Abstract：
BACKGROUND:Arthroplasty for shoulder fractures is a technically challenging and unpredictable procedure and its use is controversial. QUESTIONS/PURPOSES:We therefore asked (1) to what degree function would be restored, (2) whether tuberosity healing would reliably occur, and (3) whether stem design would influence function in patients treated with hemiarthroplasty for proximal humerus fracture. PATIENTS AND METHODS:We retrospectively reviewed all patients treated with a hemiarthroplasty for proximal humeral fracture between September 2001 and May 2006. The first 58 patients (September 2001 to March 2004) were treated with a conventional humeral prosthesis. The next 112 patients (April 2004 to May 2006) were treated with a fracture-specific humeral prosthesis. Clinical measures (American Shoulder and Elbow Surgeons scores, visual analog pain scores, and goniometric measurements of glenohumeral motion) and radiographic evaluation of tuberosity healing were performed at minimum 24-month followup (mean, 32 months; range, 24-96 months). RESULTS:Mean active anterior elevation was 118°, mean active external rotation 37.6°, and mean American Shoulder and Elbow Surgeons score 66. Overall, 127 of 170 (75%) greater tuberosities healed. With respect to stem design, active anterior elevation, active external rotation, and American Shoulder and Elbow Surgeons score were better with fracture-specific stems (129.8°, 39°, and 72, respectively) than with conventional stems (95.4°, 33.0°, and 55, respectively). Fewer tuberosities healed with conventional stems (38 of 58, 66%) than with fracture-specific stems (89 of 112, 79%). CONCLUSIONS:The use of fracture-specific stems during proximal humeral hemiarthroplasty for fracture appears to improve functional use of the injured shoulder and tuberosity healing compared to conventional stems. LEVEL OF EVIDENCE:Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Krishnan SG,Reineck JR,Bennion PD,Feher L,Burkhead WZ Jrdoi
10.1007/s11999-011-1919-6subject
Has Abstractpub_date
2011-12-01 00:00:00pages
3317-23issue
12eissn
0009-921Xissn
1528-1132journal_volume
469pub_type
杂志文章abstract：:Occupational radiation exposure was measured using three film badges and one ring thermoluminescent dosimeter. The radiation dose in the hospital but outside the operating room was measured as zero for the 12-month period. The measured trunk dose in the operating room was 5 mrem, and the measured dose to the head and ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-01-01 00:00:00
abstract：:Osteoarticular defects present a reparative challenge to orthopaedic surgeons. Osteoarticular allografts provided a promising solution. Unfortunately, many of these allografts failed secondary to articular cartilage degeneration. To determine the role of the extracellular matrix in graft failure, the authors have char...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200101000-00004
更新日期：2001-01-01 00:00:00
abstract：BACKGROUND:Healing and functional recovery have been reported using an extensively porous-coated stem in Vancouver B2 and B3 periprosthetic fractures; however, loss of cortical bone has been observed when using these stems in revision surgery for aseptic loosening. However, it is unclear whether this bone loss influenc...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-2845-6
更新日期：2013-12-01 00:00:00
abstract：UNLABELLED:Replacement of bone segments after resection of a tumor-containing bone has a long history, and currently metallic implants and allografts have reasonable rates of success in terms of patient survival and restoration of useful function. Total femoral resections for extensive tumors are uncommon but clearly r...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200509000-00012
更新日期：2005-09-01 00:00:00
abstract：:The acetabular cartilages from hip joints in adult rabbits receiving daily intramuscular injections of 1 or 5 mg hydrocortisone/kg body weight for periods of four or 12 weeks were studied by electron microscopy for quantitative analysis, nucleus to cell ratio, Golgi apparatus to cell ratio, rough endoplasmic reticulum...
