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Humeral Fractures

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https://www.readbyqxmd.com/read/28216756/outcome-of-anatomic-locking-plate-in-extraarticular-distal-humeral-shaft-fractures
#1
Deepak Jain, Gurpreet S Goyal, Rajnish Garg, Pankaj Mahindra, Mohammad Yamin, Harpal S Selhi
BACKGROUND: Extraarticular fractures of distal humerus are challenging injuries to treat because of complex anatomy and fracture patterns. Functional bracing may not provide adequate stability in these injuries and operative treatment with intramedullary nails or conventional plates also has the limitation of inadequate fixation in the short distal fragment. The 3.5 mm precontoured single column locking plate (extraarticular distal humerus plate [EADHP]) has been introduced to overcome this problem...
January 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28198550/birth-injuries-to-growth-plates-a-sheep-in-wolves-clothing
#2
Jerrin Varghese, Matthew Teng, Mingqian Huang, Dvorah Balsam
Growth plate injuries (Salter-Harris type 1 or physeal fractures) of the long bones in the newborn are easily misdiagnosed as joint fractures with dislocations due to their nonossified epiphyses on plain radiographs. Diagnosis with musculoskeletal ultrasound (US) is advantageous due to its ability to visualize the nonossified epiphysis. We present two cases of humeral growth plate fractures in newborns, one at the shoulder (proximal humerus) and the other at the elbow (distal humerus). These cases emphasize the importance of quick and noninvasive diagnosis with US to avoid unnecessary intervention...
February 15, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28194713/use-of-compressive-osseointegration-endoprostheses-for-massive-bone-loss-from-tumor-and-failed-arthroplasty-a-viable-option-in-the-upper-extremity
#3
Krista A Goulding, Adam Schwartz, Steven J Hattrup, R Lor Randall, Donald Lee, Damian M Rispoli, Daniel M Lerman, Christopher Beauchamp
BACKGROUND: Endoprostheses using principles of compressive osseointegration have shown good survivorship in several studies involving the lower extremity; however, no series to our knowledge have documented the use of this technology in the management of massive bone loss in the upper limb. QUESTIONS/PURPOSES: (1) What proportion of upper extremity implants using compressive osseointegration fixation principles achieved durable short-term fixation, and what were the modes of failure? (2) What surgical complications resulted from reconstruction using this technique? METHODS: A multiinstitutional retrospective review identified nine patients (five women; four men) who underwent 13 endoprosthetic replacements between 2003 and 2014 using compressive osseointegration (Compliant(®) Pre-stress Device [CPS]; Biomet Inc, Warsaw, IN, USA) in the upper extremity, including two proximal humeri, two humeral diaphyses, seven distal humeri, and two proximal ulna...
February 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28168131/radiological-and-functional-outcome-of-medial-epicondyle-fracture-treated-surgically-in-children-and-adolescents-a-retrospective-study
#4
Sagar Panthi, Kishor Khatri, Krishna Kharel, Raju Vaishya, Amit Kumar Agarwal, Vipul Vijay
PURPOSE: Fractures of the medial humeral epicondyle represent approximately 10% of all pediatric elbow fractures. Surgically treated pediatric fractures of the medial humeral epicondyle were analyzed retrospectively for their epidemiological, clinical, radiological and surgical parameters. The evaluation includes the Mayo elbow performance score (MEPS). METHODS: Twenty-five surgically treated fractures of the medial humeral epicondyle were analyzed...
January 4, 2017: Curēus
https://www.readbyqxmd.com/read/28162172/-radiographic-and-clinical-assessment-of-supracondylar-humeral-fractures-resulted-from-sports-in-children
#5
Z J Liu, S N Pan, L J Zhang
Objective: To investigate the radiographic and clinical assessment for supracondylar humeral fractures resulted from sports in children. Methods: The medical records of 166 patients with displaced supracondylar humerus fractures treated in Shengjing Hospital of China Medical University from January 2015 to December 2015 were reviewed.The etiology of 56 of 166 cases was relevant to the sports.Medical records of 56 of 166 patients were reviewed, incluidng gender, the mean age of patient at the time of surgery, the mean duration of injury, radiographic assessment based on the anteroposterior (AP) and lateral radiographs of the elbow, neurologic injury, the Mayo Elbow Performance Score (MEPS) and the criteria of Flynn...
