Abstract:
:During a ten-year period (1978-1988), 143 of 1386 patients with proximal humeral fractures were treated with internal osteosynthesis. Ninety-seven proximal humeral osteosynthesis cases had adequate documentation, and 77 (80%) were available for clinical review. The 97 fractures were graded by the AO/ASIF classification and included 44 Group A, 32 Group B, and 21 Group C fractures. Exercise-stable osteosynthesis using T-plate, cloverleaf plate, or small condylar plate was performed in 70% of patients. In the remaining patients, a less rigid fixation, with Kirschner wires or screws and cerclage wires, was used. Fifty-two percent of the patients had excellent and good results, 15% had fair results, and 33% had poor results. Most poor results occurred in patients with four-part fractures (61% of poor results). Of the cases involving four-part fractures, however, 22% had an excellent result after internal fixation. Displaced four-part fractures or fracture-dislocations should be treated by reconstruction of the proximal humerus, especially in young patients. The use of minimal fixation rather than rigid fixation is considered after careful assessment of the condition of the soft tissue and blood supply of the humeral head fragments. Primary treatment with endoprostheses is required when internal fixation is impractical in AO/ASIF fracture Types C 2/3 and C3 fractures. Improved clinical results may be achieved, particularly in the more severe fracture types, with increased experience in techniques of internal fixation of proximal humeral fractures.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Szyszkowitz R,Seggl W,Schleifer P,Cundy PJsubject
Has Abstractpub_date
1993-07-01 00:00:00pages
13-25issue
292eissn
0009-921Xissn
1528-1132pub_type
杂志文章,评审abstract::Pelvic osteotomy for symptomatic hip dysplasia usually is performed for young and adolescent females. Delivery after pelvic osteotomy is a concern for patients of childbearing age. We asked whether the clinical results differed before and after pregnancy, whether eccentric rotational acetabular osteotomy alters the bo...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/BLO.0b013e31803b8d82
更新日期:2007-06-01 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::Lauge-Hansen's system of classification of ankle fractures has been of pioneering importance and when correctly employed has improved the results of conservative treatment. Weber's classification scheme introduced by AO is simpler and more suited for surgical than nonoperative therapy. Both systems have deficiencies. ...
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::Total hip arthroplasty (THA) or total knee arthroplasty (TKA) is indicated for patients with juvenile rheumatoid arthritis (JRA) when marked joint destruction is present and pain or deformity compromises function despite optimal medical therapy. Relief of pain, reduction of the deformity, and dramatic improvement in f...
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:BACKGROUND:Fixation of unstable ankle fractures, including fixation of posterior malleolus fracture fragments with the attached, intact posteroinferior tibiofibular ligament (PITFL), reportedly provides more stable fixation than transsyndesmotic screws. QUESTIONS/PURPOSES:To confirm this observation we compared the Fo...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-1111-4
更新日期:2010-04-01 00:00:00
abstract::The current study was designed to compare muscle torques when using the subvastus and parapatellar approaches for unilateral total knee arthroplasty. Twelve female patients had unilateral total knee arthroplasty with the subvastus approach from January 1997 to June 1998. The historic control group consisted of 16 fema...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200205000-00027
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:Reconstruction of the extensor mechanism after resection of the proximal tibia is challenging, and several methods are available. A medial gastrocnemius flap commonly is used, although it may be associated with an extensor lag. This problem also is encountered, although perhaps to a lesser extent, with other...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-013-2851-8
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Metal-on-metal hip resurfacing arthroplasty (MOM HR) has become an established alternative to traditional metal-on-metal total hip arthroplasty (MOM THA) for younger, more active patients. Nevertheless, concerns remain regarding wear and corrosion of the bearing surfaces and the resulting systemic metal ion ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-013-2981-z
更新日期:2013-09-01 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::Arterial occlusion after total knee arthroplasty is an uncommon complication. In the literature only a few cases have been reported, and non consensus exists on the optimal management for this condition. The authors report two patients with popliteal artery thrombosis in the early postoperative period. Both patients w...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199909000-00020
更新日期:1999-09-01 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::Because of the nature of the alignment the joints of the lower extremity, any significant loss of alignment or function will place increased stress on the remaining joints. An ankle arthrodesis must be carefully aligned into slight valgus and neutral dorsiflexion, plantar flexion and the same degree of external rotati...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract::Early diagnosis of adolescent idiopathic scoliosis is essential to prevent severe deformity. The accuracy of thermographic examination of the spine in the detection of minor degrees of curvature has been assessed in 125 asymptomatic young persons mean age 13.4 +/- 0.8 years who were also examined clinically and by spi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1980-05-01 00:00:00
abstract::The effects of postoperative epidural infusions using local anesthetic and narcotic were assessed in reference to lower extremity blood flow. Nineteen patients who underwent unilateral total hip arthroplasty were randomly assigned to receive a postoperative epidural infusion of either 5 microg/ml fentanyl or 5 microg/...
