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Humeral Fractures

Yashwant Singh Tanwar, Yatinder Kharbanda, Atin Jaiswal, Vikas Birla, Ramsagar Pandit
INTRODUCTION: Coronal plane distal humeral injuries are relatively rare. Numerous classification systems have been proposed as the complexity of these fractures has been realized. We in the present series of ten patients describe the surgical technique of Open Reduction and Internal Fixation of Coronal plane fractures of the distal humerus with headless compression screws performed using the anterolateral approach. MATERIAL AND METHOD: It was a retrospective study, the data collected from March 2010 to 2015 was analysed and the final outcome was assessed using the DASH score...
2018: SICOT-J
S Jin, E Hsieh, L Peng, C Yu, Y Wang, C Wu, Q Wang, M Li, X Zeng
This study is the first meta-analysis investigating the pooled incidence rates of fractures among patients with RA. Our results demonstrated that this population is at high risk of overall and fragility fractures. Consideration of vertebral imaging and RA-specific risk factor assessment may aid in fracture prevention for this vulnerable group. INTRODUCTION: This systematic review and meta-analysis aims to estimate the incidence of fractures (overall and fragility) in patients with rheumatoid arthritis (RA)...
March 15, 2018: Osteoporosis International
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
Marc Randall Kristensen, Jeppe Vejlgaard Rasmussen, Brian Elmengaard, Steen Lund Jensen, Bo Sanderhoff Olsen, Stig Brorson
Background and purpose - It is unclear whether previous osteosynthesis is a risk factor for inferior outcome following shoulder arthroplasty for a proximal humeral fracture. We used data from the Danish Shoulder Arthroplasty Registry (DSR) to examine this question. Patients and methods - All 285 patients treated with a shoulder arthroplasty after failed osteosynthesis of a proximal humeral fracture reported to DSR from 2006 to 2013 were included. Each case was matched with 2 controls (570) treated with a primary shoulder arthroplasty for an acute proximal humeral fracture...
March 14, 2018: Acta Orthopaedica
Tao Jiang, Lin Jiang, Jun-de Shi, Yong-Ge Jiang, Du-Liang Liu
OBJECTIVE: To explore the treatment skill and clinical effect of bone setting manipulation in treating proximal humeral fracture with shoulder dislocation. METHODS: From January 2015 to December 2015, 118 cases of proximal humeral fractures with shoulder joint dislocation were treated by bone setting reduction and fixation with adhesive tape or Kirschner wire after reduction, including 56 males and 62 females with an average age of 61 years old ranging from 48 to 88 years old...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Qing-Feng Shen, Xin Wen, Sheng-Wu Yang, Xin Chen, Wei-Xing Fan, Guo-Zhu Xu, Fang-Zheng Yu, Jun-Yi Zhu, Jian Wang
OBJECTIVE: To compare the clinical efficacy of minimally invasive percutaneous plate osteosynthesis(MIPPO)and open reduction and internal fixation (ORIF) in treating senile NEER IIproximal humerus fractures. METHODS: From March 2014 to March 2016, 46 elderly patients with Neer II proximal humerus fractures were retrospectively reviewed. Among them, 20 patients in MIPPO group included 9 males and 11 females with an average age of (70.4±4.4) years old; while 26 patients in ORIF group included 11 males and 15 females with an average age of (70...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Rony-Orijit Dey Hazra, Helmut Lill, Gunnar Jensen, Julia Imrecke, Alexander Ellwein
Around one third of humeral fractures and 2-6% of all fractures occur to the distal part of the humerus. There is a bimodal distribution differentiating between young male patients with high-energy and elderly female patients with low-energy trauma related to osteoporosis. The AO classification and Dubberley subclassification are used in daily routine. Most fractures are diagnosed on radiographs. For further evaluation, three-dimensional computed tomography is recommended, especially for comminuted or complex fractures...
