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Humeral Fractures

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https://www.readbyqxmd.com/read/29158650/partial-humeral-replacement-for-peri-prosthetic-fractures-of-the-humerus
#1
Ruben Manohara, Colin R Howie
Introduction: Treating peri-prosthetic fractures of the humerus can be very challenging, especially when there is poor bone stock and in the presence of adjacent joint prostheses. We discuss the option of a partial humeral replacement as a salvage procedure for such cases with some technical comments. Methods: This paper presents a technique which utilises a custom- made cemented connector to incorporate the existing well functioning elbow or shoulder replacement with a commercially available partial humeral replacement (PHR) or to an existing prosthetic humeral stem...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29152005/humeral-head-replacement-and-reverse-shoulder-arthroplasty-for-the-treatment-of-proximal-humerus-fracturesm
#2
REVIEW
Aaron Andrew Frombach, Kendra Brett, Peter Lapner
Acute proximal humeral fractures in the elderly are generally treated non-operatively if alignment is acceptable and in stable fracture patterns. When operative treatment is indicated, surgical fixation is often difficult or impossible to obtain. Hemiarthroplasty has long been the standard of care. However, with its reliance on tuberosity healing, functional outcomes and patient satisfaction are often poor. Reverse shoulder arthroplasty has emerged as a new technology for treating proximal humeral fractures but the indications for its use remain uncertain...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29146509/isolated-coronal-shear-fracture-of-the-nonossified-humeral-trochlea-in-a-7-year-old-patient
#3
Michiyo Tomaru, Denju Osada, Kazuya Tamai, Hiroshi Taneichi
Coronal shear fractures of the nonossified humeral trochlea are extremely rare in skeletally immature children. This fracture is difficult to diagnose accurately on routine radiographs. In addition, the mechanism of injury and appropriate treatment methods are unknown. We present the case of a 7-year-old boy who sustained an isolated coronal shear fracture of the nonossified humeral trochlea. Internal fixation of the fracture was performed with 2 K-wires. Two and a half years after surgery, the patient had pain-free active range of motion of the elbow from 0° to 130° with full forearm rotation and magnetic resonance imaging showed healing of the chondral fragment of the trochlea...
November 14, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29137199/epidemiology-of-bone-fracture-in-female-trauma-patients-based-on-risks-of-osteoporosis-assessed-using-the-osteoporosis-self-assessment-tool-for-asians-score
#4
Cheng-Shyuan Rau, Shao-Chun Wu, Pao-Jen Kuo, Yi-Chun Chen, Peng-Chen Chien, Hsiao-Yun Hsieh, Ching-Hua Hsieh
Background: Osteoporotic fractures are defined as low-impact fractures resulting from low-level trauma. However, the exclusion of high-level trauma fractures may result in underestimation of the contribution of osteoporosis to fractures. In this study, we aimed to investigate the fracture patterns of female trauma patients with various risks of osteoporosis based on the Osteoporosis Self-Assessment Tool for Asians (OSTA) score. Methods: According to the data retrieved from the Trauma Registry System of a Level I trauma center between 1 January 2009 and 31 December 2015, a total of 6707 patients aged ≥40 years and hospitalized for the treatment of traumatic bone fracture were categorized as high-risk (OSTA < -4, n = 1585), medium-risk (-1 ≥ OSTA ≥ -4, n = 1985), and low-risk (OSTA > -1, n = 3137) patients...
November 13, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29135565/pediatric-and-adolescent-anterior-shoulder-instability-clinical-management-of-first-time-dislocators
#5
Kenneth M Lin, Evan W James, Elad Spitzer, Peter D Fabricant
PURPOSE OF REVIEW: The purpose of this review is to discuss the epidemiology, pathoanatomy, diagnosis, and clinical management of pediatric and adolescent patients following a first-time shoulder dislocation. RECENT FINDINGS: Shoulder instability is becoming increasingly common as pediatric and adolescent patients engage in earlier organized sports competition. Recommended treatment following a first-time glenohumeral dislocation event in adolescents depends on several factors, but surgical stabilization is becoming more frequently performed...
November 11, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29128375/is-the-pectoralis-major-tendon-a-reliable-reference-for-restoration-of-humeral-length-with-fracture-hemiarthroplasty
#6
Beom-Soo Kim, Du-Han Kim, Kwang-Soon Song, Byung-Woo Min, Ki-Cheor Bae, Chul-Hyun Cho
BACKGROUND: The primary objective was to calculate and to apply the numeric value of the distance from the pectoralis major tendon insertion to the superior aspect of the humeral head (PMTD) without any radiation exposure or equipment through basic data such as age, sex, height, and weight of Asian populations. METHODS: We analyzed shoulder magnetic resonance images of 260 patients (107 men and 153 women; average age, 59.8 years). The superior border of the pectoralis major was identified on the transverse section and cross-referenced with the coronal section...
November 8, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29127126/atraumatic-bilateral-humeral-head-fracture-secondary-to-single-seizure
#7
Amal A Alduhoori, Radhakrishnan Renganathan, Ali Reza Dehdashtian, Khurram A Siddiqui
No abstract text is available yet for this article.
