Abstract:
BACKGROUND:Despite an increasing prevalence of patients sustaining pathologic fractures of neoplastic origin, few studies have investigated 30-day postoperative complication profiles following surgical treatment of pathologic humerus fractures. The purposes of this study were to use a large nationally representative database to determine short-term complication profiles after surgical treatment of pathologic humerus fractures and assess how these complications compared to more commonly studied native humerus fractures. METHODS:Using the National Surgical Quality Improvement Program database, we identified 30,866 patients who underwent surgical treatment for either pathologic (n=449) or native humerus fractures (n=30,417) from 2007-2017. 30-day postoperative complication profiles were ascertained and compared between the two groups using chi-squared analyses. Three logistic regression models were then performed to determine which complications were primarily attributable to the pathologic fracture itself versus the increased comorbidity burden faced by these patients. RESULTS:Pathologic humerus fracture patients experienced significantly higher rates of death (6.0% vs. 0.3%, p<0.001), serious adverse events (12.2% vs. 3.7%, p<0.001), minor complications (15.8% vs. 4.8%, p<0.001), extended postoperative lengths of stay (42.3% vs. 21.3%, p<0.001), discharge to facilities (22.3% vs. 13.5%, p<0.001), and readmissions (14.8% vs. 3.4%, p<0.001) compared to patients with native humerus fractures. With respect to specific complications, patients with pathologic fractures were at significantly higher risk of pulmonary complications (1.3% vs. 0.3%, p<0.001), renal complications (0.7% vs. 0.2%, p=.007), thromboembolic complications (1.6% vs. 0.6%, p=0.01), and transfusions (15.1% vs. 4.1%, p<0.001). CONCLUSION:After surgical treatment, patients with pathologic humerus fractures had significantly higher complication rates compared to native humerus fractures, suggesting that guidelines and treatment algorithms for native humerus fractures may not be generalizable for those of pathologic origin. These findings have significant implications for preoperative patient counseling and may be used to negotiate higher reimbursements rates for these patients given a significantly higher morbidity and mortality than was previously described in literature. Postoperatively, orthopedic surgeons should closely monitor patients with pathologic humerus fractures for deep vein thrombosis, renal complications, and pulmonary complications, utilize blood sparing techniques, and employ a multidisciplinary approach to help manage and prevent a more heterogenous profile of postsurgical complications. LEVEL OF EVIDENCE:Level III; Retrospective Cohort Design using Large Database; Treatment Study.
journal_name
J Shoulder Elbow Surgjournal_title
Journal of shoulder and elbow surgeryauthors
Amen TB,Varady NH,Birir A,Hayden BL,Chen AFdoi
10.1016/j.jse.2020.10.024subject
Has Abstractpub_date
2020-11-18 00:00:00eissn
1058-2746issn
1532-6500pii
S1058-2746(20)30896-Xpub_type
杂志文章abstract::The strength of classic transosseous suture repair of rotator cuff tendons was compared with similar repairs with four "third-generation" suture anchors. Results demonstrate the repair construct selected had a significant influence on failure at ultimate load (p = 0.005). Among the anchors tested the Statak design was...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/s1058-2746(96)80028-0
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Low-cost motion analysis systems (LCMASs) have emerged as easy and practical methods to measure the functional workspace (FWS). Thus, we ventured to apply an LCMAS, the Kinect2 gaming camera, to evaluate the FWS in patients with shoulder osteoarthritis (OA) and patients who underwent total shoulder arthropla...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.03.029
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Olecranon fractures are common in elderly patients, causing significant morbidity and functional impairment. Traditional surgical treatments are often complicated by hardware failure and prominence, frequently requiring reoperation. To address these concerns, a suture anchor fixation technique was developed ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2015.02.017
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to analyze the outcome of open Bankart repair for failed stabilization surgery at a mean follow-up of >10 years. MATERIALS AND METHODS:Thirty patients underwent revision open Bankart repair by a single surgeon for failed prior stabilization surgery, with a standard technique an...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2014.11.036
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:The high incidence of rotator cuff disease combined with high failure rates for nonoperative treatment of full-thickness rotator cuff tears underlines the importance of improving nonoperative management of rotator cuff tears. The study objective was to assess changes in in vivo glenohumeral kinematics of pat...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2015.08.048
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate the long-term clinical and radiologic results after arthroscopic transosseous rotator cuff repair (TORCR). METHODS:A total of 69 patients with full-thickness supraspinatus tendon tears with or without infraspinatus tendon tears treated with arthroscopic TORCR by a s...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.09.003
更新日期:2019-04-01 00:00:00
abstract:PURPOSE:To correlate the Patient Reported Outcomes Measurement Information System Upper Extremity (PROMIS UE) score with pre-existing validated outcome scores, American Shoulder and Elbow Surgeons score (ASES), and Constant score (CS) in patients with idiopathic adhesive capsulitis (AC). METHODS:Patients with a clinic...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.05.040
更新日期:2020-07-07 00:00:00
abstract::A modified surgical approach to the posterior aspect of the glenohumeral joint and/or the dorsal glenoid is described. This access does not alter any muscle insertion or neuromuscular planes. After the skin incision is made, the inferior border of the spinal part of the deltoid is identified and the deltoid muscle is ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1067/mse.2001.112885
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Our primary efficacy objective was to evaluate the effectiveness of the internal joint stabilizer of the elbow (IJS-E) in maintaining concentric location of the elbow during and after removal of the device in the treatment of persistent or recurrent instability after elbow fracture or dislocations, or both. ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.jse.2016.09.023
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:The main limits of the Grammont design reverse shoulder arthroplasty (RSA) are loss of external rotation and scapular notching. They can be addressed with glenoid or humeral lateralization. The aim of the study was to compare outcomes of lateralized bony increased-offset RSA (BIO-RSA) vs. standard RSA in pat...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.05.023
