Abstract:
:Outcome after surgical treatment for nonunion and malunion of midshaft displaced clavicle fractures has generally been described as favorable and equal to results of acute repair. This assumption has been based on subjective criteria, however, and no direct comparison is available in the literature. This study used objective measurements of limb function to compare outcome in patients who underwent delayed operative intervention for nonunion and malunion with the outcome of patients who underwent immediate open reduction and internal fixation after displaced clavicle fracture. All patients had sustained completely displaced, closed, isolated midshaft clavicle fractures, of whom 15 had undergone acute open reduction and internal fixation with a compression plate at a mean of 0.6 months after injury (acute group). Another 15 patients had undergone delayed reconstruction with open reduction, bone grafting, and compression plate fixation for nonunion or malunion a mean of 63 months after injury (delayed group). The 2 groups were similar in age, gender, original fracture characteristics, and mechanism of injury. Complete assessment included standard history and physical examination, the Disabilities of the Arm, Shoulder and Hand (DASH) score and Constant Shoulder Score, subjective rating of outcome satisfaction, and objective muscle strength testing using a previously validated and published protocol on the Baltimore Therapeutic Equipment (BTE) work simulator. There were no significant differences between acute fixation and delayed reconstruction groups with regard to strength of shoulder flexion (acute, 94%; delayed, 93%; P = .82), shoulder abduction (acute, 97%; delayed, 97%; P = .92), external rotation (acute, 97%; delayed, 90%; P = .11), or internal rotation (acute, 98%; delayed, 96%; P = .55). Constant scores in the acute group were superior (acute, 95; delayed, 89; P = .02), but differences in DASH scores were not significant (acute, 3.0; delayed, 7.2; P = .15). Shoulder flexion muscle endurance was significantly decreased in the delayed group (acute, 109%; delayed, 80%; P = .05). Differences in muscle endurance in other planes were not significantly different (abduction endurance: acute, 107%; delayed, 81%; P = .24). Both groups rated their satisfaction with the procedure as excellent. Late reconstruction of nonunion and malunion after displaced midshaft fractures of the clavicle is a reliable and reproducible procedure that results in restoration of objective muscle strength similar to that seen with immediate fixation; however, there are subtle decreases in endurance strength and outcome compared with acute fracture repair. This information should not be used to justify primary operative repair in isolation but is useful in decision-making when counseling patients with displaced midshaft fractures of the clavicle.
journal_name
J Shoulder Elbow Surgjournal_title
Journal of shoulder and elbow surgeryauthors
Potter JM,Jones C,Wild LM,Schemitsch EH,McKee MDdoi
10.1016/j.jse.2007.01.001subject
Has Abstractpub_date
2007-09-01 00:00:00pages
514-8issue
5eissn
1058-2746issn
1532-6500pii
S1058-2746(07)00317-5journal_volume
16pub_type
杂志文章abstract:BACKGROUND:This study reports the outcomes of reverse shoulder arthroplasty (RSA) in patients younger than 55 years with midterm to long-term follow-up. METHODS:Sixty-seven patients (average age, 47.9 years; range, 21-54 years) were identified who underwent RSA with an average 62.3 months of follow-up (24-144 months)....
