Abstract：
UNLABELLED:Our goal was to analyze the results of unconstrained shoulder replacement in a large series of sequelae of proximal humeral fractures in order to validate a previously described surgical classification. In a multicenter study, we retrospectively evaluated 203 patients with sequelae of proximal humeral fractures who were treated with a nonconstrained modular and adaptable prosthesis. The mean followup was 42 months (range, 24-96 months). We identified 137 impacted fractures with humeral head collapse or necrosis (Type 1 sequelae), 25 unreducible dislocations or fracture-dislocations (Type 2), 22 nonunions of the surgical neck (Type 3), and 19 severe tuberosity malunions (Type 4). Results of nonconstrained shoulder arthroplasty for the treatment of Type 1 and Type 2 sequelae were predictably good because no greater tuberosity osteotomy was performed. The distorted anatomy was accepted, and both the prosthesis and technique were modified accordingly. Total shoulder arthroplasty yielded better results than hemiarthroplasty. Patients with Type 3 or Type 4 sequelae had poor functional results with nonconstrained arthroplasty because greater tuberosity osteotomy was needed. This study validates our fracture sequelae classification. We no longer use unconstrained prostheses in Type 3 and Type 4 fracture sequelae and propose peg bone grafting or low-profile fracture prosthesis for patients with Type 3 sequelae and reverse arthroplasty for those with Type 4 sequelae. LEVEL OF EVIDENCE:Prognostic study, level IV (case series). See Guidelines for Authors for a complete description of levels of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Boileau P,Chuinard C,Le Huec JC,Walch G,Trojani Cdoi
10.1097/01.blo.0000195679.87258.6esubject
Has Abstractpub_date
2006-01-01 00:00:00pages
121-30eissn
0009-921Xissn
1528-1132pii
00003086-200601000-00021journal_volume
442pub_type
杂志文章,多中心研究abstract：:Insufficient posterior tibial tendons in 28 specimens from patients with clinical Stage II or III disease were examined to clarify the etiology of adult-acquired flatfoot deformity. Hematoxylin and eosin and Masson trichrome-stained sections of formalin-fixed tissue were viewed in plain and polarized light. We perform...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000218759.42805.43
更新日期：2006-09-01 00:00:00
abstract：:Heterotopic ossification can impair the functional results of total hip arthroplasty. The causative role of trochanteric osteotomy in heterotopic ossification is uncertain. Postoperative radiographs of 100 total hip arthroplasties were analyzed for incidence of heterotopic ossification. Forty procedures were performed...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-11-01 00:00:00
abstract：:A proprioception measurement system was designed and constructed to evaluate lower-limb knee joint proprioception in ten above-knee amputees. The system permitted the testing of subjects in a position simulating late swing phase of gait. The threshold for detection of slow passive motion and the ability to reproduce s...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-11-01 00:00:00
abstract：:In situ hybridization and ultrastructural immunohistochemistry were used to study the synthesis and distribution of 2 bone matrix proteins, bone sialoprotein and osteopontin, in the proximal tibial epiphysis in 21-, 32-, and 84-day-old rats. Bone sialoprotein messenger ribonucleic acid expression was restricted to cel...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199609000-00033
更新日期：1996-09-01 00:00:00
abstract：:The primary indication for arthroplasty of the hip is the elimination of pain and the restoration of function. This paper addresses the progression of developments leading to the present satisfactory attainment of this goal. Having achieved this goal, patients and surgeons have come to expect far more than the necessi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1985-11-01 00:00:00
abstract：BACKGROUND:For unicompartmental knee arthroplasty (UKA), abnormal loading on the tibiofemoral joint could exacerbate knee osteoarthritis or implant wear. Joint moments are an indirect measure of such loading. However, little is known about knee moments of patients with UKA, tempering enthusiasm for its use. QUESTIONS/...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-3128-y
更新日期：2014-01-01 00:00:00
abstract：:Multiple myeloma and solitary plasmacytoma are common reticuloendothelial diseases. They involve primarily the bone marrow but have occasional extramedullary components. Numerous complications have been reported with these diseases. Despite modern modes of therapy, the prognosis remains grim. Myeloma and plasmacytoma ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-03-01 00:00:00
