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Humeral Fractures

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https://www.readbyqxmd.com/read/28634742/outcomes-of-coronoid-first-repair-in-terrible-triad-injuries-of-the-elbow
#1
Junren Zhang, Mark Tan, Ernest Beng Kee Kwek
BACKGROUND: Clinical outcomes of terrible triad injuries (TTIs) of the elbow are historically poor. To date, it is still debatable whether the coronoid needs to be fixed and if so, how and in which sequence. METHODOLOGY: Between 2010 and 2013, 13 patients were treated surgically for acute TTIs of the elbow at a Tertiary Level 1 Trauma Centre by a single surgeon, using a standardized protocol, which included coronoid-brachialis complex fixation via pull-through trans-osseous sutures, radial head fixation or prosthetic replacement and a repair of the lateral ulnar collateral ligament...
June 20, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28630838/a-case-report-of-an-unusual-case-of-tuberculous-osteomyelitis-causing-spontaneous-pathological-fracture-of-humerus-in-a-middle-aged-female
#2
Umesh Birole, Ashish Ranade, Mahesh Mone
INTRODUCTION: Tuberculosis is a major health problem worldwide. Extrapulmonary tuberculosis is often secondary to some primary foci in lungs. There are reports of tuberculous osteomyelitis involving maxilla, ulna, femur, and shoulder joint but none have reported pathological fracture in humeral diaphysis due to tuberculosis osteomyelitis without shoulder joint involvement. We report a case of pathological fracture of humerus diaphysis due to tuberculous osteomyelitis with normal articular space...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28628579/distal-humeral-flexion-osteotomy-for-the-treatment-of-supracondylar-extension-type-malunions-in-children
#3
Sebastian Farr, Rudolf Ganger, Werner Girsch
Distal humeral extension-type malunions may occur as a complication following improper reduction of supracondylar humerus fractures. We evaluated results after distal humeral flexion osteotomies for sagittal realignment of the humeral condyle in children. Medical records and radiographs of all patients younger than 18 years of age, who underwent this procedure because of a clinically relevant lack of elbow flexion, were evaluated. In a cohort of 18 children with a mean age of 8 years at the time of surgery and a mean follow-up duration of 1 year, elbow flexion increased significantly from a mean of 101° preoperatively to 126° at the final follow-up; established radiographic parameters (e...
June 16, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28625096/surgical-technique-and-early-outcomes-of-intramedullary-nailing-of-displaced-proximal-humeral-fractures-in-an-asian-population-using-a-contemporary-straight-nail-design
#4
Toon Dong Hao, Andy Wee Teck Huat
BACKGROUND: Despite being a common orthopedic injury, the optimal management of proximal humeral fractures remains a topic of debate. Although intramedullary nails have been used to treat these fractures, several complications have been reported with older nail devices. We describe our surgical technique and aim to evaluate the early functional and radiological outcomes of displaced Neer's two- to four-part proximal humeral fractures undergoing fixation with a contemporary straight intramedullary nail...
May 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28607872/vascularized-fibula-based-physis-transfer-a-follow-up-study-of-longitudinal-bone-growth-and-complications
#5
Ronnie L Shammas, Yash J Avashia, Alfredo E Farjat, Anthony A Catanzano, L Scott Levin, William C Eward, Brian E Brigman, Detlev Erdmann
BACKGROUND: The vascularized free fibula epiphyseal transfer provides an option for the preservation of limb lengthening after resection of the proximal humerus in pediatric sarcoma patients. The purpose of this study was to provide a long-term follow-up of longitudinal growth patterns and outcomes after free fibula epiphyseal transfer in upper extremity reconstruction. METHODS: A retrospective review of 4 patients who underwent free fibula epiphyseal transfer after oncologic resection of the proximal humerus for osteosarcoma was performed...
May 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28606839/brachial-plexus-injury-in-a-6-year-old-boy-with-100-displaced-proximal-humeral-metaphyseal-fracture-a-case-report
#6
Elizabeth Nora Jovanovich, James F Howard
Post-traumatic brachial plexopathies can occur following displaced proximal humeral fractures, causing profound functional deficits. Described here is an unusual case of a displaced proximal humeral metaphyseal fracture in a young child. The patient underwent closed reduction and serial casting, but hand weakness and forearm sensory loss persisted. Needle EMG localized the injury to the mid/proximal arm near the fracture site, resulting in damage to the posterior and medial cords of the brachial plexus with profound involvement of the radial, ulnar, and median nerves and sparing of the axillary nerve...
June 9, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28597975/domestic-predation-of-an-elder-a-fatal-dog-attack-case
#7
Erwan Le Garff, Vadim Mesli, Yann Delannoy, Jocelyn Pollard, Anne Becart, Valéry Hedouin
We present the case of a 91-year-old woman lived alone at her home with two domestic dogs, that is,, a Labrador Retriever and a Staffordshire Bull Terrier and found dead. The investigation of the scene revealed that the Bull Terrier's jawbone and chest were covered with blood. The autopsy revealed multiple, histologically confirmed, life-threatening skin and bone lacerations without scavenging marks. The punctures and tearing of each of the wounds on the skin were compatible with bites. A left humeral fracture and multiple fractures of the right facial bones were observed...
