Journal of shoulder and elbow surgery
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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.
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J Shoulder Elbow Surg · Dec 2011
Comparative StudyA cadaveric model for suprascapular nerve injury during glenoid component screw insertion in reverse-geometry shoulder arthroplasty.
Reverse-geometry shoulder replacement requires fixation of a baseplate (called a metaglene) to the glenoid, to which a convex glenosphere is attached. Most systems use screws to achieve this fixation. The suprascapular nerve passes close to the glenoid and is known to be at risk of injury when devices and sutures are inserted into the glenoid. We investigate the risk posed to the suprascapular nerve by placement of metaglene fixation screws. ⋯ Metaglene fixation with screws poses a significant risk to the suprascapular nerve. Caution should be used when inserting the posterior and superior screws in particular. Short locking screws may allow adequate fixation while minimizing the risk of neurologic injury.