abstract：:A xanthoma, located in the ulna, not accompanied by the traditional cutaneous and tendinous manifestations (xanthoma and xanthelasma) and with a late onset of alterations in lipid values, was diagnosed in a 56-year-old man. The lesion had a slow but constant growth leading to internal calcifications. Hyperlipidemia Ty...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000063790.32430.10
更新日期：2003-05-01 00:00:00
abstract：:Patients with Perthes' disease develop a lesion comparable to osteochondritis dissecans (OCD). The frequency of this combination was about 6% of all Perthes' disease patients conservatively treated. In three out of 17 patients reported here, the lesion caused minor symptoms, but was associated with dislocation, loose ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1980-10-01 00:00:00
abstract：:The case report presents a nine-year-old child with an osteoid osteoma of the femoral neck, simulating an inflammatory synovitis. Osteoid osteoma is a common benign bone tumor. However, when intracapsular lesions occur they may pose a diagnostic challenge. Nonspecific clinical signs and symptoms, such as inflammatory ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-10-01 00:00:00
abstract：BACKGROUND:Although not all elderly patients with femoral neck fractures are candidates for THA, active, mentally competent, independent patients achieve the most durable functional scores with THA compared with hemiarthroplasty. However, a relatively high frequency of early or late dislocation could reduce the potenti...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-1987-7
更新日期：2011-11-01 00:00:00
abstract：BACKGROUND:Although several types of culture medium have been used for preservation of osteochondral allografts, the viability of chondrocytes decreases with increasing storage duration. We previously showed the University of Wisconsin solution is more suitable for graft preservation than culture medium. QUESTIONS/PUR...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-2182-6
更新日期：2012-10-01 00:00:00
abstract：BACKGROUND:Serum C-reactive protein (CRP) is a general marker of inflammation, and recent studies suggest that measurement of CRP in synovial fluid may be a more accurate method for diagnosing periprosthetic joint infection (PJI). QUESTIONS/PURPOSES:We aimed to (1) determine if there is a correlation between serum and...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-014-3828-y
更新日期：2014-12-01 00:00:00
abstract：BACKGROUND:Unloader braces are a nonsurgical approach for predominantly unicompartmental knee arthritis. Although noninvasive, braces are expensive and it is unclear whether clinical factors, if any, will predict regular brace use. QUESTIONS/PURPOSES:We asked: (1) Do patients continue to use the unloader brace more th...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-2814-0
更新日期：2013-06-01 00:00:00
abstract：:A study of 281 patients evaluated for a meniscus pathologic condition was performed to assess the accuracy of the clinical diagnosis and arthrogram and delineate the role of arthroscopy. Following the clinical examination, the surgeon stated his level of confidence in his diagnosis, as did the radiologist in his inter...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1982-03-01 00:00:00
abstract：BACKGROUND:Septic arthritis is frequently associated with adjacent infections including osteomyelitis and subperiosteal and intramuscular abscesses. While often clinically indiscernible from isolated septic arthritis, the diagnosis of adjacent infections is important in determining the need for additional surgical inte...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999.0000000000000019
更新日期：2018-01-01 00:00:00
abstract：:The burgeoning of major research related to the effectiveness and appropriateness of clinical treatment methods as part of efforts to improve the quality of patient care provides added emphasis to consumer needs for certification and recertification. While there are multiple factors involved, the prime consumer questi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-08-01 00:00:00
abstract：:Fingertip amputations are the most common type of amputation injury in the upper extremity. These injuries are either seen in the emergency room or in an office setting. These lesions are very frequent and require precise wound care for optimal results. The longer finger and the thumb, being the most distal and indepe...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-199808000-00008
更新日期：1998-08-01 00:00:00