November 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29125707/vascularized-humeral-periosteal-flap-to-treat-lateral-humeral-condyle-nonunion-an-anatomical-study-and-report-of-two-successfully-treated-pediatric-cases
#8
S Sergi Barrera-Ochoa, Francisco Soldado, Alfonso Rodriguez-Baeza, Paula Diaz-Gallardo, Felipe Hodgson, Pablo S Corona, Jorge Knörr
PURPOSE: Nonunion is a common complication of lateral condyle humeral (LCH) fractures in children. In situ fixation with a screw and bone grafting is the classically-recommended method of treatment. The purpose of this study is to analyze the feasibility of obtaining a vascularized periosteal flap obtained from the lateral humerus and based on the posterior collateral radial vessels (PCRV). Second, to report the results after the application in two pediatric cases. METHODS: Periosteal branches of PCRV were studied in ten upper limbs from fresh human cadavers...
November 10, 2017: Microsurgery
https://www.readbyqxmd.com/read/29122426/anatomical-factors-contributing-to-radial-nerve-excursion-at-the-brachium-a-cadaveric-study
#9
Wayne A Chen, T David Luo, Michael D Wigton, Zhongyu Li
PURPOSE: The radial nerve appears to be more vulnerable to injury in the brachium than the median and ulnar nerves. The underlying mechanism for this increased vulnerability is not well explained. We hypothesize that the radial nerve has less excursion than the median and ulnar nerves because it is anatomically tethered by the lateral intermuscular septum (LIS) and that elbow positioning and LIS release will improve its excursion. METHODS: Eight paired fresh-frozen cadaveric upper extremity specimens were used...
November 7, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29122375/blunt-traumatic-axillary-artery-truncation-in-the-absence-of-associated-fracture
#10
Emily Bokser, William Caputo, Barry Hahn, Josh Greenstein
BACKGROUND: Axillary artery injuries can be associated with both proximal humeral fractures (Naouli et al., 2016; Ng et al., 2016) [1,2] as well as shoulder dislocations (Leclerc et al., 2017; Karnes et al., 2016) [3,4]. We report a rare case of an isolated axillary artery truncation following blunt trauma without any associated fracture or dislocation. CASE REPORT: A 58-year-old male presented to the emergency department for evaluation after falling on his outstretched right arm...
October 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29122128/carbon-fibre-reinforced-peek-radiolucent-intramedullary-nail-for-humeral-shaft-fracture-fixation-technical-features-and-a-pilot-clinical-study
#11
Niksa Kojic, Christoph Rangger, Celenk Özgün, Jakisa Lojpur, Jerome Mueller, Yoram Folman, Eyal Behrbalk, Bore Bakota
PURPOSE: This prospective pilot study investigated the safety and efficacy of a novel radiolucent intramedullary nail (IMN) made of Carbon-Fibre-Reinforced Polyaryl-Ether-Ether-Ketone (CFR-PEEK) for humeral shaft fracture fixation. STUDY DESIGN: A prospective, single-arm, four-centre study. PATIENTS AND METHODS: A total of 46 patients with 46 humeral fractures classified as 12 A-B were treated with a novel CFR-PEEK IMN and followed for 12 months...
November 2017: Injury
https://www.readbyqxmd.com/read/29122115/humeral-shaft-cerclage-wiring-a-safe-technique-to-prevent-radial-nerve-injury
#12
Stephan Grechenig, Gloria Hohenberger, Bore Bakota, Mario Staresinic, Peter Grechenig, Antonio Ernstberger
Humeral periprosthetic fractures are a challenging problem and their occurrence has increased, particularly over the last decade. The role of cerclage wires or cables in these fractures includes revisions with longer stems, and augmentation of a plate osteosynthesis in which the stem does not allow additional screw placement or structural bone grafts as supplementary fixation. These procedures are demanding because of the proximity of the radial nerve within the operating field. Placing a cerclage wire or cable around the fractured fragments offers a simple and safe procedure to avoid radial nerve injury or palsy in the treatment of complex humeral shaft fractures...
November 2017: Injury
https://www.readbyqxmd.com/read/29119298/locking-plates-versus-intramedullary-nails-in-the-management-of-displaced-proximal-humeral-fractures-a-systematic-review-and-meta-analysis
#13
REVIEW
Qi Sun, Wei Ge, Gen Li, Jiezhou Wu, Guanghua Lu, Ming Cai, Shaohua Li
PURPOSE: To compare the clinical outcome and complications of locking plates versus intramedullary nails in patients with displaced proximal humeral fractures. Our hypothesis was that there would be no difference between these two implants with regard to clinical outcome and complications. METHODS: We performed a systemic review of PubMed, EMBASE, Clinical Trials Registry, Cochrane Central Register of Controlled Trials and Google Scholar to identify all relevant randomized controlled trials, prospective and retrospective comparative studies on April 26, 2017...