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：:Bone allografts are commonly used in spinal surgery. Structural allografts placed anteriorly in the spine may be used as interbody grafts or as strut grafts spanning multiple segments. Posterior allografts are used to supplement autologous bone for spinal fusions in patients who lack sufficient host bone and to avoid ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-199603000-00010
更新日期：1996-03-01 00:00:00
abstract：:Recent surgical advancements in anterior cruciate ligament reconstructions have led to better results in the treatment of knee injuries. Functional knee braces have been prescribed in greater number, leading to an increased production of commercially available braces. The effectiveness of braces remains controversial ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1995-08-01 00:00:00
abstract：:Defects from curettage for giant cell tumors of bone frequently have been reconstructed with bone cement with or without reinforcement pins. The biomechanical basis for the addition of reinforcement pins was examined using a model of a contained defect in the proximal tibia. Fifty-four cadaveric proximal tibia in matc...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200402000-00038
更新日期：2004-02-01 00:00:00
abstract：:Mesenchymal neoplasms are a heterogeneous group of tumors comprising more than 200 benign entities and approximately 100 sarcomas. Large intraobserver and interobserver variability mandates improvements in diagnostic criteria. Gene expression microarrays are one tool in an evolving field of technology that permits the...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000093897.12372.88
更新日期：2003-10-01 00:00:00
abstract：BACKGROUND:Modern metal-on-metal hip resurfacing arthroplasty designs have been used for over a decade. Risk factors for short-term failure include small component size, large femoral head defects, low body mass index, older age, high level of sporting activity, and component design, and it is established there is a su...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2347-y
更新日期：2012-11-01 00:00:00
abstract：:This is a report on a University of Illinois Hospital series of cases of extracapsular base of the neck osteotomy for slipped capital femoral epiphyses. The osteotomy was performed on 20 hips in 16 patients, with a 71/2 year average follow-up. The results of this procedure are encouraging and illustrate the advantages...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-05-01 00:00:00
abstract：:Calcified cartilage transplants induce bone formation. This process may be inhibited if the recipient is immunized by the transplant. To study the relation between the degree of antigen incompatibility between the donor and recipient and bone formation in more detail, chondrocytes isolated from cartilaginous epiphyses...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-01-01 00:00:00
abstract：BACKGROUND:It is easy to accurately measure web site usage and to quantify key parameters such as page views, site visits, and more complex variables using commercially available tools that analyze web site log files and search engine use. This information can be used strategically to guide the design or redesign of a ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-010-1333-5
更新日期：2010-10-01 00:00:00
abstract：:During the past ten years, approximately 3000 cases of knee arthroscopy have been performed in a CO2 medium. The setup for the use of CO2 is quite simple and is explained here on a step-by-step basis. Advantages are a better visual field and no motion of tissue in the arthroscopic field. The disadvantages are minimal....
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-03-01 00:00:00
abstract：BACKGROUND:Decision-making regarding nonoperative versus operative treatment of patients with thoracolumbar burst fractures in the absence of neurologic deficits is controversial. Lack of evidence-based practice may result in patients being treated inappropriately and being exposed to unnecessary adverse consequences. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s11999-011-2157-7
更新日期：2012-02-01 00:00:00
abstract：UNLABELLED:We describe the condylar cutoff sign, a radiographic sign in knees with a discoid lateral meniscus, for diagnosis of complete discoid meniscus. We retrospectively reviewed tunnel-view radiographs of 100 patients (100) knees including 50 with complete discoid lateral meniscus and 50 with normal menisci. All p...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0447-5
更新日期：2009-05-01 00:00:00
abstract：BACKGROUND:Complicated tibial fractures with severe soft tissue trauma are challenging to treat. Frequently associated acute compartment syndrome can result in scarring of muscles with impaired function. Several studies have shown a relationship between angiogenesis and more effective muscle regeneration. Vascular endo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2456-7
更新日期：2012-12-01 00:00:00