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.09.051
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Proximal humerus fractures are one of the most common fractures among elderly patients. We performed a systematic review to detail the demographics, outcomes, and complications of patients who undergo reverse shoulder arthroplasty for complex proximal humerus fractures. METHODS:A systematic review of the li...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jse.2013.09.012
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Accurate glenoid component placement is important to prevent glenoid component failure in total shoulder arthroplasty (TSA). Navigation may reduce the variability of glenoid component version and inclination; therefore, the aims of this study were to determine, in patients undergoing TSA, whether computer na...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.04.037
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Sensory innervation to the shoulder provided by the distal suprascapular nerve (dSSN) remains the subject of debate. The purpose of this study was to establish consensus with respect to the anatomic features of the sensory branches of the dSSN. The relevant hypothesis was that the dSSN would give off 3 senso...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.02.016
更新日期:2019-09-01 00:00:00
abstract::Restoration of painless and satisfactory elbow function after a fracture of the distal humerus requires anatomic reconstruction of the articular surface, restitution of the overall geometry of the distal humerus, and stable fixation of the fracture fragments to allow early and full rehabilitation. Although these goals...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2004.09.033
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Deep prosthetic infection is a potentially devastating complication after total elbow arthroplasty, with an incidence of up to 12%. This study examined the demographics, microbiologic profile, and outcomes of infected total elbow arthroplasty treated with 2-stage revision in a tertiary referral unit. METHOD...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2017.12.033
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Glenoid replacement is challenging due to the difficult joint exposure and visualization of anatomical reference landmarks. Improper positioning of the glenoid component or inadequate correction of the retroversion using currently available instrumentation may lead to early failure. The objective of this stu...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jse.2009.02.022
更新日期:2009-11-01 00:00:00
abstract:HYPOTHESIS:Chondrolysis has been observed after shoulder arthroscopy and results in severe glenohumeral complications. MATERIALS AND METHODS:Twenty three cases of post-arthroscopic glenohumeral chondrolysis, occurring between 2005-2006, are reported following a variety of arthroscopic shoulder procedures. Presenting c...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2008.10.017
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:This study evaluated recovery from chronic lateral epicondylitis after arthroscopic treatment. METHODS:Twenty-three consecutive patients (5 men, 18 women) with chronic lateral epicondylitis underwent arthroscopic surgery. Patients were a mean age of 49 years. Prospective outcome data were collected before t...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2014.05.010
更新日期:2014-10-01 00:00:00
abstract::There is little information available concerning the results of rotator cuff debridement in patients with rheumatoid arthritis (RA). We performed a review of 16 shoulders with underlying RA that underwent arthroscopic rotator cuff tear debridement; there were 10 full-thickness tears and 6 partial-thickness tears. Of t...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2006.04.014
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:To examine the rates and predictors of deep periprosthetic infections after shoulder hemiarthroplasty. METHODS:We used prospectively collected institutional registry data on all primary shoulder hemiarthroplasty patients from 1976-2008. We estimated survival free of deep periprosthetic infections using Kapl...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2011.08.067
更新日期:2012-10-01 00:00:00
abstract:HYPOTHESIS:The purpose of this study was to determine the minimal detectable change (MDC) for the Constant score in patients with impingement, a supraspinatus tear, or a massive rotator cuff (RC) tear as observed changes smaller than the MDC might be the result of measurement error. METHODS:The Constant score was reco...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2014.07.003
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Mobile technology offers the prospect of delivering high-value care with increased patient access and reduced costs. Advances in mobile health (mHealth) and telemedicine have been inhibited by the lack of interconnectivity between devices and software and inability to process consumer sensor data. The object...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.01.013
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:The purpose of this study was (1) to evaluate the rates of reverse shoulder arthroplasty (RSA) revisions during a 12-year period, (2) to assess the influence of primary diagnosis and the impact of implant modifications on revisions, (3) to describe surgical management of failed RSA, and (4) to analyze outcom...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2015.09.027
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:A familial and genetic predisposition for the development of rotator cuff tearing has been identified. The purpose of this study was to determine if a familial predisposition exists for healing after rotator cuff repair and if the reported significant association with a single-nucleotide polymorphism (SNP) i...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.02.019