June 9, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28593403/submuscular-double-bridge-plating-for-complex-distal-fractures-of-the-humerus-an-alternative-safe-and-efficient-treatment-method
#8
Andre Wajnsztejn, Diego Dantas de Albuquerque, Italo Espinola, Pablo Falchetto Altoé, Leandro Ejnisman, Mario Lenza, Robinson Esteves Santos Pires
PURPOSE: The aim of our study is to show the functional outcomes and complication rates of humeral complex fractures in adults, using osteosynthesis with two bridging orthogonal submuscular plates. METHODS: The study consists of a prospective case series of 13 patients with isolated humeral complex fractures treated with two bridging orthogonal submuscular plates. Functional assessment was performed using disabilities of the arm, shoulder, and hand (DASH) score with 30 items...
June 7, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28588662/management-of-painful-reverse-shoulder-arthroplasty
#9
REVIEW
Anders L Ekelund
Even though reverse shoulder arthroplasty is a very successful procedure, painful complications occur. During the initial postoperative years, the most common reasons for pain are instability, postoperative fracture of the acromion or spine, and periprosthetic infection. Later, aseptic loosening, with humeral loosening being more frequent that glenoid loosening, can be a source of pain and reduction in function. A careful patient history, clinical examination, plain radiographs, computed tomography and blood tests give an explanation for the pain in most cases...
July 2017: Shoulder & Elbow
https://www.readbyqxmd.com/read/28576702/operative-management-of-supracondylar-humeral-fractures-in-children-comparison-of-five-fixation-methods
#10
Sébastien Pesenti, Alexandre Ecalle, Lilian Gaubert, Emilie Peltier, Elie Choufani, Elke Viehweger, Jean-Luc Jouve, Franck Launay
BACKGROUND: The best method for stabilising supracondylar humeral fractures (SHFs) in children remains unclear. The objective of this study was to compare the outcomes of five different fixation methods for SHFs in children. HYPOTHESIS: Differences in intra-operative and short-term post-operative parameters can be demonstrated across different fixation methods for SHFs in children. PATIENTS AND METHODS: We reviewed the medical files of paediatric patientsmanaged at our centre between 2006 and 2016 for SHFwith major displacement (type 3 or4 in the Lagrange-Rigault classification)...
May 30, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28576701/relevance-of-mri-for-management-of-non-displaced-lateral-humeral-condyle-fractures-in-children
#11
C Thévenin-Lemoine, S Salanne, T Pham, F Accadbled, C Baunin, J Sales De Gauzy
The treatment for non-displaced (< 2 mm displacement) fractures of the lateral humeral condyle in children is controversial. Most studies recommend non-surgical treatment. However, plain radiographs are not sufficient to evaluate extension of the fracture line through the articular cartilage. This explains the high frequency of secondary displacements and non-unions, despite well-conducted conservative treatment. We hypothesized that MRI could be used to analyse whether the fracture is complete or incomplete...
May 30, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28567159/humeral-tip-apex-distance-as-a-prognostic-marker-for-proximal-humeral-fractures-in-203-patients
#12
Dominik Saul, Tobias Himmelmann, Klaus Dresing
BACKGROUND: Humeral head fractures and their postoperative outcome remain a challenging problem in surgical daily routine. Predictive factors for loss of fixation are rare. OBJECTIVE: Determination of predictive factors for the failure of osteosynthesis with the loss of fixation or migration of screws in humeral head fractures. METHOD: From 1995 to 2011, 408 patients with proximal humeral fractures [mean age 66.6 years, 50.9-82.3 years] and osteosynthesis were analyzed...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28567157/modified-open-suprapectoral-endobutton-tension-slide-tenodesis-technique-of-long-head-of-biceps-with-restored-tendon-tension-length
#13
Jagadish Prabhu, Mohammed Khalid Faqi, Rashad Khamis Awad, Fahad Alkhalifa
BACKGROUND: The vast majority of biceps tendon ruptures occurs at the proximal insertion and almost always involves the long head. There are several options for long head of biceps (LHB) tenodesis with advantage and disadvantages of each technique. We believe that the suprapectoral LHB tenodesis described in this article enables the restoration of the anatomic length-tension relation in a technically reproducible manner, when following the guidelines set forth in this article, and restores biceps contour and function adequately with a low risk of complications...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28560796/postoperative-evaluation-of-reduction-loss-in-proximal-humeral-fractures-a-comparison-of-plain-radiographs-and-computed-tomography
#14
Xiao-Yang Jia, Yan-Xi Chen, Min-Fei Qiang, Kun Zhang, Hao-Bo Li, Yu-Chen Jiang, Yi-Jie Zhang
OBJECTIVE: To compare postoperative CT images with plain radiographs for measuring prognostic factors of reduction loss of fractures of the proximal part of the humerus. METHODS: A total of 65 patients who sustained fractures of the proximal humerus treated with locking plates from June 2012 to October 2015 were retrospectively analyzed. There were 24 men and 41 women, with a mean age of 60.0 years (range, 22-76 years). According to the Neer classification system of proximal humeral fracture, there were 26 two-part, 27 three-part and 12 four-part fractures of the proximal part of the humerus, and all fractures were treated with open reduction and internal fixation (ORIF) using locked plating...
