Abstract:
OBJECTIVES:The increasing number of fractures of the proximal humerus, especially in the elderly, carries with it the unsolved problem of the optimal treatment for the displaced or unstable fractures. The authors' goal was to analyze whether fixation with a bent valgus angled blade plate could improve the outcomes reported in the literature to date. DESIGN:Prospective clinical study. SETTING:Urban level 1 university trauma center. PATIENTS:Over a 27-month period, 42 consecutive patients were treated for an unstable or displaced proximal humerus fracture. INTERVENTION:Open reduction and internal fixation with a 90-degree cannulated angled blade plate prebent to 110 degrees. MAIN OUTCOME MEASUREMENTS:Active follow-up for 1 year with assessment of objective and subjective functional results (ie, motion; strength; Constant score; Disabilities of the Arm, Shoulder, and Hand (DASH) score; and visual analog scale (VAS)) and radiographic assessment (reduction, alignment, necrosis, and nonunion). RESULTS:Follow-up was completed for 86% of the patients, who achieved a mean Constant score of 66 points (82% of the contralateral side) with a mean forward flexion of 125 degrees and an average strength of 72% of the contralateral side. Low disability (mean DASH score 22) and pain values (mean VAS 2) were demonstrated after this type of stabilization. The overall complication rate was 33% (12/36), with protrusion of the blade into the glenohumeral articulation as the most frequent problem (8/36, 22%). The negative impact of an adverse event on subjective and objective outcomes was only significant for forward flexion (P = 0.02). Neither clinical outcome nor complication rate was different when compared to patients with regard to fracture type (3 versus 4 parts) or age (younger or older than 70 years). CONCLUSIONS:Fixation of displaced proximal humeral fractures with an angled blade plate provided sufficient stability. Blade perforation into the humeral joint occurred in every fourth patient and was found to be the major reason for a high complication rate. In view of this major problem, the technique described here cannot be recommended, even though the absence of nonunions in our series seems to support the low invasiveness of this surgical approach.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Meier RA,Messmer P,Regazzoni P,Rothfischer W,Gross Tdoi
10.1097/00005131-200604000-00004subject
Has Abstractpub_date
2006-04-01 00:00:00pages
253-60issue
4eissn
0890-5339issn
1531-2291pii
00005131-200604000-00004journal_volume
20pub_type
杂志文章abstract:OBJECTIVE:Risk for bleeding complications during and after early hip fracture surgery for patients taking clopidogrel and other anticoagulants have not been defined. The purpose of this study is to assess the perioperative bleeding risks and clinical outcome after early hip fracture surgery performed on patients taking...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318240d70f
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVES:To compare the efficacy of negative pressure wound therapy (NPWT) versus conventional dressings (CD) in the management of open fractures. DATA SOURCES:A systematic search of English articles in the PubMed/MEDLINE, Embase, and the Cochrane Library through April 2019 comparing NPWT versus CD in the management...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001750
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVES:This study compared the acute treatment effects of systemic analgesics with (celecoxib) and without anti-inflammatory activity (acetaminophen) on bone fracture healing. STUDY DESIGN:Longitudinal time study of fracture healing in rats. METHODS:Closed, mid diaphyseal femur fractures were produced in female S...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000184144.98071.5d
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVE:To report on the anatomic variations of the lateral femoral cutaneous nerve with respect to the ilioinguinal surgical dissection. DESIGN:Cadaveric anatomic study. PATIENTS/PARTICIPANTS:Sixty-eight ilioinguinal dissections performed in fifty cadavers. INTERVENTION:The lateral femoral cutaneous nerve was ide...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199901000-00005
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVE:The purpose of the present study was to compare the biomechanical stability of C1 and C2 vertebrae after treatment of ligamentous instability by either modified Brooks posterior wiring (MB) or transarticular screw (TAS) techniques. We hypothesized that the TAS technique would be more stable because of direct ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199909000-00004
更新日期:1999-09-01 00:00:00
abstract::Lateral condyle fractures are second only to supracondylar humeral fractures when it comes to pediatric elbow fractures. Whether minimally displaced or substantially displaced, these growth plate fractures may present significant treatment challenges. These include nonunion, malunion, avascular necrosis, and growth di...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000001543
更新日期:2019-08-01 00:00:00
abstract::Rupture of the medial head of the gastrocnemius muscle ("tennis leg") is an affliction generally associated with athletic activity. The diagnosis is made by careful history and physical examination. Although its findings are characteristic, previous reports have documented misdiagnosis of this lesion as thrombophlebit...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199406000-00016
更新日期:1994-01-01 00:00:00
abstract::Severe open foot and ankle injuries are still a challenge for the orthopaedic surgeon. Their treatment is even more difficult in third world countries and in war settings where high-energy trauma with severe soft tissue damage is more frequent. Lack of equipment, poor resources and hygiene, and different cultural syst...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181d4be0f
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVE:New locked plate devices offer theoretical advantages for the treatment of supracondylar femur fractures associated with a total knee arthroplasty (TKA). These devices also can be inserted with relative ease by using minimally invasive techniques, provide a fixed angle construct, and improve fixation in osteo...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200603000-00005
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVES:Noncompliance with postoperative follow-up visits remains a common problem in orthopaedic trauma. The aim of this study was to identify risk factors for loss of follow-up after orthopaedic trauma. DESIGN:Retrospective review. SETTING:Urban level 1 academic trauma center. PATIENTS:A total of 307 (226 men/8...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000346
更新日期:2015-11-01 00:00:00
abstract::Bone healing after fracture occurs in a well-organized manner and involves a multitude of cell types, inflammatory cytokines, growth factors, prostaglandins, and certain vitamins. Some of the means by which alterations in these essential components affect bone repair are understood, whereas others still need to be del...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0b013e318274da8b
更新日期:2012-12-01 00:00:00