abstract：BACKGROUND:Recently, the authors of two prospective multicenter observational studies recommended surgery to improve head sphericity in older children, whereas large retrospective observational studies suggest that surgery does not improve head sphericity in older children. Thus, the treatment for Legg-Calvé-Perthes di...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s11999-012-2326-3
更新日期：2012-09-01 00:00:00
abstract：UNLABELLED:Ankle arthroplasty is increasingly used to treat advanced ankle arthritis. Earlier prostheses have given way to second-generation implants, on which we are accumulating medium-term data. The Scandinavian Total Ankle Replacement (STAR) is a three-component uncemented implant in wide use in Europe and the only...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-009-0971-y
更新日期：2010-04-01 00:00:00
abstract：:Complications after ankle ligament reconstruction are infrequent, but present significant challenges to the treating orthopaedist. Local wound problems and nerve injuries may cause difficulty in the early postoperative period. Recurrent instability may be attributable to failure of the operation, poor rehabilitation, ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-200110000-00013
更新日期：2001-10-01 00:00:00
abstract：:Magnetic resonance imaging has become a powerful tool for diagnosing many orthopaedic disorders. To use the technology appropriately and understand the nature of the images, it is important that the referring orthopaedic surgeon be familiar with the underlying principles of image formation. In this article, the author...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1995-12-01 00:00:00
abstract：:The effects of polymethylmethacrylate (PMMA) on DNA, protein, and sulfated-proteoglycan synthesis by rabbit articular chondrocytes were observed in monolayer cultures. PMMA pellets in ratios of 1:1 and 1:2 (liquid monomer:powder) significantly reduced [3H]thymidine incorporation into DNA during the first 24 h of cultu...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-10-01 00:00:00
abstract：:Osteosarcoma is the most common primary bone malignancy. Despite improvements in therapy, approximately 30% of patients experience pulmonary metastasis. Expression of several growth factors, including VEGF and BMPs, has been implicated in tumor progression and metastatic potential. We hypothesized increased metastatic...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000229333.98781.56
更新日期：2006-09-01 00:00:00
abstract：:Glomus tumors are benign vascular tumors composed of round to oval uniform cells associated with vascular structures, usually found in the soft tissue of the nail bend. A 24-year-old woman with a two-year history of progressive right elbow pain and swelling was found to have a histologically characteristic intraosseou...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-07-01 00:00:00
abstract：:A 19-year-old man with a fracture of the distal humerus avulsed the anterior interosseous nerve. Avulsion of this nerve may be more common than previously believed. As shown by a cadaver study, the mechanism of injury is related to traction on the median nerve. Complete clinical assessment requires an accurate neurolo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-12-01 00:00:00
abstract：:The purpose of the current study was to determine the incidence of distal biceps tendon ruptures within a defined population, to describe the demographics of affected individuals, and to identify potential risk factors. The healthcare system in this study provides care to a known number of members in an area defined b...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：2002-11-01 00:00:00
abstract：:The objective of this study was to reconstruct full thickness cartilage defects in rabbit knees with in vitro engineered cartilage tissue based on noncryopreserved and cryopreserved chondrocytes in polymer fleece scaffolds. Osteochondral defects in rabbits were filled with polymer cylinders with noncryopreserved or cr...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200009000-00035
更新日期：2000-09-01 00:00:00
abstract：:Thirteen insufficiency stress fractures of the femoral neck in 13 elderly patients (average age, 82 years) were studied retrospectively. All occurred in Caucasian women with severe osteoporosis. A vague pain about the hip, of spontaneous onset, was the main symptom on first visit. The diagnosis was delayed in most cas...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-07-01 00:00:00
abstract：:Aneurysmal bone cysts are benign primary or secondary lesions that commonly arise in long bones and often before skeletal maturity. Little has been written about aneurysmal bone cysts that abut the physeal plate. The records of 15 patients with juxtaphyseal aneurysmal bone cysts were reviewed. Fourteen of the patients...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199907000-00026
更新日期：1999-07-01 00:00:00
abstract：:It is well-known that the long-standing relationship between orthopaedics and industry has benefited both parties. However, strong evidence indicates that the relationship is no longer a balanced one. Through a very effective stratagem, industry has used its enormous marketing power to a degree where the education of ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000074407.99625.67
更新日期：2003-07-01 00:00:00
