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Humeral Fractures

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https://www.readbyqxmd.com/read/28088942/a-distal-lock-electromagnetic-targeting-device-for-intramedullary-nailing-suggestions-and-clinical-experience
#1
Guido Antonini, Wilfried Stuflesser, Cornelio Crippa, Georgios Touloupakis
PURPOSE: To describe our clinical experience with a system named SureShot? Distal Targeting (Smith & Nephew, Memphis, USA) based on magnetic field presence and discuss our suggestions on this technique. METHODS: We analysed prospectively 47 patients affected by humeral, tibial or femoral fractures, treated in our institution during a 3-year period of time (August 2010 to September 2013). We considered the following parameters: the time to set up, the time to position a single screw, the effectiveness of the system (drilling ad screwing), the irradiation exposure time during distal locking procedure and surgical complications...
December 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28079807/a-case-report-distal-humeral-diaphyseal-fracture-in-a-child
#2
Yuji Tomori, Takuya Sawaizumi, Mitsuhiko Nanno, Shinro Takai
RATIONALE: Distal humeral diaphyseal fractures are much less common than supracondylar humeral fractures. The triangular shape and thinner periosteum in the diaphyseal region than in the supracondylar region of the distal diaphysis makes the treatment of diaphyseal fractures difficult. Nonoperative treatment for this fracture is challenging and troublesome; thus, open reduction and internal fixation (OR/IF) is generally recommended. PATIENT CONCERNS: We herein report a distal humeral diaphyseal fracture in a child...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28070676/-upper-extremity-fractures-in-the-elderly
#3
Roland Biber, S Grüninger, H J Bail
Upper extremity fractures in the elderly are very frequent and second only to hip fractures in the group of fragility fractures. Their impact on mobility and functional decline seems to be underestimated especially when they occur in combination with lower extremity fractures. Fractures of the proximal humerus and the distal radius can often be treated conservatively; however, the indications for operative treatment must not be based on fracture morphology alone and due consideration should be given to all concomitant circumstances affecting functional aspects of patients...
January 9, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28065869/predictors-of-radial-nerve-palsy-recovery-in-humeral-shaft-fractures-a-retrospective-review-of-17-patients
#4
Nadine Nachef, VarenkaBariatinsky, Steeve Sulimovic, Christian Fontaine, Christophe Chantelot
BACKGROUND: Radial nerve injury is common in humeral shaft fractures and fails to recover spontaneously in 30% of cases. Few studies have evaluated predictors of recovery.The objectives of this study were to identify predictors of radial nerve palsy recovery and to assess the usefulness of surgical radial nerve exploration in patients with pre-operative radial nerve palsy. HYPOTHESIS: Factors predicting the outcome of radial nerve palsy can be identified. METHODS: Of 373 patients with humeral shaft fractures between 2005 and 2012, 43 had radial nerve palsy, including 23 who were lost to follow-up and 17 who were evaluated retrospectively at a mean of 26 months (range, 12-84 months) after internal fixation...
January 5, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28063677/the-results-of-tension-band-rotator-cuff-suture-fixation-of-locked-plating-of-displaced-proximal-humerus-fractures
#5
Dave R Shukla, Steven McAnany, Christian Pean, Samuel Overley, Andrew Lovy, Bradford O Parsons
INTRODUCTION: The purpose of this study was to assess 1-year outcomes of patients with displaced proximal humerus fractures who underwent treatment with locked plate fixation with rotator cuff suture augmentation. METHODS: A total of 86 patients who had sustained 2, 3 and 4-part displaced proximal humerus fractures underwent locked plate fixation with multiple sutures placed in the cuff tendons. Clinical outcome variables included active forward elevation (AFE), active external rotation (AER), and Constant and American Shoulder and Elbow Surgeons (ASES) scores...
December 29, 2016: Injury
https://www.readbyqxmd.com/read/28060232/a-dedicated-orthopaedic-trauma-operating-room-improves-efficiency-at-a-pediatric-center
#6
Christopher M Brusalis, Apurva S Shah, Xianqun Luan, Meaghan K Lutts, Wudbhav N Sankar
BACKGROUND: Dedicated orthopaedic trauma operating rooms have improved operating room efficiency, physician schedules, and patient outcomes in adult populations. The purpose of this study was to determine if a dedicated orthopaedic trauma operating room was associated with improved patient flow and cost savings at a level-I pediatric trauma center. METHODS: A retrospective analysis was performed for two 3-year intervals before and after implementation of a weekday, unbooked operating room reserved for orthopaedic trauma cases...
January 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28057631/ultimate-fracture-load-of-cadaver-proximal-humeri-correlates-more-strongly-with-mean-combined-cortical-thickness-than-with-areal-cortical-index-dexa-density-or-canal-to-calcar-ratio
#7
J G Skedros, C S Mears, W Z Burkhead
OBJECTIVES: This investigation sought to advance the work published in our prior biomechanical study (Journal of Orthopaedic Research, 2016). We specifically sought to determine whether there are additional easy-to-measure parameters on plain radiographs of the proximal humerus that correlate more strongly with ultimate fracture load, and whether a parameter resembling the Dorr strength/quality characterisation of proximal femurs can be applied to humeri. MATERIALS AND METHODS: A total of 33 adult humeri were used from a previous study where we quantified bone mineral density of the proximal humerus using radiographs and dual-energy x-ray absorptiometry (DEXA), and regional mean cortical thickness and cortical index using radiographs...