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Studies have demonstrated mixed results after humeral head replacement (HHR) for osteoarthritis at short- and medium-term follow-up intervals. The purpose of this study was to investigate the long-term outcomes (minimum 10 years) of HHR for the treatment of osteoarthritis. METHODS:This study included 44 sho...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2017.10.017
更新日期:2018-05-01 00:00:00
abstract::Subacromial bursal specimens from 63 patients undergoing surgery for rotator cuff tearing (n = 43), the impingement syndrome (n = 14), and calcifying tendinitis n = 6) were studied to characterize the reactions that develop at the tendinopathy "lesional" sites. Intensity of the bursal reactions and production of type ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/s1058-2746(97)90033-1
更新日期:1997-03-01 00:00:00
abstract:BACKGROUND:Patients undergoing shoulder surgery in the beach chair position may be at increased risk for serious neurocognitive complications due to cerebral ischemia. We sought to define the incidence, patient risk factors, and clinical sequelae of intraoperative cerebral desaturation events. METHODS:Regional cerebra...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2012.12.036
更新日期:2013-09-01 00:00:00
abstract::Cadaveric anatomic dissections of 50 shoulders have been done with measurement and histologic analysis of the coracoacromial ligament. In subjects older than 50 years of age the coracoacromial ligament does not have a constant form. Three main types were identified: quadrangular, Y-shaped, and a broad band. A previous...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/s1058-2746(95)80021-2
更新日期:1995-09-01 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
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 ob...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2007.01.001
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:While many injuries to the rotator cuff in professional baseball players can be managed nonoperatively, recovery fails to occur with nonoperative treatment in some players and surgery on the rotator cuff is performed in an attempt to return to sport (RTS). METHODS:All professional baseball players who under...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.01.029
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:There are various modifications of the Bankart repair, and postoperative changes to the glenoid morphology after the repair are reported. Among the various procedures performed, a decrease in the lateral glenoid diameter might be related to the surgery that involves removal of the articular cartilage and rep...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.04.023
更新日期:2021-01-01 00:00:00
abstract::The distribution of mineralization of the subchondral bone plate (DMSB) is used as a parameter for the individual stress distribution of joints. In this study the DMSB of the glenoid from healthy glenohumeral joints was analyzed. In a standardized manner, 44 macroscopically normal shoulder specimens (28 individuals ag...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1067/mse.2002.121635
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:Shoulder arthroscopy is a common orthopedic procedure typically performed on an outpatient basis. Occasionally, patients require an unplanned hospital admission. An understanding of the incidence and risk factors for admission after shoulder arthroscopy may assist surgeons in determining which patients may b...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.09.031
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:The Oxford Shoulder Score (OSS) is an internationally-used patient-based outcome score. Up to now, it was not validated in Dutch. The purpose of this study was to produce a Dutch translation of the OSS and to test this version in terms of reliability and validity. METHODS:Translation of the OSS was done acc...
journal_title:Journal of shoulder and elbow surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.jse.2010.01.017
更新日期:2010-09-01 00:00:00
abstract:INTRODUCTION:Structural glenoid bone grafting in reverse total shoulder arthroplasty (RSA) has previously been reported to have good functional outcomes and low complication rates. We have observed different complication rates and hypothesized that baseplate fixation and severity of deformity may be predictors of early...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.07.035
更新日期:2020-03-01 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:HYPOTHESIS:The aim of this study was to assess the effect of open resection arthroplasty for osteoarthritis of the sternoclavicular (SC) joint on pain levels, functional outcomes, and return to sport. METHODS:Patients from a single surgeon's practice who underwent open resection arthroplasty (maximum 10-mm resection) ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.07.008
更新日期:2017-02-01 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:BACKGROUND:Significant controversy surrounds optimal treatment of displaced 4-part proximal humeral fractures. Reverse total shoulder arthroplasty (RTSA) has recently been proposed as an alternative to hemiarthroplasty (HA) and open reduction-internal fixation (ORIF). Several authors have questioned the additional impl...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2013.07.044
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:This study evaluated patients with and without a prosthetic dislocation after reverse total shoulder arthroplasty (RTSA) to identify risk factors for instability. METHODS:Dislocation and nondislocation cohorts were established for analysis in 119 patients who had undergone RTSA at our institution between 20...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.04.015
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:Instability arthropathy is a known cause of glenohumeral osteoarthritis (OA) among patients with and without prior shoulder stabilization. This study aims to compare the clinical, radiographic, and patient-reported outcome measure (PROM) scores among total shoulder arthroplasty (TSA) patients with and withou...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.04.003
更新日期:2020-07-01 00:00:00
abstract:HYPOTHESIS:Triceps tendon anatomy is important for surgical approaches to the elbow and tendon repair. The purpose of this study is to describe both the qualitative and quantitative anatomy of the triceps brachii tendon insertion. MATERIALS AND METHODS:Thirty-six elbows were dissected from twenty-three cadavers. Dimen...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2009.10.008
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:Posterior glenoid defects increase the risk of glenoid component loosening after total shoulder arthroplasty (TSA). The goal of this work was to evaluate the mechanical performance of a novel posterior-step glenoid prosthesis, designed to compensate for biconcave (type B2) glenoid defects. Two prototypes ("P...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2010.12.008
更新日期:2012-01-01 00:00:00