Abstract：
UNLABELLED:Fractures of the proximal humerus can be treated effectively but require proper characterization. None of the existing classifications intended to facilitate characterization have been satisfactory. We studied proximal humerus fractures using radiographs alone and radiographs plus computed tomography scans to ascertain which imaging studies were most useful to characterize these fractures. We designed an assessment protocol consisting of 17 parameters divided in four groups: cephalodiaphyseal relationship (six parameters), cephalotuberosity relationship (six parameters), humeral head (two parameters), and fracture fragment description (three parameters). The computed tomography scans were assessed using 11 parameters (the same parameters used for assessing radiographs except for the six cephalodiaphyseal parameters). Four observers analyzed the parameters in 30 selected fractures with biplanar radiographic projections (30 patients) and computed tomography scans (22 patients) on two occasions. We found good interobserver reliability and intraobserver reliability with radiographs alone for the cephalodiaphyseal parameters. The best interobserver reliabilities with radiographs plus computed tomography scans were with the number of fragments, displacement of the lesser tuberosity, and extraarticular or articular fractures. Computed tomography allows better assessment of some parameters in characterizing proximal humeral fractures. The use of a structured protocol in reading images seems useful and allows better reliability than reported for other approaches. LEVEL OF EVIDENCE:Diagnostic study, Level III (study of nonconsecutive patients without consistently applied reference "gold" standard). See the Guidelines for Authors for a complete description of levels of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Mora Guix JM,Gonzalez AS,Brugalla JV,Carril EC,Baños FGdoi
10.1097/01.blo.0000205899.28856.98subject
Has Abstractpub_date
2006-07-01 00:00:00pages
225-33eissn
0009-921Xissn
1528-1132pii
00003086-200607000-00033journal_volume
448pub_type
杂志文章abstract：:Assessment of surgically repaired cartilage lesions with standardized cartilage sensitive magnetic resonance imaging was done to evaluate the integrity, morphologic features, and signal of the articular surface, thereby obtaining information about the natural history of these procedures in the knee. Magnetic resonance...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000129162.36302.4f
更新日期：2004-05-01 00:00:00
abstract：:In 15 normal adults an advanced biomechanical analysis of walking patterns at slow, natural, and fast cadences showed that the ankle had two mechanical power phases: a negative work phase during weight acceptance, followed by a dominant burst of positive work at push-off. The knee had four power phases: a negative wor...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-05-01 00:00:00
abstract：BACKGROUND:The majority of patients with osteosarcoma and Ewing's sarcoma are diagnosed before skeletal maturity. Paley's multiplier is used for height prediction in healthy children, and has been suggested as a method to make growth predictions for children with osteosarcoma and Ewing's sarcoma when considering limb s...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-014-3636-4
更新日期：2014-08-01 00:00:00
abstract：:Eighty-eight osteoarticular distal femoral allografts and 68 proximal tibial allografts have been transplanted at the authors' institution from 1958 to 1970. These allografts were used in limb-sparing operations performed after the diagnosis of benign or malignant tumors. All allografts were preserved by freezing to -...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1994-06-01 00:00:00
abstract：:A system has been developed that allows the surgeon to match a prosthesis to any femoral cavity. The surgeon may choose how and where it will preferentially fit. The surgeon does not have to create a cavity to suit a premade prosthesis. The system is based on a novel technique for making a mold of the prepared femoral...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-12-01 00:00:00
abstract：:Bilateral simultaneous Achilles tendon ruptures are rare, with only ten cases reported in the English literature. Our case is that of a 44-year-old woman, along with a review of the literature. Affected persons usually are on chronic steroid treatment and in the fifth to seventh decades of life. The patient may have c...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-12-01 00:00:00
abstract：:Neonatal osteomyelitis has been frequently reported, but only rarely as a complication of repeated heel punctures. The need for constant monitoring of premature newborns and those having low birthweight and serious deformities necessitates repeated blood samples, usually obtained by heel puncture. Os calcis osteomyeli...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1981-05-01 00:00:00
abstract：BACKGROUND:Major disadvantages of antibiotic bone cements include limited drug release and reduced strength resulting from the addition of high doses of antibiotics. Bacterial cellulose, a three-dimensional hydrophilic mesh, may retain antibiotics and release them gradually. We hypothesized that the addition of cellulo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-010-1626-8
更新日期：2011-02-01 00:00:00
abstract：:Synovial tissues taken from 13 cases of synovial chondromatosis (SC) were examined by light and electron microscopy. In three of the 13 cases, early cellular changes were observed by electron microscopy. Most of the foci were independently situated within an accumulation of fine, homogenous chondroid matrix in the sub...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-03-01 00:00:00
abstract：:The clinical biocompatibility and degradation behavior of absorbable fracture fixation devices are still incompletely known in humans. Fifty-one patients with displaced fracture of the ankle treated by open reduction and internal fixation with absorbable screws made of polylevolactide were seen in followup for at leas...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1995-11-01 00:00:00
abstract：UNLABELLED:Risk factors to explain the poor survival of patients with osteosarcoma of the pelvis are poorly understood. Therefore, we attempted to identify factors affecting survival and development of local recurrence and metastasis. We retrospectively reviewed 43 patients who had high-grade pelvic tumors and were tre...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0495-x
更新日期：2009-02-01 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：:Ten cases of septic olecranon bursitis and two cases of septic prepatellar bursitis were treated in the period from 1975 to 1980 with antibiotics and percutaneous tube placement for suction-drainage and local antibiotic irrigation. All patients had positive bacterial cultures: Staphylococcus aureus in nine, beta-hemol...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-05-01 00:00:00