2018: Obere Extremität
C Z Esenyel, I Kalkar, M Adaş, S S Dedeoğlu, C D Büyükkurt, H Cabuk, A E Esenyel
Objective: To evaluate the functional and radiological results of patients with and without medial calcar continuity in plate osteosynthesis applied for a proximal humerus fracture retrospectively. Methods: The study included 27 patients to whom plate osteosynthesis was applied because of a proximal humerus fracture between January 2, 2010, and December 30, 2013, at Okmeydanı Research and Training Hospital. Patients were separated into Group A with medial calcar continuity and Group B without medial calcar continuity...
March 2018: Nigerian Journal of Clinical Practice
Wei Huang, Kun Zhang, Yangjun Zhu, Zhan Wang, Zijun Li, Jun Zhang
A non-union, especially atrophic non-unions, is a permanent failure of healing following a fracture and can be difficult to treat. Approximately 5-10% of fractures will result in a non-union during the healing process. non-unions can be classified into two types: atrophic non-union which is often due to impaired bone healing with a potential biological mechanism, and hypertrophic non-union which is due to inadequate fixation after fracture. Genetic variations also play an important role in the fracture healing response...
2018: PloS One
Mauricio Silva, Gal Sadlik, Tigran Avoian, Edward Ebramzadeh
BACKGROUND: The ideal type of immobilization for nondisplaced pediatric elbow fractures has not been established. We hypothesized that the use of a long-arm cylinder made of soft cast material will result in similar outcomes to those obtained with a traditional long-arm hard cast. METHODS: We randomly assigned 100 consecutive children who presented with a closed, nondisplaced, type I supracondylar humeral fracture or an occult, closed, acute elbow injury, to 1 of 2 groups: group A (n=50) received a long-arm, traditional fiberglass (hard) cast...
April 2018: Journal of Pediatric Orthopedics
Andreas Panagopoulos, Irini Tatani, Seferlis Yannis, Bavelou Aikaterini, Antonis Kouzelis, Minos Tyllianakis, Panayotis Dimakopoulos
Background: The valgus-impacted (VI) 4-part fractures are a subset of fractures of the proximal humerus with a unique anatomic configuration characterized by a relatively lower incidence of avascular necrosis after operative intervention. Objectives: The present study reports the midterm clinical and radiological results of a large series of consecutive patients with 4-part VI fractures treated with a minimal invasive technique of internal fixation. Methods: Over a ten-year period (2004-2014), we treated 56 patients with a true 4-part valgus impacted fracture of the proximal part of the humerus...
2018: Open Orthopaedics Journal
Andrew Chia Chen Chou, Ho Yin Kevin Wong, Sumanth Kumar, Arjandas Mahadev
BACKGROUND: Distal humerus physeal separations are rare pediatric elbow fractures that are often misdiagnosed and difficult to treat. Adequate reduction is often technically challenging and up to 71% of children develop postoperative cubitus varus. We propose using the medial and lateral humeral lines as an adjunct to elbow arthrography in order to guide intraoperative fixation of distal humerus physeal separations to reduce the incidence of postoperative cubitus varus. METHODS: From 2009 to 2014, all pediatric patients under the age of 3 diagnosed with a distal humerus physeal separation and treated surgically at our institution were included for analysis...
March 5, 2018: Journal of Pediatric Orthopedics
Erik Hohmann
Subpectoral tenodesis is performed at the surgical neck of the humerus. In a cadaveric study, the insertion of a unicortical PEEK (polyether ether ketone) screw decreased the torsional load to failure (fracture) by 30% compared with intact control specimens but was similar to unicortical reaming without screw insertion. Placing the biceps tendon into the tunnel and securing it with a unicortical screw reduced the torsional load to failure by 20%. Whether these facts are significant is currently unknown, but the creation of a stress riser is a concern and may possibly result in surgical neck fractures...
