamongkol, Suwitcha Sripadungkul
BACKGROUND: Complications following locking plate fixation in proximal humeral fractures often related to malposition plates and inadequate screw fixation. However, literature did not define the best anatomical reference point for plate positioning. We conducted a study to assess the occurrence of subacromial impingement and screw perforation with two anatomical reference points for proximal humeral plate positioning. METHOD: Sixty shoulders of 30 cadavers were dissected, and proximal humeral locking plate was placed in two different levels in the coronal plane of the upper tip of plate: (1) the proximal portion of bicipital groove group and (2) the most prominent of lesser tuberosity group...
April 24, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29688964/comparison-of-three-surgical-treatment-options-for-unicameral-bone-cysts-in-humerus
#20
Blaž Mavčič, Vinay Saraph, Magdalena M Gilg, Marko Bergovec, Janez Brecelj, Andreas Leithner
Treatment of unicameral bone cysts (UBC) in the humerus with drainage screws is scarcely reported in the literature. The aim of this retrospective study was to compare drainage screws and alternative treatment methods with respect to the number of required surgical procedures to achieve sufficient UBC healing, postoperative fractures/recurrences/complications, and radiological outcome. Medical archives of two tertiary orthopedic referral centers were screened for all patients who were treated surgically for humeral UBC in the period 1991-2015 with a histologically/cytologically confirmed diagnosis...
April 23, 2018: Journal of Pediatric Orthopedics. Part B
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