January 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28050700/when-is-it-safe-to-reduce-fracture-dislocation-of-shoulder-under-sedation-proposed-treatment-algorithm
#8
Konrad Sebastian Wronka, Abhimanyu Ved, Khitish Mohanty
INTRODUCTION: Shoulder dislocations are common. It is known that incongruent shoulder should be promptly reduced. However, when associated with fracture of the proximal humerus, there is a clinical dilemma if reduction under sedation is a safe option. We wanted to establish when it is safe to attempt reduction of a shoulder fracture dislocation under sedation in emergency room. METHODS: This is a retrospective cohort study assessing consecutive patients presenting with a dislocation of a gleno-humeral joint with an associated fracture of the humerus between 2007 and 2015...
January 3, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28050640/is-the-humeral-stem-useful-in-anatomic-total-shoulder-arthroplasty
#9
Philippe Collin, Tetsu Matsukawa, Pascal Boileau, Ulrich Brunner, Gilles Walch
PURPOSE: Traditionally and since Neer, the humeral side of shoulder arthroplasty consisted of a stemmed component but the real need for stem fixation in total shoulder arthroplasty (TSA) has barely been investigated. The current study evaluated the clinical and radiological outcomes with a stemless TSA. METHODS: Forty-seven patients, 20 female and 27 male patients with an average age of 63, were selected in four orthopaedic centres during a four year period, and implanted with a humeral head prosthesis with a three-fin design and titanium coating...
January 3, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28045839/the-use-of-magnetic-resonance-imaging-in-management-of-minimally-displaced-or-nondisplaced-lateral-humeral-condyle-fractures-in-children
#10
Gregory Haillotte, Manon Bachy, Marion Delpont, Reda Kabbaj, Hubert Ducou le Pointe, Raphaël Vialle
OBJECTIVES: Fractures of the lateral humeral condyle are common in children. Nondisplaced fractures are managed with cast immobilization and frequent radiographic follow-up. Possibility of assessing the displacement and stability of such fractures may be helpful in planning the initial treatment and survey. Magnetic resonance imaging (MRI) could be a useful tool in determining the stability of lateral condyle in children. We propose to investigate the use of MRI in such indication. METHODS: Fourteen patients presenting with a minimally displaced or nondisplaced fracture were initially treated with a long arm cast and had an MRI within 5 days of injury...
January 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28040088/restoration-of-long-bone-defects-treated-with-the-induced-membrane-technique-protocol-and-outcomes
#11
Peter V Giannoudis, Paul J Harwood, Theodoros Tosounidis, Nikolaos K Kanakaris
This prospective study was undertaken at a regional tertiary referral centre to evaluate the results of treatment of bone defects managed with the induced membrane (IM) technique. Inclusion criteria were patients with bone defects secondary to septic non-union, chronic osteomyelitis and acute fracture with bone loss. Pathological fractures with bone loss were excluded. Data collection included patient demographics, pathology, previous surgical intervention, size of bone defect, type of graft implanted, time-to-union and complications/reinterventions...
December 2016: Injury
https://www.readbyqxmd.com/read/28040080/is-it-safe-to-assist-proximal-humeral-nailing-to-residents-an-analysis-of-1134-cases
#12
Burak Altintas, Roland Biber, Hermann J Bail
INTRODUCTION: Intramedullary nailing is a common procedure for the treatment of proximal humeral fractures. In practical resident training this standardized operation plays an important role in the introduction to osteosynthesis. Our aim was to investigate whether assisting this operation to residents influences the surgical complication rate both in-house and on re-admission. METHODS: All 1134 patients who received a proximal humeral Targon PH nail (Aesculap) for proximal humeral fractures were included between 2000 and 2013...
December 2016: Injury
https://www.readbyqxmd.com/read/28040077/closing-the-gap-a-novel-technique-for-humeral-shaft-nonunions-using-cup-and-cone-reamers
#13
Brian T Nickel, Mitchell R Klement, Marc J Richard, Robert Zura, Grant E Garrigues
INTRODUCTION: Nonunion following closed treatment of humeral shaft fracture is estimated to be 5.5%. Many surgical techniques have been described to address humeral shaft nonunion including: open reduction, internal fixation (ORIF) with compression plating and bone graft, dual plating, cortical strut allograft and autograft, and adding biologic augmentation (BMP). The current standard of care includes ORIF with compression plating and bone grafting, but even this technique has an approximated 10% failure rate...
