Abstract:
BACKGROUND:Previous meta-analyses comparing the surgical and nonsurgical treatment of midshaft clavicle fractures have demonstrated extensive heterogeneity, that is, treatment effect variation, in different pooled outcomes. We aimed to investigate the amount of heterogeneity seen in pooled treatment effects and to explore which moderator variables serve to explain this heterogeneity. METHODS:A follow-up literature search, based a previous study, was conducted. All randomized controlled trials and high-quality observational studies with suitable treatment cohorts were identified and included in this systematic review and meta-regression analysis. The proportions of male patients, patients with the dominant hand injured, and smokers, as well as fracture type and mean age, were included as covariates in meta-regression analyses investigating the effect on the pooled estimate of treatment effect heterogeneity. The pooled treatment effects assessed were nonunion rate, malunion rate, Disabilities of the Arm, Shoulder and Hand score, and Constant score at 1 year, as well as revision surgery rate. RESULTS:High heterogeneity was observed in 4 of 8 pooled treatment effects and moderate, in 2 of 8. An association between any of the covariates, including smoking, with the pooled treatment effect for the nonunion rate could not be established. Regarding malunion, the proportion of patients with the dominant hand injured showed linear dependency with the risk ratio. The proportion of male patients correlated with the pooled mean difference in both the Disabilities of the Arm, Shoulder and Hand score and Constant score. Mean age and fracture type correlated with the pooled mean difference in the Constant score. CONCLUSION:On the basis of our results, several potential moderators influence the treatment effect when comparing surgical and nonsurgical treatment of midshaft clavicle fractures. These findings have implications for shared decision making and when making treatment recommendations.
journal_name
J Shoulder Elbow Surgjournal_title
Journal of shoulder and elbow surgeryauthors
Reito A,Launonen A,Paloneva Jdoi
10.1016/j.jse.2020.02.011subject
Has Abstractpub_date
2020-08-01 00:00:00pages
1726-1734issue
8eissn
1058-2746issn
1532-6500pii
S1058-2746(20)30221-4journal_volume
29pub_type
杂志文章,meta分析abstract:BACKGROUND:Very little information on medium- to long-term results is available for surgically treated proximal humeral fractures. The aim of this prospective treatment study was to present long-term results after angular stable plate fixation of displaced proximal humeral fractures and to detect which specific patient...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2014.08.009
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:The eccentric glenosphere (EG) has been proposed as a way to prevent scapular notching in reverse shoulder arthroplasty (RSA). The purpose of this study was to investigate whether the use of an EG decreases scapular notching compared to matched standard concentric glenosphere (CG) controls. METHODS:A retros...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.10.032
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Double-strand lateral ulnar collateral ligament (LUCL) reconstruction is an effective treatment for posterolateral rotatory instability (PLRI) of the elbow, but anatomic landmarks for ulnar tunnel placement are often difficult to identify intraoperatively, which potentially can result in a nonanatomic LUCL r...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.08.008
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to investigate the incidence of venous thromboembolism (VTE) after elective arthroscopic shoulder surgery. MATERIALS AND METHODS:One hundred seventy-five consecutive patients who underwent arthroscopic shoulder surgery were enrolled (mean age, 61 years). Patients who had VTE pr...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2014.01.054
更新日期:2014-05-01 00:00:00
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::The purpose of this study was to evaluate the results of an anatomic open stabilization procedure. Twenty-three consecutive patients with traumatic, recurrent, anterior glenohumeral instability were managed with a modified open procedure. All had a Bankart lesion. A standardized, true anatomic capsulolabral reconstruc...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2003.09.006
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Tenotomy and tenodesis are common treatments for lesions in the long head of biceps tendon (LHBT); however, which treatment is superior is still controversial. This study compared the outcomes of tenotomy with outcomes of tenodesis for treatment of LHBT lesions with rotator cuff tears. METHODS:The study enr...