journal_title:Clinical orthopaedics and related research
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1997-01-01 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:Nailing comminuted femur fractures may result in leg shortening, producing significant complications including pelvic tilt, narrowing of the hip joint space, mechanical and functional changes in gait, an increase in energy expenditures, and strains on spinal ligaments, leading to spinal deformities. The freq...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-013-3292-0
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Extensive posteromedial release to correct severe varus deformity during TKA may result in mediolateral or flexion instability and may require a constrained implant. We describe a technique combining computer navigation and medial condylar osteotomy in severe varus deformity to achieve a primary goal of liga...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-012-2773-x
更新日期:2013-05-01 00:00:00
abstract::Fifteen consecutive total hip arthroplasties (THAs) in 14 patients considered at risk for developing significant heterotopic ossification (HO) were treated postoperatively with 7.5 Gy of external beam radiation in three fractions. Eight hips in eight of the patients (Group I) had developed previous Brooker Class III o...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1992-07-01 00:00:00
abstract::During the past ten to 20 years, there have been many advances in the understanding of the way in which skeletal metastases develop and great strides in the methods of detection, particularly with the development of the gamma camera and axial or whole-body skeletal scintigraphy. Skeletal metastases may present with pa...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-09-01 00:00:00
abstract::Interposition grafting material is used frequently to treat osteoarthritis of the base of the thumb or tendinous and ligamentous injuries of the hand. The observation of duplicated tendons in the first dorsal compartment of the hand prompted us to explore the possibility of using the accessory abductor pollicis longus...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-1059-4
更新日期:2010-05-01 00:00:00
abstract::Twenty-two patients (23 shoulders) with arthrographically verified adhesive capsulitis of the glenohumeral joint were treated by a combination of distention-arthrography, local anesthetics and steroids intraarticularly, and manipulation. The mean duration of the disease at the time of treatment was 14 months, and all ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1992-09-01 00:00:00
abstract::Two hundred cases of intracapsular femoral neck fractures have been treated with a multiple parallel pin technique similar to that originated by Austin Moore. The technique employs a personally designed guide which facilitates insertion of multiple parallel pins. The fixation obtained satisfactorily resists shear stre...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-11-01 00:00:00
abstract::This is a report of the fifth known case of recurrent Legg--Calve--Perthes' disease. Roentgenograms of the hips after the first avascular episode, at the age of 3 years and 6 months resemble to a certain extent, Dysplasia Epiphysealis Capitis Femoris. ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1977-07-01 00:00:00
abstract::The wear of high molecular weight polyethylene sockets was measured on radiographs, over a period of 9 to 10 years, in a group of patients whose ages averaged 73.3 years at the end of the period. The average rate of wear was 0.15 mm/year and 68 per cent of patients followed this pattern. Wear more than 2.5 mm in 10 ye...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1975-10-01 00:00:00
abstract:BACKGROUND:We previously reported the 5-year followup of hips with femoroacetabular impingement (FAI) that underwent surgical hip dislocation with trimming of the head-neck junction and/or acetabulum including reattachment of the labrum. The goal of this study was to report a concise followup of these patients at a min...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-014-4025-8
更新日期:2015-04-01 00:00:00
abstract::Radiotherapy may be indicated for the management of bone metastases because of associated pain, fracture, or neurologic complications. For metastatic bone pain, simple low-dose radiation treatment is usually effective for local problems. When there are multiple sites of bone pain, external beam irradiation using wide-...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1995-03-01 00:00:00
abstract::Progressive loss of hip containment attributable to dysplasia epiphysealis hemimelica of the right proximal femur and macrodactyly of the right second toe was diagnosed and monitored by radiographs and magnetic resonance imaging in a 7-year-old boy. The patient had early surgical correction including shortening osteot...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000136904.78496.d9
更新日期:2004-10-01 00:00:00
abstract::There are 3 common types of spondylolisthesis: dysplastic; isthmic; degenerative. This classification, presented anew in an article published in this volume, evolved from a discussion by the members of the International Society for the Study of the Lumbar spine. The surgical treatment is designed to correct a combinat...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1976-06-01 00:00:00
abstract:UNLABELLED:We review evidence-based treatments for patients seeking care for lower-back pain and patients who have been diagnosed with nonspecific lower-back pain. The review is based on selected systematic reviews and national and international guidelines for the treatment of lower-back pain. Additional randomized con...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000198721.75976.d9
更新日期:2006-02-01 00:00:00
abstract::During a consensus conference in Fall, 1998, the Academic Orthopaedic Society identified the values and qualities of professionalism as defined by its members. One hundred eighty-six respondents rated 20 characteristics and values describing professionalism, based on the extent to which they believed each item was app...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200009000-00015
更新日期:2000-09-01 00:00:00