Journal of shoulder and elbow surgery
-
J Shoulder Elbow Surg · Dec 2011
Comparative StudyThe safe zone for avoiding suprascapular nerve injury during shoulder arthroscopy: an anatomical study on 500 dry scapulae.
Suprascapular nerve injury may be a complication during shoulder arthroscopy. Our aim was to verify the reliability of the existing data, assess the differences between scapulae in the 2 genders and in the same subject, obtain a safe zone useful to avoid iatrogenic nerve lesions, and analyze the existing correlations between the scapular dimensions and the safe zone. ⋯ Knowledge of the safe zone, for avoiding suprascapular nerve injury, is important; gender and specific scapular dimensions should be evaluated, as they influence the dimensions of the safe zone. The linear predictors should be used to obtain specific values of the posterosuperior limit in each patient.
-
J Shoulder Elbow Surg · Dec 2011
Comparative StudyProximal periarticular locking plates in proximal humeral fractures: functional outcomes.
Some recent studies have asserted that locking plates do not provide adequate fixation of proximal humeral fractures. The purpose of this study is to review our experience with proximal humeral locking plates, including complications, functional outcomes, and predictors of successful treatment. ⋯ Displaced proximal humeral fractures can be successfully fixed with locking plates when attention is paid to anatomic reduction, proper plate placement below to the greater tuberosity to allow abduction, screws in the head with subchondral bone purchase, calcar screws from inferior-lateral to superior-medial and delaying shoulder motion until at least 2 weeks.
-
J Shoulder Elbow Surg · Dec 2011
Comparative StudyResponsiveness of the EQ-5D in patients with proximal humeral fractures.
This study evaluated the internal and external responsiveness of the EuroQol EQ-5D (EuroQol Group, Rotterdam, The Netherlands) health status component, defined as the instrument's ability to capture clinically important changes in patients with a proximal humeral fracture within the context of a prospective study. ⋯ The EQ-5D displayed good internal and external responsiveness in patients with proximal humeral fractures and can be recommended for use as a quality of life measure in patients with this particular injury.
-
J Shoulder Elbow Surg · Dec 2011
Comparative StudyTreatment of persistent instability after posterior fracture-dislocation of the elbow: restoring stability and mobility by internal fixation and hinged external fixation.
Long-term results after the treatment of fracture-dislocations of the elbow have often been disappointing, because of post-traumatic instability, stiffness, and early arthritis. We present the results after surgical restoration of stability in complex fracture-dislocations of the elbow using early postoperative mobilization with a hinged external fixator after internal reconstruction of the static stabilizers. ⋯ Surgical restoration of the static stabilizers in combination with hinged external fixation leads to satisfactory results when performed within the first 6 weeks after injury. When definite surgical stabilization is delayed more than 6 weeks, the procedure can still restore stability but the functional results are often disappointing.
-
J Shoulder Elbow Surg · Dec 2011
Comparative StudyTransfer of latissmus dorsi and teres major tendons without subscapularis release for the treatment of obstetrical brachial plexus palsy sequela.
Patients with obstetrical brachial plexus palsy (OBPP) sequela exhibit adduction and internal rotation contractures. The muscular imbalance may result in secondary bony changes. Tendon transfers and muscular releases may improve shoulder function in these patients. The aim of this study is to evaluate the functional and radiological results of pectoralis major tendon Z-plasty with transfer of latissimus dorsi and teres major tendons to rotator cuff tendons without release of subscapularis muscle in patients with mild sequela of OBPP. ⋯ Pectoralis major tendon lengthening with transfer of latissimus dorsi and teres major tendons to rotator cuff is an effective and reproducible technique and can improve shoulder functions in patients with OBPP. Subscapularis release is not always required to overcome internal rotation contracture. Secondary glenohumeral changes might also be prevented with this approach.