May 30, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28553421/irreducible-anterior-shoulder-dislocation-with-interposition-of-the-long-head-of-the-biceps-and-greater-tuberosity-fracture-a-case-report-and-review-of-the-literature
#15
Konstantinos Pantazis, Andreas Panagopoulos, Irini Tatani, Basilis Daskalopoulos, Ilias Iliopoulos, Minos Tyllianakis
BACKGROUND: Failure of closed manipulative reduction of an acute anterior shoulder dislocation is seldom reported in the literature and is usually due to structural blocks such as soft tissue entrapment (biceps, subscapularis, labrum), bony fragments (glenoid, greater tuberosity) and severe head impaction (Hill-Sachs lesion). CASE REPORT: We present a case of an irreducible anterior shoulder dislocation in a 57-year-old male patient after a road-traffic accident...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28540999/do-cerclage-cables-delay-the-time-to-bone-union-in-patients-with-an-unstable-humeral-shaft-fracture-treated-with-intramedullary-nails
#16
Kyeong Jin Han, Doo Hyung Lee, Joon Young Bang
PURPOSE: To evaluate the time to bone union after open reduction and internal fixation with cerclage cables followed by intramedullary nailing (IMN) for unstable humeral shaft fractures. MATERIALS AND METHODS: Patients with a humeral shaft fracture treated by IMN were enrolled. One group of patients was treated via open reduction and internal fixation with cables followed by IMN (cable group; n=32), while the other group was treated with a conventional closed IMN (non-cable group; n=64)...
July 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28538289/a-three-dimensional-analysis-of-the-fracture-planes-in-pediatric-lateral-humeral-condyle-fractures-for-image-based-pin-positioning-during-fixation
#17
Do Young Park, Jae Ho Cho, Doo-Hyung Lee, Wan-Sun Choi, Jun Young Bang, Xiang Yun Yin
OBJECTIVE: To determine the 3 dimensional morphology of pediatric lateral condylar physeal fractures using 3-dimensional computed tomography (3D-CT) and to identify optimal pin positions for percutaneous pinning. DESIGN: Prospective case series of consecutively treated patients SETTING:: Tertiary university hospital setting. PATIENTS: Preoperative 3D-CTs in pediatric surgical candidates diagnosed with lateral condylar physeal fractures INTERVENTION:: Closed reduction and percutaneous pinning was performed...
May 17, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28529869/septic-arthritis-of-the-shoulder-with-proximal-humerus-osteomyelitis-treated-by-ilizarov-shoulder-arthrodesis
#18
John Kendall, Martin McNally
Septic arthritis of the shoulder can destroy the glenohumeral joint resulting in significant pain, instability and poor function. Surgical treatment is notoriously difficult with significant risk of complications. Shoulder arthrodesis has been performed using both internal and external fixation but has high complication rates in the presence of infection. We present our experience of managing a patient with significant pain and loss of function as a result of septic arthritis of the shoulder following infected proximal humeral fracture fixation with associated proximal humeral osteomyelitis...
2017: Journal of bone and joint infection
https://www.readbyqxmd.com/read/28526166/transhumeral-anterior-radial-nerve-transposition-to-simplify-anticipated-future-humeral-reconstruction
#19
REVIEW
David A Muzykewicz, Reid A Abrams
Anterior transhumeral radial nerve transposition has been described in the treatment of humeral shaft fracture to protect the nerve from implant irritation or callus entrapment. Transposing the radial nerve through a facilitating humeral defect also simplifies revision surgery should nonunion result. Here we describe a surgical technique for anterior transhumeral radial nerve transposition for complex humeral reconstruction when subsequent revision surgery is anticipated. Three cases are used for illustration: (1) revision of a total elbow arthroplasty with periprosthetic fracture; (2) revision of a total elbow arthroplasty after aseptic loosening from an allograft/prosthesis composite; and (3) septic humeral nonunion with substantial bone loss...
May 16, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28522075/retrospective-analysis-of-proximal-humeral-fracture-dislocations-managed-with-locked-plates
#20
Vivek Trikha, Vivek Singh, Buddhadeb Choudhury, Saubhik Das
BACKGROUND: Fracture-dislocation is the extreme variant of injury to the proximal humerus that occurs more commonly in young adults as a result of high-velocity trauma. We evaluated the functional and radiologic outcome of fixation of proximal humeral fracture-dislocations with locked plates. METHODS: This was a retrospective review of 33 proximal humeral fracture-dislocations in 29 patients with a mean age of 35 years (range, 19-60 years) treated by open reduction and internal fixation with locked plates between January 2009 and December 2013...
May 15, 2017: Journal of Shoulder and Elbow Surgery
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