January 17, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28153021/intramedullary-cortical-bone-strut-improves-the-cyclic-stability-of-osteoporotic-proximal-humeral-fractures
#6
Chih-Kun Hsiao, Yi-Jung Tsai, Cheng-Yo Yen, Cheng-Hung Lee, Teng-Yao Yang, Yuan-Kun Tu
BACKGROUND: Proximal humeral fractures treated with locking plate can fail due to varus collapse, especially in osteoporotic bone with medial cortex comminution. The use of an intramedullary strut together with locking plate fixation may strengthen fixation and provide additional medial support to prevent the varus malalignment. This study biomechanically investigates the influence of an intramedullary cortical bone strut on the cyclic stability of proximal humeral fractures stabilized by locking plate fixation in a cadaver model...
February 2, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28149732/arthroscopic-reduction-and-balloon-humeroplasty-in-the-treatment-of-acute-hill-sachs-lesions
#7
Drew Ratner, Jeffrey Backes, John M Tokish
Shoulder instability is often associated with an impaction fracture of the humeral head, commonly referred to as a "Hill-Sachs lesion." This lesion is present in both anterior and posterior instability. Forty percent to 90% of anterior shoulder dislocations have associated Hill-Sachs lesions, whereas 29% to 86% of posterior shoulder dislocations have reverse Hill-Sachs lesions. Both of these lesions can contribute to recurrent instability of the shoulder and require surgery to be treated. Currently, the most common procedures to address Hill-Sachs lesions are the remplissage procedure (transfer of the infraspinatus into the posterior humeral head defect), capsular shift, disimpaction technique, humeral head resurfacing, bone block transfer, or shoulder arthroplasty...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28149195/non-unions-after-fixation-of-humeral-fractures-using-hackethal-s-bundle-nailing-technique
#8
Petr Obruba, Stefan Rammelt, Lubomir Kopp, Karel Edelmann, Jakub Avenarius
OBJECTIVE: The aim of the study was to identify factors contributing to the development of non-union after fixation of diaphyseal humeral fractures using Hackethal's intramedullary nailing technique. METHODS: In the time period from 2001 to 2010 156 patients with diaphyseal humeral fractures were treated surgically using Hackethal's technique. Six of them (3.8%) developed non-union. This group included three women and two men aged 63-69 years and one woman aged 37 years...
September 2016: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/28139385/nonoperative-management-versus-reverse-shoulder-arthroplasty-for-treatment-of-3-and-4-part-proximal-humeral-fractures-in-older-adults
#9
Troy A Roberson, Charles M Granade, Quinn Hunt, James T Griscom, Kyle J Adams, Amit M Momaya, Adam Kwapisz, Michael J Kissenberth, Stefan J Tolan, Richard J Hawkins, John M Tokish
BACKGROUND: The treatment of 3- and 4-part proximal humeral fractures in the older adult is controversial. No study has directly compared reverse shoulder arthroplasty (RSA) with nonoperative treatment for these fractures. The purpose of this study was to compare clinical and patient-reported outcomes between RSA and nonoperative treatment groups. METHODS: A retrospective review was performed on all 3- and 4-part proximal humeral fractures treated with either RSA or nonoperative treatment with minimum 1-year follow-up...
January 27, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28135232/evaluation-and-treatment-of-open-distal-humeral-fractures
#10
Zachary R Zimmer, John G Horneff, Ryan M Taylor, L Scott Levin, Stephen Kovach, Samir Mehta
No abstract text is available yet for this article.