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.2016.02.006
更新日期:2016-07-01 00:00:00
abstract::Twenty-three shoulders in 23 patients with failed treatment of three- and four-part proximal humerus fractures subsequently treated with prosthetic arthroplasty were reviewed. The initial treatment was closed in 10 cases and open in 13. The complications of treatment included malunions in 17, nonunions in four, trauma...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/s1058-2746(05)80020-5
更新日期:1995-07-01 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::The Liverpool Elbow Score (LES) is a newly developed, validated elbow-specific score. It consists of a patient-answered questionnaire (PAQ) and a clinical assessment. The purpose of this study was to determine whether the PAQ portion of the LES could be used independently as a postal questionnaire for the assessment o...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2006.08.008
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:Shoulder resurfacing has regained popularity in recent years. This report presents the long-term (>20 years) results of this procedure with regard to patient satisfaction and implant survival. MATERIALS AND METHODS:We followed up 61 patients who underwent shoulder resurfacing procedures (74 shoulders) for a...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2010.08.014
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:The role of the anconeus in elbow stability has been a long-standing debate. Anatomic and electromyographic studies have suggested a potential role as a stabilizer. However, to our knowledge, no clinical or biomechanical studies have investigated its role in improving the stability of a combined lateral coll...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.11.040
更新日期:2019-05-01 00:00:00
abstract: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 ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.10.021
更新日期:2017-05-01 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::The posterior border of the ulna is the most important bony landmark for all dorsal surgical approaches and the guideline for open reduction, internal fixation of displaced comminuted fractures of the proximal ulna. We examined 74 cadaveric specimens to evaluate the anatomy of the proximal ulna, especially the course ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2006.12.008
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Little information is available on the results of the different stabilization techniques described for treatment of acute acromioclavicular (AC) joint injuries. Additionally, no studies have analyzed isometric performance of the shoulder after AC stabilization. The objective of our study was to present funct...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2010.08.007
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND AND HYPOTHESIS:IDEAL (Iterative Decomposition of Echoes of Asymmetrical Length) imaging is a magnetic resonance imaging sequence that precisely measures rotator cuff muscle fatty infiltration. The influence of lower levels of fatty infiltration on outcomes after rotator cuff repair remains unclear. We hypoth...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.05.018
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Obtaining postoperative laboratory studies after primary reverse shoulder arthroplasty (RSA) is a common practice. However, justification of this practice remains unclear. This study assesses the utility of routine postoperative laboratory studies in RSA. METHODS:The electronic medical records of 369 patien...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.12.023
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:This systematic review aims to synthesize published data for the most common subscapularis takedown and repair to compare outcomes in the setting of shoulder arthroplasty. METHODS:Searches of MEDLINE and Cochrane Library databases identified studies that reported clinical or radiologic outcomes for subscapu...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jse.2017.08.003
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Delayed surgical treatment of hip fractures is associated with adverse medical outcomes, but it is unclear whether the same is true for proximal humeral fractures. The purpose of this study was to evaluate the relationship between surgical delay for proximal humeral fracture and inpatient adverse events, in-...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2014.03.010
更新日期:2014-09-01 00:00:00
abstract:HYPOTHESIS/BACKGROUND:Evaluate the accuracy for shoulder magnetic resonance imaging (MRI) interpretations of typical community radiologists and compare this to selected fellowship trained musculoskeletal radiologists. METHODS:The MRIs of 104 shoulders of 100 consecutive different patients who had undergone shoulder ar...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2011.01.003
更新日期:2011-06-01 00:00:00
abstract::Reconstruction of a normal glenohumeral relationship is desirable for a successful arthroplasty. Double-contrast computed tomography was performed on 49 healthy shoulders in young volunteers. For creation of a uniform spatial reference system, the subjects were positioned in a thoracobrachial orthosis with the arm add...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/s1058-2746(02)86884-7
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:Scapular notching is a common observation during radiological follow-up of reverse shoulder arthroplasty. The purpose of this study was to evaluate the effect of glenosphere design and humeral component retroversion on movement amplitude in the scapular plane and inferior scapular impingement. MATERIALS AND...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2013.05.009
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Overhead athletes are subject to adaptations in the shoulder including glenohumeral internal rotation deficit (GIRD). It has been documented that this alteration is more evident in overhead athletes with pain. Our objective was to compare glenohumeral rotation motion between symptomatic and asymptomatic hand...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2012.08.027
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:Radiocapitellar pathology after traumatic injury to the elbow can be challenging to treat. The anconeus interposition arthroplasty has been proposed to treat radiocapitellar or proximal radioulnar joint dysfunction and pain, or both. This study evaluated whether radial head excision (native or prosthetic), f...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.02.052
更新日期:2018-06-01 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: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::The coracoclavicular ligaments vary widely in morphology and anatomic descriptions. Few authors have adequately described the coracoclavicular ligaments' anatomy, and a number of discrepancies exist in the anatomy literature. This study examines the complex anatomy of the coracoclavicular ligaments and their relations...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1067/mse.2001.118480
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND:To examine the rates and predictors of deep periprosthetic infections after primary total shoulder arthroplasty (TSA). METHODS:We used prospectively collected data on all primary TSA patients from 1976-2008 at Mayo Clinic Medical Center. We estimated survival free of deep periprosthetic infections after pri...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2012.01.006
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:There is an increasing trend toward the use of reverse total shoulder arthroplasty (RTSA) over stemmed hemiarthroplasty (HA) for the management of proximal humeral fractures. There are limited data available comparing the revision rates for RTSA and HA in the setting of a fracture. The aim of this study was ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.04.005
更新日期:2020-12-01 00:00:00