November 9, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29116417/epidemiology-of-fractures-in-armenia-development-of-a-country-specific-frax-model-and-comparison-to-its-surrogate
#14
O Lesnyak, S Sahakyan, A Zakroyeva, J P Bilezikian, N Hutchings, V Babalyan, R Galstyan, A Lebedev, H Johansson, N C Harvey, E McCloskey, John A Kanis
Fracture probabilities derived from the surrogate FRAX model for Armenia were compared to those from the model based on regional estimates of the incidence of hip fracture. Disparities between the surrogate and authentic FRAX models indicate the importance of developing country-specific FRAX models. Despite large differences between models, differences in the rank order of fracture probabilities were minimal. OBJECTIVE: Armenia has relied on a surrogate FRAX model based on the fracture epidemiology of Romania...
November 7, 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/29116358/humeral-head-inferior-subluxation-in-proximal-humerus-fractures
#15
Stefano Carbone, Matteo Papalia, Valerio Arceri, Stefano Placidi, Andrea Carbone, Riccardo Mezzoprete
PURPOSE: The objectives of this study are to propose a reliable radiologic method for detecting static inferior subluxation of humeral head, to calculate the relative intra- and inter-observer reliability, and to evaluate its presence pre- and post-surgery. METHODS: This is a retrospective observational study of patients surgically treated for a fracture of the proximal humerus. Fractures were classified using Codman-Lego criteria (radiographic, CT images), osteoporosis was assessed...
November 7, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29103824/modified-anterolateral-approach-for-internal-fixation-of-holstein-lewis-humeral-shaft-fractures
#16
Ho Min Lee, Young Sung Kim, Suk Kang, Min Young Lee, Jong Pil Kim
BACKGROUND: The authors modified the anterolateral approach for Holstein-Lewis humeral shaft fractures using a plating technique to achieve sufficient distal fixation by minimal splitting of the brachioradialis muscle to fix the most distal screws. The purpose of this retrospective study was to evaluate the efficacy of our modified anterolateral approach for Holstein-Lewis humeral fractures and document clinical and functional results. MATERIALS AND METHODS: Between 2008 and 2014, 18 patients (mean age 35...
November 2, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29102769/a-scale-space-curvature-matching-algorithm-for-the-reconstruction-of-complex-proximal-humeral-fractures
#17
Lazaros Vlachopoulos, Gábor Székely, Christian Gerber, Philipp Fürnstahl
The optimal surgical treatment of complex fractures of the proximal humerus is controversial. It is proven that best results are obtained if an anatomical reduction of the fragments is achieved and, therefore, computer-assisted methods have been proposed for the reconstruction of the fractures. However, complex fractures of the proximal humerus are commonly accompanied with a relevant displacement of the fragments and, therefore, algorithms relying on the initial position of the fragments might fail. The state-of-the-art algorithm for complex fractures of the proximal humerus requires the acquisition of a CT scan of the (healthy) contralateral anatomy as a reconstruction template to address the displacement of the fragments...
October 27, 2017: Medical Image Analysis
https://www.readbyqxmd.com/read/29098356/large-diaphyseal-incorporating-allograft-prosthetic-composites-when-how-and-why-treatment-of-advanced-proximal-humeral-bone-loss
#18
REVIEW
P B McLendon, J L Cox, M A Frankle
BACKGROUND: Proximal humeral bone loss in shoulder arthroplasty is a complex problem with a heterogeneous presentation. Different etiologies may contribute to varying degrees of severity in bone loss that dictate different treatment approaches. OBJECTIVES: The purpose of this is article is to describe our technique for treatment of proximal humeral bone loss with proximal humeral allograft prosthetic composites (APC) and identify factors that may predict when larger allografts may be necessary...
November 2, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/29094012/managing-extremely-distal-periprosthetic-femoral-supracondylar-fractures-of-total-knee-replacements-a-new-philos-ophy
#19
Kevin J Donnelly, Adam Tucker, Angel Ruiz, Neville W Thompson
We report two cases where a proximal humeral locking plate was used for the fixation of an extremely distal, type III peri-prosthetic femoral fractures in relation to a total knee replacement (TKR). In each case there was concern regarding the fixation that could be achieved using the available anatomic distal femoral plates due to the size and bone quality of distal fragment. The design of the Proximal Humeral Internal Locking System (PHILOS) allows nine 3.5-mm locking screws to be placed over a small area in multiple directions...
October 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29081829/the-applications-of-finite-element-analysis-in-proximal-humeral-fractures
#20
REVIEW
Yongyu Ye, Wei You, Weimin Zhu, Jiaming Cui, Kang Chen, Daping Wang
Proximal humeral fractures are common and most challenging, due to the complexity of the glenohumeral joint, especially in the geriatric population with impacted fractures, that the development of implants continues because currently the problems with their fixation are not solved. Pre-, intra-, and postoperative assessments are crucial in management of those patients. Finite element analysis, as one of the valuable tools, has been implemented as an effective and noninvasive method to analyze proximal humeral fractures, providing solid evidence for management of troublesome patients...
2017: Computational and Mathematical Methods in Medicine
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