Abstract:
:Results of hemiarthroplasty for complex four-part proximal humerus fractures in the elderly have been unreliable. Although patients often achieve pain relief, return of above-shoulder level function can be challenging, because tuberosity nonunion, malunion, and/or resorption is quite common. The reverse shoulder replacement has been advocated as a reliable alternative for these patients. Preliminary studies have suggested that tuberosity healing is critical for achieving external rotation strength after reverse shoulder arthroplasty. We describe a technique of tuberosity repair using a wedge horseshoe graft, which can provide improved surface area for tuberosity healing. A clinical series of seven patients treated with this technique is reported with a minimum follow-up of 12 months (range, 12-23 months). The tuberosity union rate was 86% (six of seven patients). Average active forward elevation was 117° (range, 95°-150°), and active external rotation was 19° (range 0°-30°). Visual analog scale pain scores averaged 0.6 (range, 0-1), visual analog scale function averaged 8.7 (range, 7-10), mean American Shoulder and Elbow Surgeons pain was 47.1 (range, 45-50), and mean American Shoulder and Elbow Surgeons function was 39.2 (range, 31-50). Subjective satisfaction ratings were excellent for four patients, and good for two, and satisfactory for one. No patients were unsatisfied with their outcomes. The horseshoe graft technique provides a reliable means for anatomic restoration of the tuberosities, facilitating the return of shoulder function in elderly patients with complex four-part proximal humerus fractures treated with a reverse total shoulder.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Levy JC,Badman Bdoi
10.1097/BOT.0b013e3181f22088subject
Has Abstractpub_date
2011-05-01 00:00:00pages
318-24issue
5eissn
0890-5339issn
1531-2291journal_volume
25pub_type
杂志文章abstract::After open reduction of a burst fracture of L1, transpedicular bone grafting of the fractured vertebral body was performed. Bone grafts accidentally slipped into the spinal canal through the damaged medial wall of the pedicle. No adverse effects were noted clinically, but this case illustrates that transpedicular bone...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199209000-00019
更新日期:1992-01-01 00:00:00
abstract::In a 3-year prospective randomized trial, the prognostic value of osteoporosis in terms of predicting healing complications due to implant failures or loss of fracture reduction has been studied in 113 patients with inter-trochanteric hip fractures treated with either a sliding screwplate or Ender nailing. According t...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005131-199310000-00006
更新日期:1993-01-01 00:00:00
abstract::Antegrade intramedullary nails are an established, effective method of fixation for humeral shaft fractures. One significant limitation of this technique is chronic postoperative shoulder pain, which is likely related to the standard approach that involves splitting the rotator cuff to gain access to the nail starting...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000684
更新日期:2017-02-01 00:00:00
abstract::Although Kirschner wires are useful implants in many situations, migration of the wire and irritation of the surrounding soft tissues are common complications. Seven steps are described herein, which result in a Kirschner wire that is bent 180° angle, providing a smooth anchor into bone. Use of this technique produces...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318290f818
更新日期:2013-11-01 00:00:00
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 repo...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200604000-00004
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:Although there is general agreement as to the pathophysiology and treatment of compartment syndrome and the importance of intramuscular pressure measurements, there are many methods described to obtain these measurements. Variations in experimental measurements using current electronic monitoring, needle, an...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31822908cf
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy of anesthetic type on clinical outcomes after operative treatment of distal radius fractures. DESIGN:Retrospective review of prospectively collected data. SETTING:Academic medical center. PATIENTS:One hundred eighty-seven patients with a distal radius fracture (OTA type 23) were ide...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318238becb
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to evaluate functional outcome, patient self-assessment, and radiographic outcome at 1 year in displaced three- and four-part proximal humeral fractures (OTA group 11-B2 and 11-C2). DESIGN:Randomized controlled trial. SETTING:Academic medical center. PATIENTS/PARTICIPANTS:Fif...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,随机对照试验
doi:10.1097/BOT.0b013e31821c2e15
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVES:To identify associated injuries that occur in varus posteromedial rotatory instability (VPMRI) of the elbow and present their surgical management. DESIGN:Level II retrospective study. SETTING:Tertiary referral center. PATIENT/PARTICIPANTS:Twenty-seven patients with VPMRI injuries treated surgically over a...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001313
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVES:This study was designed to evaluate the frequency of intraoperative problems and complications involved with Less Invasive Stabilization System (LISS) plate removal. DESIGN:Retrospective study. SETTING:Single academic level I trauma center. METHODS:Medical records were reviewed for demographics, surgical ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181c29bf5
更新日期:2010-06-01 00:00:00
abstract::A case of a complex distal humeral fracture is presented. The patient lacked sufficient bony architecture to allow for conventional reconstruction. A technique is described using an intramedullary plate to obtain bony stabilization and permit early range of motion exercises. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200205000-00011
更新日期:2002-05-01 00:00:00
abstract:OBJECTIVE:To determine the relative stability achieved in unstable supracondylar femur fractures treated with long (36 cm) and short (20 cm) retrograde intramedullary nails using 1 or 2 proximal locking bolts. We hypothesized that longer nails would reduce fracture site motion compared with short nails and that 2 proxi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200407000-00004
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVES:The stiffness of locking plates provide increased stability for early fracture healing but may limit late interfragmentary motion (IFM) necessary for secondary bone healing. An ideal plating construct would provide early rigidity and late flexibility to optimize bone healing. A novel screw plate construct ut...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001664
更新日期:2020-03-01 00:00:00