January 3, 2017: JBJS Reviews
https://www.readbyqxmd.com/read/28132729/malnutrition-an-underestimated-factor-in-the-inpatient-treatment-of-traumatology-and-orthopedic-patients-a-prospective-evaluation-of-1055-patients
#11
Christoph Ihle, Thomas Freude, Christian Bahrs, Eva Zehendner, Janick Braunsberger, Hans Konrad Biesalski, Christine Lambert, Ulrich Stöckle, Elke Wintermeyer, Julia Grünwald, Leonard Grünwald, Gunnar Ochs, Ingo Flesch, Andreas Nüssler
INTRODUCTION: Suboptimal nutritional status is often observed among hospitalized patients across all medical specialties. The objective of the present study was to (1) analyze the prevalence of malnutrition in hospitalized orthopedic and trauma patients and (2) to evaluate the relationship between malnutrition and selected clinical outcomes. MATERIALS AND METHODS: The prospective field study was conducted between 06/2014 and 06/2015 in a German level I trauma center (Department of Traumatology, Septic Trauma Surgery and Arthroplasty) with a total number of 1055 patients...
January 22, 2017: Injury
https://www.readbyqxmd.com/read/28131681/intraobserver-and-interobserver-agreement-in-the-classification-and-treatment-of-proximal-humeral-fractures
#12
Mauro E C Gracitelli, Thiago A G Dotta, Jorge H Assunção, Eduardo A Malavolta, Fernando B Andrade-Silva, Kodi E Kojima, Arnaldo A Ferreira Neto
BACKGROUND: There is controversy surrounding the reliability of radiographic measurements and existing classifications for proximal humeral fractures. METHODS: Ten orthopedists, divided into 2 groups by length of experience, evaluated radiographs in 3 views from 40 proximal humeral fractures. We evaluated 11 radiographic criteria (including the Neer and pathomorphologic classifications, head-shaft angle, displacement of the humeral shaft, and lesser and greater tuberosities) and treatment indication...
January 25, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28120283/surgical-management-of-complex-proximal-humeral-fractures-pinning-locked-plate-and-arthroplasty-clinical-results-and-functional-outcome-on-retrospective-series-of-patients
#13
I Repetto, M Alessio-Mazzola, P Cerruti, F Sanguineti, M Formica, L Felli
PURPOSE: The aim of the study was to compare the clinical results and related complications of four different surgical treatments of complex proximal humeral fractures according to their classification and features of patients. METHODS: Between 2007 and 2011, 92 consecutive patients with diagnosis of three-four-part displaced fractures, fractures with head dislocation and head-splitting fractures were evaluated postoperatively with Constant-Murley score, disability of arm, shoulder and hand score and simple shoulder test...
January 24, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28120098/analysis-of-four-fragment-fractures-of-the-proximal-humerus-the-interest-of-2d-and-3d-imagery-and-inter-and-intra-observer-reproducibility
#14
X Ohl, P Mangin, C Barbe, V Brun, C Nerot, F Sirveaux
The treatment of the four-part fractures of the proximal humerus remains a therapeutic challenge. The decision-making is based on preoperative criteria concerning the displacement of the fracture, the stability of the fracture and the risk of avascular necrosis of the humeral head. The aim of this study was to analyse the inter- and intra-observer reproducibility of those criteria previously described by Hertel. Three observers analysed three times 20 radiologic files comprising 2D X-rays, 2D CT scan and 3D reconstructions for the intra-observer study, and an expert committee was used to assess the inter-observer reproducibility...
January 24, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28120001/numerical-investigation-of-fracture-impaction-in-proximal-humeral-fracture-fixation-with-locking-plate-and-intramedullary-nail
#15
Yen-Nien Chen, Chih-Wei Chang, Chia-Wei Lin, Chih-Wei Wang, Yao-Te Peng, Chih-Han Chang, Chun-Ting Li
INTRODUCTION: Fracture impaction is a surgical technique used to support the fractured humerus with locking plate or intramedullary nail when treating proximal humeral fractures. However, few studies have investigated the mechanical difference between fracture impaction with locking plate and with intramedullary nail. The mechanism of fracture impaction to increase stability is still unclear. The aim of this study was to use numerical methods to compare the biomechanical effect of treating proximal humeral fracture...