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Gang Xue, Kapil Chahal, Thou Lim, Siyuan Hu, Shaohua Li, Jie Liu
PURPOSE: Greater tuberosity fractures (GTFs) account for 17 to 21% of proximal humerus fractures, most of these fractures are treated conservatively, but treatment for displaced fractures is still controversial. The aim of this study is to compare intra-operative clinical conditions and post-operative outcomes when displaced GTFs are treated with either proximal humeral internal locking system (PHILOS) or mini locking plate with trans-osseous sutures. METHODS: This is a retrospective study conducted in Shanghai Tenth People's Hospital...
March 3, 2018: International Orthopaedics
G J Ter Boo, T Schmid, I Zderic, D Nehrbass, K Camenisch, R G Richards, D W Grijpma, T F Moriarty, D Eglin
Antibiotic-loaded biomaterials (ALBs) have emerged as a potential useful adjunctive antimicrobial measure for the prevention of infection in open fracture care. A biodegradable thermo-responsive poly(N-isopropylacrylamide) grafted hyaluronic acid (HApN) hydrogel loaded with gentamicin has recently been shown to prevent implant-related infection in a rabbit osteosynthesis model. The primary aim of this study was to determine the influence of this HApN hydrogel on bone healing at an early stage (4 weeks). A rabbit humeral osteotomy model with plating osteosynthesis was used to compare fracture healing in rabbits receiving the hydrogel as compared with control animals...
March 2, 2018: European Cells & Materials
Stefano Carbone, Riccardo Mezzoprete, Matteo Papalia, Valerio Arceri, Andrea Carbone, Stefano Gumina
OBJECTIVE: The objectives of the study were: a) to identify osteoporotic proximal humerus fractures in a large consecutive series of patients; b) to identify radiographic fracture patterns among osteoporotic and non-osteoporotic proximal humerus fractures; and c) to calculate intra- and inter-observer reliability of assessment of osteoporosis and of radiographic fracture patterns. METHODS: This was a prospective observational study of patients admitted to the emergency department affected by a proximal humerus fracture between June 2014 and June 2016...
March 2018: European Journal of Radiology
Carlos Torrens, Eduard Alentorn-Geli, Felipe Mingo, Carlo Gamba, Fernando Santana
PURPOSE: To investigate the influence of greater tuberosity healing on the functional outcomes of reverse shoulder arthroplasty (RSA) for the treatment of acute complex proximal humeral fractures (PHFs), and to investigate the influence of patient- and surgery-related factors in the healing of the greater tuberosity. METHODS: Retrospective study including 41 consecutive PHFs treated using RSA with minimum 2-year follow-up. In all the cases, tuberosities were reattached with a standardized technique...
January 2018: Journal of Orthopaedic Surgery
F F Fernandez, S Vatlach, T Wirth, O Eberhardt
The medial condyle fracture of the humerus is-in comparison to the lateral condyle fracture-a very rare Salter-Harrison IV-fracture of the elbow. In this prospective study 14 children were included and reviewed. One child had minimal displacement fracture type I, one child had type II, and 12 children had type III-fractures. One patient was treated conservatively by an upper arm cast; thirteen were surgically treated using open reduction and osteosynthetical treatment. Postoperatively the elbow was immobilized in 90° flexion and neutral position in a long-arm cast for 4-6 weeks...
February 26, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Minfei Qiang, Xiaoyang Jia, Yanxi Chen, Kun Zhang, Haobo Li, Yuchen Jiang, Yijie Zhang
BACKGROUND Screw perforation and varus collapse are common complications of treatment with a PHILOS (proximal humerus internal locking system) plate for proximal humerus fractures, which are associated with improper screw length selection and lack of medial column support. The purposes of this study were: (1) to measure the proper length of periarticular screws of the PHILOS plate in the humeral head, and (2) to determine what factors influence the screw length and implantation of the inferomedial support screw...
February 25, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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...
February 21, 2018: Clinical Orthopaedics and related Research
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