abstract::Recent studies on ankle syndesmosis injuries have shown that a significant amount of rotational malediction of the distal fibula are missed and may lead to poor functional outcome. A new set of radiographic criteria were developed to help detect distal fibula internal and external rotation using conventional fluorosco...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31828f89a9
更新日期:2013-12-01 00:00:00
abstract::Aggressive treatment of the multiply injured patient often requires early fixation of many fractures, some of which may be open. Often, patients develop postoperative fevers requiring a thorough workup to rule out infection. Recently, indium-111 white blood cell (WBC) imaging has become a valuable adjunct in the diagn...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract::A prospective randomized study was set up, comparing a compression hip screw with the Vandeputte (VDP) endoprosthesis treatment for fresh, unstable peritrochanteric fractures, according to the Evans-Jensen and AO systems. Ninety patients, ages > or = 70 years, 47 of whom were treated with a compression hip screw and 4...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005131-199509040-00004
更新日期:1995-01-01 00:00:00
abstract:OBJECTIVES:Hand dominance has been reported to be an important factor affecting outcomes after upper extremity trauma but remains unstudied after hemiarthroplasty for fracture. This study determined whether dominance affected outcomes after hemiarthroplasty for proximal humerus fractures. DESIGN:Retrospective cohort s...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000294
更新日期:2015-08-01 00:00:00
abstract::Femoral shaft fractures are commonly treated with closed reduction and reamed intramedullary nailing. However, some reductions are difficult to obtain or maintain, especially in muscular or large patients. When closed methods fail to achieve reduction, percutaneous techniques are extremely useful. In addition, the use...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000890
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:Comparison between a Less Invasive Stabilization System (LISS) using monocortical screws with angular stability and two conventional plate systems Condylar Buttress Plate (CBP) and Dynamic Condylar Screw (DCS) for the treatment of distal femoral fractures with respect to biomechanical properties. DESIGN:Biom...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200109000-00004
更新日期:2001-09-01 00:00:00
abstract::Acute compartment syndrome of the deltoid is rare with only 6 cases reported in the literature. To our knowledge, there are no reported cases of deltoid compartment syndrome after surgery on the shoulder. In this case, the patient developed a tense painful anterior deltoid 3 hours after antegrade nailing of a segmenta...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318199e83c
更新日期:2009-03-01 00:00:00
abstract::Intracapsular femoral neck fractures are common in the elderly population after a simple fall. However, femoral neck fractures in the physiologically young are less common. Regardless, femoral neck fractures can be a source of significant morbidity and mortality if not treated correctly. Multiple management strategies...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000288
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVES:Improved patient outcomes after plating of displaced clavicle fractures have been demonstrated by recent clinical studies. Many of these patients, however, complain of anterior chest wall numbness after this procedure; we hypothesize that numbness likely persists long term for many patients, but without effe...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000095
更新日期:2014-11-01 00:00:00
abstract::A case of an angulated, greenstick fracture of the scapula mimicking scapular winging in a skeletally immature 12-year-old boy is described. The bony deformity was visualized with plain radiography. CT was helpful in exclusion of a thoracic injury or an underlying neoplasm. Closed reduction yielded satisfactory result...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000174707.10980.f4
更新日期:2006-02-01 00:00:00
abstract::Monteggia fractures represent approximately 1 to 2 percent of forearm fractures, whereas Galeazzi fractures represent 3 to 6 percent. The combination of these injuries in the same extremity is an exceedingly rare occurrence. We report a case of ipsilateral combination Monteggia and Galeazzi fractures in an adult patie...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200202000-00011
更新日期:2002-02-01 00:00:00
abstract::Posterior wall (PW) fractures are the most common fractures requiring surgical fixation in acetabular surgery. Extra-articular screw placement must be confirmed intraoperatively. Herein we describe the use of the inlet and obturator oblique view (the Leeds view) for screw placement in elementary PW and in associated b...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章
doi:10.1097/BOT.0000000000000724
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVES:To assess whether plate bending at a hole significantly changes the biomechanical properties of a locked screw. METHODS:Coronal plane bends of 5-, 15-, or 45-degree angles were placed in 3.5-mm locking compression plates with the apex at a locking hole. An additional 45-degree angle test group was created i...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182a73a77
更新日期:2014-04-01 00:00:00
abstract::Not all fractures heal well or rapidly in the adult skeleton, and basic scientists and clinicians continue to search for ways to make fractures heal more predictably. It is a fundamental tenet of orthopaedics that skeletal injury is followed by inflammation and that this inflammatory response is the first stage in a s...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0b013e3181f17b33
更新日期:2010-09-01 00:00:00
abstract::Healing patterns were compared between transverse and 60 degrees oblique osteotomies in canine tibiae stabilized under external fixation. Under similar in vitro testing conditions (osteotomy ends in contact), the axial stiffness of the oblique osteotomy under external fixation was 45% of the paired transverse osteotom...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199109000-00016
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVES:The purpose of this study is to evaluate the predictive ability of the Orthopedic Trauma-Open Fracture Classification (OTA-OFC) system in regards to short-term (90 days) outcomes of amputation, infection necessitating intravenous antibiotics, and wound healing in clinical practice across multiple centers. D...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,多中心研究
doi:10.1097/BOT.0000000000000648
更新日期:2016-11-01 00:00:00
abstract::This paper presents a modified surgical technique for interlocked intramedullary stabilization of tibia fractures. An external distractor is used to achieve an indirect fracture reduction on a fluoroscopy table. This method avoids the potential traction complications associated with conventional fracture tables. The f...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00