January 24, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28111621/treatment-of-humeral-fracture-after-shoulder-arthroplasty-using-functional-brace-a-case-report
#16
Nobuo Terabayashi, Kazu Matsumoto, Iori Takigami, Yoshiki Ito
INTRODUCTION: A periprosthetic humeral fracture is rare after shoulder arthroplasty, and such cases have considerable problems. Patients with this kind of fracture are often complicated by osteopenia, other types of severe disease, or are elderly. Surgical treatment of this fracture type carries some risk, and surgeons may be unsure about the most appropriate approach to adopt. CASE REPORT: The present case occurred in a 78-year-old woman with an osteoporotic humeral bone, and chronic dislocation of shoulder after shoulder arthroplasty...
April 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28111180/computed-tomography-based-prediction-of-the-straight-antegrade-humeral-nail-s-entry-point-and-exposure-of-critical-types-truth-or-fiction
#17
Simon A Euler, Clemens Hengg, Matthias Boos, Grant J Dornan, Travis Lee Turnbull, Markus Wambacher, Franz S Kralinger, Peter J Millett, Maximilian Petri
BACKGROUND: Straight antegrade intramedullary nailing of proximal humerus fractures has shown promising clinical results. However, up to 36% of all humeri seem to be "critical types" in terms of the potential violation of the supraspinatus (SSP) tendon footprint by the nail's insertion zone. The aims of this study were to evaluate if a computed tomography (CT) scan could reliably predict the nail's entry point on the humeral head and if it would be possible to preoperatively estimate the individual risk of iatrogenic violation of the SSP tendon footprint by evaluating the uninjured contralateral humerus...
January 19, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28109556/minimally-invasive-lateral-plate-placement-for-metadiaphyseal-fractures-of-the-humerus-and-its-implications-for-the-distal-deltoid-insertion-it-is-not-only-about-the-radial-nerve-a-cadaveric-study
#18
Emanuel Benninger, Christoph Meier
INTRODUCTION: Minimally invasive lateral placement of plates on the humerus may be associated with a risk of injury to the radial nerve. Whereas this potential complication has been investigated in several studies, there is no data regarding potential injuries to the distal insertion of the deltoid muscle when the plates are passed distally in a submuscular tunnel. METHODS: Minimally invasive plate placement was performed on eight arms in fresh cadavers. A lateral deltoid split approach was made and the plates were introduced in an antegrade submuscular manner from proximal to distal...
January 13, 2017: Injury
https://www.readbyqxmd.com/read/28107267/the-prevalence-of-the-complications-and-their-associated-factors-in-humeral-lengthening-for-achondroplasia-retrospective-study-of-54-cases
#19
Natsuko Nakano-Matsuoka, Kenichi Fukiage, Yuki Harada, Naoya Kashiwagi, Tohru Futami
The aim of this study is to evaluate the complications of humeral lengthening and their associated factors. Fifty-four achondroplastic patients were treated by bilateral humeral lengthening. Our original shoulder sling was sufficient to prevent shoulder dislocation. Pre-existing radial head dislocation was observed in 18 patients. Lengthening was accomplished in all cases without a decrease in the elbow function. Seven humeri fractured after the fixator removal. The risk factors for postoperative fracture were a waiting period of less than 5 days, a healing index less than 25, and the concave shape of the callus...
January 19, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28105502/transfracture-medial-transposition-of-the-radial-nerve-associated-with-plate-fixation-of-the-humerus
#20
Ali Hassan Chamseddine, Amer Abdallah, Hadi Zein, Assad Taha
PURPOSE: The aim of this study was to illustrate safety, feasibility and advantages of transfracture medial transposition of the radial nerve during the lateral approach and lateral plating of humeral fractures located in the mid and distal shaft. METHODS: This was a retrospective review and analysis of medical records and radiographs of 19 patients who underwent a transfracture medial transposition of the radial nerve. Fifteen patients were treated for fresh fracture and four for nonunion...
January 19, 2017: International Orthopaedics
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