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Multiple perioperative factors have been implicated in infection risk after shoulder arthroplasty. The purpose of this study was to determine surgical site infection (SSI) risk due to medical comorbidities or blood transfusion after primary or revision shoulder arthroplasty. METHODS:Comprehensive data on me...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2017.04.006
更新日期:2017-11-01 00:00:00
abstract:HYPOTHESIS AND BACKGROUND:The purpose of this study was to compare the accuracy of patient-specific guides for total shoulder arthroplasty (TSA) with traditional instrumentation in arthritic cadaver shoulders. We hypothesized that the patient-specific guides would place components more accurately than standard instrume...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jse.2014.10.013
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:We further modified the suture bridge method using suture anchors especially for olecranon fractures in elderly patients with a poor soft-tissue envelope and report the radiologic and clinical results through a retrospective study. METHODS:Our method was used in 13 patients with a mean age of 69.7 years. Al...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.02.011
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Symptomatic meso- type os acromiale is a common pathology with inconsistent outcomes of treatment with various surgical techniques. We report the outcome of a new technique for arthroscopic fusion of symptomatic os acromiale with absorbable screws. MATERIALS AND METHODS:The study included 8 shoulders in 8 p...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2011.12.011
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Loosening associated with cemented polyethylene glenoid components is a major concern following total shoulder arthroplasty (TSA). The purpose of this study was to investigate the clinical and radiographic results associated with use of a novel uncemented soft-metal-backed glenoid component (SMBG), with a mi...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jse.2009.12.021
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Restoration of native glenohumeral joint line is important for a successful outcome after reverse shoulder arthroplasty (RSA). The aims of this study were to quantify the restoration of glenoid joint line after structural bone grafting and RSA, and to evaluate graft incorporation, correction of glenoid versi...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.09.031
更新日期:2020-11-02 00:00:00
abstract::The subscapularis muscle and tendon were studied in 25 cadaveric specimens. The subscaputaris insertion into the proximal humerus and its musculolendinous junction was defined. We found that the subscapularis muscle had a gradual formation of the musculotendinous junction and, in contrast to classical descriptions, in...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/S1058-2746(09)80039-6
更新日期:1994-07-01 00:00:00
abstract::Currently, there is no information in the literature on operative treatment of proximal humeral fractures in patients with rheumatoid arthritis. Eleven patients underwent osteosynthesis of the proximal humerus from December 1987 to December 2002. Nine patients were treated for acute fractures, and two were treated for...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2005.02.023
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:The repetitive overhand throwing can potentially cause physiologic or pathologic changes in musculoskeletal and vascular structures. The purpose of this study was to investigate the effects of throwing on upper extremity arterial blood flow before and after a controlled pitching session. The hypothesis is th...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2010.09.007
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:Assessments used to measure outcomes associated with rotator cuff pathology and after repair are varied. This lack of standardization leads to difficulty drawing comparisons across studies. We hypothesize that this variability in patient-reported outcome measures and objective metrics used in rotator cuff st...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jse.2015.08.007
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:The precarious anatomy of the articular surface of the distal humerus, as well as its meager subchondral bony support and limited soft-tissue attachments, presents enormous challenges for the operative correction of post-traumatic intra-articular deformities. This study presents 8 patients who underwent arti...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2013.12.020
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Repair of proximal humeral fractures with locking plates has greatly improved outcomes. However, an alarming rate of complications including screw cutout and impingement under the acromion has recently been reported. A novel locking plate with smooth pegs was developed to reduce these risks. The purpose of t...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2012.04.005
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:Magnetic resonance imaging (MRI) arthrography has been considered the gold standard for imaging ulnar collateral ligament (UCL) injuries. No classification system has been described for UCL tears to help discuss and guide treatment options. We propose that an MRI-based UCL classification system would correla...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.05.006
更新日期:2016-10-01 00:00:00
abstract::Triceps splitting, triceps reflecting, and olecranon osteotomy are the most common posterior surgical approaches to the adult elbow, but no comparative data exist as to the exposure provided by each approach. The aim of this study was to determine which of these approaches provides the greatest exposure of the distal ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1067/mse.2001.116517
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:In throwing athletes, cubital tunnel syndrome and insufficiency of the ulnar collateral ligament (UCL) are common pathologic processes of the elbow. The objective of this study was to investigate the effect of UCL tears on ulnar nerve elongation in the simulated throwing position. METHODS:Eight fresh frozen...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.02.009
更新日期:2019-09-01 00:00:00