December 2016: Injury
https://www.readbyqxmd.com/read/28040072/biomechanical-testing-to-evaluate-the-cut-through-resistance-of-intramedullary-nails-for-the-proximal-humerus
#14
Maximilian Wanzl, Peter Foehr, Ulrich Schreiber, Rainer H Burgkart, Andreas Lenich
Intramedullary nailing for stabilization of proximal humeral fractures is well-established. Complications as part of a cut-through, such as backing out of locking screws, loss of reduction, and perforation of the screws into the glenoid, are equally well-known. The test bench presented in this study enables testing of the cut-through behavior of multiple intramedullary implants on a simulated osteoporotic three-part fracture configuration with three different loading circumstances (A, B and C). In situation A, the glenohumeral dynamic force with progressive loadings entered at an angle of 15° to the humeral shaft...
December 2016: Injury
https://www.readbyqxmd.com/read/28040071/proximal-humeral-fractures-non-operative-treatment-versus-intramedullary-nailing-in-2-3-and-4-part-fractures
#15
Mirjam Lange, Daniel Brandt, Thomas Mittlmeier, Georg Gradl
BACKGROUND: Little is known about non-operative treatment of proximal humerus 4-part and severe displaced fractures as those are normally treated operatively. In this study, we present a historical collective of two level I trauma centers, where all humeral head fractures, despite displaced fractures, received non-operative treatment within a 10 years period. Functional and clinical results of 2-, 3- and 4-part fractures were compared to those after fixed angle intramedullary nailing by matched pair analysis...
December 2016: Injury
https://www.readbyqxmd.com/read/28040070/humeral-head-necrosis-after-proximal-humeral-nailing-what-are-the-reasons-for-bad-outcomes
#16
Birgit Zirngibl, Roland Biber, Hermann Josef Bail
INTRODUCTION: Humeral head necrosis (HHN) remains a major problem in fracture care. Neither its occurrence, its extend, nor its impact on clinical outcomes is predictable on the long term. This study was designed to evaluate clinical and radiological outcomes in patients depending on the influence of HHN. PATIENTS AND METHODS: 32 patients with a 3-6 year follow up participated in this study. Their humeral fractures had been stabilized with a standard Targon PH nail (Aesculap, Tuttlingen, Germany) for an acute humeral head fracture...
December 2016: Injury
https://www.readbyqxmd.com/read/28026723/comminuted-fracture-of-elbow-ostheosynthesis-vs-total-joint-replacement
#17
J Zwingmann, M V Neumann, T O Hammer, K Reising, N P Südkamp
Comminuted fractures of the elbow are very rare and in most cases very complex and the successful treatment can be a challenge for the treating surgeon. Due to the elbow joint's complex functional anatomy, the multi-fragmentary nature of many fractures and concomitant destabilizing associated injuries, comminuted fractures of the elbow still present a serious challenge for the orthopedic surgeon. Especially in more severe communicated injuries an osteosynthesis or endoprosthesis must be discussed with the patient...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28026722/non-union-in-upper-limb-fractures-clinical-evaluation-and-treatment-options
#18
M V Neumann, J Zwingmann, M Jaeger, T O Hammer, N P Südkamp
Although non-unions in the upper limb are rare different treatment options of this challenging situation are still affected with up to 20% of failure rate due to current literature. Risk factors for delayed and non-union of fractures are mainly the size of the fracture gap and bone loss of open fractures or in primary surgery followed by other relevant internal and external factors. In the upper limb non-unions of long bones are described with up to 30% after operative intervention. Especially in the upper limb range of motion is limited in non-union cases and disables adjacent joints like the shoulder, elbow and wrist hence reducing the total activity level of affected patients...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28002327/a-bayesian-network-meta-analysis-of-three-different-surgical-procedures-for-the-treatment-of-humeral-shaft-fractures
#19
Hao Qiu, Zhihui Wei, Yuting Liu, Jing Dong, Xin Zhou, Liangjun Yin, Minhua Zhang, Minpeng Lu
BACKGROUND: The optimal surgical procedure for humeral shaft fractures remains a matter of debate. We aimed to establish the optimum procedure by performing a Bayesian network meta-analysis. METHODS: PubMed, EMBASE, the Cochrane Library, and Medline were searched for both randomized controlled trials and prospective studies of surgical treatment for humeral shaft fractures. The quality of the included studies was assessed according to the Cochrane Collaboration's "Risk of bias"...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28002221/gartland-type-3-supracondylar-humeral-fractures-in-children-which-open-reduction-approach-should-be-used-after-failed-closed-reduction
#20
Yusuf Onur Kzlay, Cem Nuri Aktekin, Mehmet Hakan Özsoy, Ertuğrul Akşahin, Abdurrahman Sakaoğullar, Murad Pepe, Onur Kocadal
OBJECTIVES: For displaced supracondylar humeral fractures in children, in the event of closed reduction failure, anatomic reduction is achieved via open reduction techniques; however, there are no confirmative reports among the published open reduction approaches that deliver the best functional and cosmetic results. Here, we compared long-term functional and cosmetic results of different surgical approaches. DESIGN: Retrospective cohort study. SETTING: Ankara Education and Research Hospital/Turkey...
January 2017: Journal of Orthopaedic Trauma
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