abstract：:Observations of the knee joint made at surgical synovectomy in young children with the chronic synovitis stage of hemophilic arthropathy permitted description of the evolution of the subchondral cyst in this disease. Beginning as a subchondral hematoma beneath the load-bearing surfaces of the joint, the subchondral cy...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-05-01 00:00:00
abstract：BACKGROUND:Small recent case series using CT-based navigation suggest such approaches may aid in surgical planning and improve accuracy of intended resections, but the accuracy and clinical use have not been confirmed. QUESTIONS/PURPOSES:We therefore evaluated (1) the accuracy; (2) recurrences; and (3) function in pat...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2557-3
更新日期：2013-03-01 00:00:00
abstract：:Alcohol can induce adipogenesis by bone marrow stromal cells and may cause osteonecrosis of the femoral head. Currently, there are no medications available to prevent alcohol-induced osteonecrosis. We hypothesized puerarin, a Chinese herbal medicine with antioxidative and antithrombotic effects, can prevent alcohol-in...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0178-7
更新日期：2008-05-01 00:00:00
abstract：:The benefit of reduced polyethylene wear with ceramic in hip replacements does not seem to have been universally appreciated. In this current study, wear predictions from laboratory and clinical studies were compared for ceramic-on-polyethylene and cobalt chrome-on-polyethylene combinations. Many laboratory studies in...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-200010000-00006
更新日期：2000-10-01 00:00:00
abstract：:Saos-2 cultured human osteosarcoma cells contain an extractable bone inducing agent that can induce heterotopic bone in the muscle of Nu/Nu mice. A semipurified GuHCl extract of Saos-2 cells also can promote healing and complete bony union in otherwise non-healing surgically induced defects of rat femur. Northern blot...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1995-04-01 00:00:00
abstract：:The regeneration of bone remains an elusive yet important goal in the field of orthopaedic surgery. Despite its limitations, autogenous cancellous bone grafting continues to the most effective means by which bone healing is enhanced clinically. Biosynthetic bone grafts currently are being developed as an alternative t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-199910001-00011
更新日期：1999-10-01 00:00:00
abstract：:It has been reported that flexibility of the neck decreases after cervical laminoplasty. It also is known that kyphosis can be an unfavorable result after posterior decompression surgery of the cervical spine. To examine whether a decrease in cervical mobility resulting from contracture of the cervical spine helps pre...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200208000-00016
更新日期：2002-08-01 00:00:00
abstract：:Ninety-two patients (103 hips) treated with total hip arthroplasty (THA) were assessed before and after operation to determine nutritional status and any correlation with delayed wound healing. Parameters indicative of nutritional status (serum albumin and serum transferrin) were assessed, along with immunologic and a...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-08-01 00:00:00
abstract：:The is a report of a 5-year-old girl with osteogenesis imperfecta, an uncommon abnormality considered to encompass several distinct disorders and biochemically classified as a connective tissue disease. Affected individuals, in the more severe form of the disease, often die in utero or shortly thereafter secondary to ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-09-01 00:00:00
abstract：:Syndesmosis sprains have received increasing recognition during recent years because of a heightened awareness of the mechanism, symptoms, and signs of injury. Syndesmosis injuries take longer to recover than lateral ankle sprains, and no consensus exists regarding optimal treatment of these injuries. Therefore, we un...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/BLO.0b013e31802eb471
更新日期：2007-02-01 00:00:00
abstract：:Scoliosis in Marfan's syndrome may be painful, but severe spondylolisthesis with a cauda equina tension syndrome as the cause of pain has only recently been recognized. Scoliosis may be associated with spondylolisthesis. The scoliosis may be sciatic or structural. These may be true structural curves or secondary to th...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-08-01 00:00:00
abstract：:Chronic spontaneous dislocation of the sternoclavicular joint occurs more frequently in athletes than nonathletes, causing weakness and sometimes pain during prolonged stress upon the arm. Five such joints were successfully treated in 4 patients by means of a dynamic method of repair--tenodesis of the sternal head of ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-05-01 00:00:00