abstract::To evaluate the use of a two-prong splint for displaced, proximal, humerus, epiphyseal fractures, seven children with Neer-Horwitz Classification Type 3-4 fractures of the proximal humerus were retrospectively investigated. After closed reduction, fracture stabilization was accomplished with the use of a two-prong spl...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200309000-00007
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVES:To evaluate the role of a modified Pauwels' intertrochanteric osteotomy (MPIO) in neglected femoral neck fractures in children. DESIGN:Prospective study with retrospective analysis. SETTING:Tertiary care Postgraduate Institute of Medical Sciences. PATIENTS:Ten children (8 males, 2 females) with an average...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31804cfdad
更新日期:2007-04-01 00:00:00
abstract::Leg length discrepancies can occur despite successful union of femur fractures after intramedullary nailing (IMN). Often, the leg length discrepancy can result in significant disability to the patient, altered gait biomechanics, pelvic obliquity, and pain. Therefore, a successful clinical result for such deformities a...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181f92d6e
更新日期:2011-11-01 00:00:00
abstract::Fracture compression can be achieved in many ways intraoperatively using either screws in compression plates, compression devices, or using intramedullary nails. The use of locked intramedullary nails combines the advantages of indirect fracture fixation and compression with minimal soft tissue disruption. This articl...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0b013e31819f2779
更新日期:2009-05-01 00:00:00
abstract::With the increase in demand for total hip and knee arthroplasty, the orthopaedic community has seen a dramatic increase in periprosthetic fractures. Given the high morbidity and mortality associated with these fractures, the orthopaedic surgeon needs to be prepared to deal with this difficult problem. The purpose of t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31821b8c3b
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVES:Prophylaxis against thromboembolic complications has become routine after major orthopedic surgery. In contrast, it remains an issue for debate whether prophylaxis after minor surgery and immobilization is necessary, even though these treatments are well-known risk factors for deep-vein thrombosis (DVT). The...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.bot.0000250741.65003.14
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVES:To assess the outcomes of the surgical management of "isolated" displaced lateral malleolar fractures, comparing the techniques of lateral plating and antiglide plating as described previously. DESIGN:This is a retrospective review, being largely a surgeon-randomized comparative study. SETTING:The study wa...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200208000-00008
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVES:To document the high failure rate of a specific implant: the Synthes Variable Angle (VA) Locking Distal Femur Plate. DESIGN:Retrospective. SETTING:Urban University Level I Trauma Center. PATIENT/PARTICIPANTS:All distal femur fractures (OTA/AO 33-A, B, C) treated from March 2011 through August 2013 were re...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000391
更新日期:2016-01-01 00:00:00
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journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318284785a
更新日期:2013-11-01 00:00:00
abstract::Orthopaedic surgery and biomechanics are intimately partnered topics in medicine. Biomechanical principles are used to design implants and fashion treatment protocols. Although it would seem that biomechanical principles in the design of fixation devices and fracture repair constructs have been already finalized, ther...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000001126
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVES:To determine whether severe open tibial fractures in children behave like similar fractures in adults. DESIGN AND SETTING:A combined retrospective and prospective review evaluated treatment protocol for type II and type III open tibial fractures in children over a ten-year period from 1984 to 1993. PATIENT...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199707000-00010
更新日期:1997-07-01 00:00:00
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journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200201000-00007
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to evaluate forearm rotation after volar plating of the distal radius fractures with and without pronator quadratus repair. DESIGN:This was an institutional review board-approved retrospective review of prospectively collected data. SETTING:The study was conducted at an Academ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182539333
更新日期:2013-03-01 00:00:00
abstract::Twenty-six patients with major anterior-posterior pelvic disruptions not involving the acetabulum were reevaluated an average of 8 years (minimum 5 years) after injury. All pelvic injuries were treated nonoperatively. Subjective complaints at the time of follow-up included frequent or daily low back discomfort (50%), ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-198903010-00008
更新日期:1989-01-01 00:00:00
abstract::The best results following fractures of the distal humerus are provided by anatomic reduction and rigid internal fixation. Plates of two designs placed in five different fixation configurations were used to determine the construct that would maximize rigidity of fixation of the distal humerus. Using a cadaver distal h...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract:OBJECTIVES:Retrospective evaluation of the long-term outcomes after surgical treatment of traumatic patellar dislocations in adolescents and identification of possible predictive factors of poor outcomes. DESIGN:Retrospective clinical study. SETTING:University Clinic, Level I Trauma Center. PATIENTS:All 33 adolescen...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318299cb50
更新日期:2014-03-01 00:00:00
abstract::Bone grafts are the second most common tissue transplanted in the United States, and they are an essential treatment tool in the field of acute and reconstructive traumatic orthopaedic surgery. Available in cancellous, cortical, or bone marrow aspirate form, autogenous bone graft is regarded as the gold standard in th...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000001420
更新日期:2019-04-01 00:00:00
abstract::An 80-year-old man sustained a T-shaped supracondylar fracture of the femur associated with distal one-third shaft comminution. Initial failure of a 95 degrees angle blade plate was followed by insertion of an intraarticular intramedullary nail stabilized with static locking-screw fixation. A second failure of the imp...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199308000-00004
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVE:To prospectively analyze a homogenous group of trauma patients with pure sacroiliac (SI) joint dislocations treated with iliosacral screws (ISS), with specific attention to functional outcome and its correlation with the presence or absence of SI joint ankylosis and quality of reduction. DESIGN:Retrospective...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31816b6b4e
更新日期:2008-05-01 00:00:00