abstract：:Twenty-three patients with open fractures of the humerus who had been treated with immediate external fixation were reviewed retrospectively. Eighteen patients had adequate followup and were included in this study. Four patients (22%) had Gustilo and Anderson Grade I injury; 1 (5%), Grade II; and 13 (72%), Grade III (...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199704000-00021
更新日期：1997-04-01 00:00:00
abstract：:From 1977 to 1982, 13 patients were diagnosed with avascular necrosis of the femoral head. The diagnoses were made with a combination of clinical exams, radiographs, tomograms, and Tc99 bone scans. One hip was classified as Ficat Stage I, 9 as Stage II, and 5 as Stage III. There were 11 male and 2 female patients with...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1994-09-01 00:00:00
abstract：:The choice of pin site in shoulder arthrodesis after brachial plexus injury is important for efficient external fixation. The pins are inserted into the coracoid process from the anterior aspect and the scapular spine from the acromion. This insertion method holds the scapula more rigid and allows the patient to lie s...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-10-01 00:00:00
abstract：BACKGROUND:Numerous cementless femoral stem design variations are in clinical use. Because initial implant instability and micromotion are associated with aseptic loosening of the femoral component, migration analysis provides an early assessment of implant survivorship. QUESTIONS/PURPOSES:We determined the (1) migrat...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-2160-z
更新日期：2012-02-01 00:00:00
abstract：BACKGROUND:Despite the overall success of total joint arthroplasty, patients undergoing this procedure remain susceptible to cognitive decline and/or delirium, collectively termed postoperative cognitive dysfunction. However, no consensus exists as to whether general or regional anesthesia results in a lower likelihood...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1007/s11999-013-3363-2
更新日期：2014-05-01 00:00:00
abstract：:Thirty infected total knee arthroplasties were investigated in 29 patients over an average interval of 42 months. Eleven infections began in the immediate perioperative period. Six developed from postoperative wound-healing problems. The remainder were late infections. Staphylococcus was found in 16 infections, gram-n...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1985-10-01 00:00:00
abstract：:In the majority of skeletal metastases, new bone develops simultaneously with bone destruction. The roentgenogram indicates the net effect of these two processes. Where the bone formation predominates, the lesion appears sclerotic. Where bone destruction predominates, it appears lytic. Mixed lesions may also occur. Th...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1982-09-01 00:00:00
abstract：:In 1987, after 11 years of research, press fit titanium circumferential grommets were introduced for arthroplasty of the metacarpophalangeal joint to protect the flexible hinge implant midsection from sharp bony edges and shearing forces that can initiate implant abrasions and tears leading to implant fracture and for...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1997-09-01 00:00:00
abstract：BACKGROUND:Sarcoma care is highly litigated in medical malpractice claims. Understanding the reasons for litigation and legal outcomes in sarcoma care may help physicians deliver more effective and satisfying care to patients while limiting their legal exposure. However, few studies have described malpractice litigatio...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/CORR.0000000000001340
更新日期：2020-10-01 00:00:00
abstract：:Reports using the Constant-Murley score often lack details regarding how strength measurement was performed, which may have an important impact on the results obtained. A description of the measurement is especially important when patients are unable to adopt the prescribed position of 90 degrees shoulder abduction, l...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-009-1007-3
更新日期：2010-06-01 00:00:00
abstract：BACKGROUND:The majority of metastatic bone lesions to the femoral bone can be treated without surgery or with minimally invasive intramedullary nailing. In rare patients with extensive metastatic disease to the femur, total femur replacement may be the only surgical alternative to amputation; however, little is known a...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999.0000000000000125
更新日期：2018-05-01 00:00:00
abstract：:Joint synovia and fluids taken from patients with various stages of rheumatoid arthritis (RA) were injected into embryonated chicken eggs, resulting in characteristic joint abnormalities ("crooked toes") in the extremities of the embryos and chicks. There was a direct correlation between the number of the induced lesi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-10-01 00:00:00
abstract：BACKGROUND:The notion that neutral alignment is mandatory to assure long-term durability after TKA has been based mostly on short-film studies. However, this is challenged by recent long-film studies. QUESTIONS/PURPOSES:We conducted this long-film study to know (1) whether the risk of aseptic revision for nontraumatic...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999.0000000000000012
更新日期：2018-02-01 00:00:00
abstract：:Insertion of distal interlocking screws in femoral nails can be technically demanding and may entail substantial exposure. A method of insertion of femoral interlocking screws that uses a laser guiding system in addition to the standard image intensifier was used in an attempt to improve the accuracy of distal screw p...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-08-01 00:00:00
abstract：:A review of the existing data on shoulder laxity in females reveals there are insufficient data to confirm the commonly held belief that shoulders in females are more lax than shoulders in males. Laxity is not synonymous with instability. Although females may have increased generalized joint laxity relative to males, ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：2000-03-01 00:00:00
abstract：:Distraction osteogenesis is used to treat atrophic nonunion and focal osteomyelitis. It enhances blood vessel formation in the distracted callus and in the surrounding soft tissues. Long-term angiogenesis, however, is not well described. We hypothesized newly formed blood vessels persist in the surrounding muscles unt...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000238795.82466.74
更新日期：2007-01-01 00:00:00
abstract：:An extraarticular ligament reconstruction to stabilize the painful, hypermobile trapeziometacarpal (basal) joint by routing a portion of the flexor carpi radialis (FCR) through the thumb metacarpal has been performed in 25 "prearthritic" (Stage I) and 17 minimally involved (Stage II) basal joints. At an average follow...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-07-01 00:00:00
