Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Oct 2014
Successful injection of the acromioclavicular joint with use of ultrasound: anatomy, technique, and follow-up.
Injection into the acromioclavicular (AC) joint is often inaccurate (approximately 50%) even in experienced hands. In light of new anatomic observations, we evaluate accuracy of an innovative ultrasound-guided method and follow the clinical course of successful therapeutic injections. ⋯ This high level of clinical injection success, irrefutably substantiated with arthrography, has not been previously demonstrated. The anterior superior aspect of the joint is the preferred place for entry. Initial intra-articular blockage to fluid inflow is common but can be surmounted. Encouraging 6-month results of steroid instillation in isolated AC disease do not apply to patients with coexisting shoulder pathologic processes.
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J Shoulder Elbow Surg · Oct 2014
Time to functional recovery after arthroscopic surgery for tennis elbow.
This study evaluated recovery from chronic lateral epicondylitis after arthroscopic treatment. ⋯ Arthroscopic surgery for lateral epicondylitis provides significant improvement in pain and functional recovery up to 3 months after surgery. However, it takes more than 6 months for the VAS score during activity to fall below 10 points.
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J Shoulder Elbow Surg · Oct 2014
Elastic stable intramedullary nailing versus Kirschner wire pinning: outcome of severely displaced proximal humeral fractures in juvenile patients.
Significantly displaced juvenile proximal humeral fractures (Neer-Horowitz type 3 and 4) usually require reduction and fixation. The most commonly used fixation methods are Kirschner wire (K-wire) pinning or retrograde elastic stable intramedullary nailing (ESIN). However, results comparing the long-term outcome of both methods are absent in the literature. The aim of this study was to provide an outcome comparison of both techniques. ⋯ ESIN and K-wire pinning have a favorable and comparable functional outcome and therefore seem to be adequate methods for treating Neer-Horowitz type 3 and 4 proximal humeral fractures in juvenile patients. The initially achieved improvement of the neck-shaft angle can be maintained at long-term follow-up.
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J Shoulder Elbow Surg · Oct 2014
Accuracy of patient-specific guided glenoid baseplate positioning for reverse shoulder arthroplasty.
The accuracy of reproducing a surgical plan during shoulder arthroplasty is improved by computer assistance. Intraoperative navigation, however, is challenged by increased surgical time and additional technically difficult steps. Patient-matched instrumentation has the potential to reproduce a similar degree of accuracy without the need for additional surgical steps. The purpose of this study was to examine the accuracy of patient-specific planning and a patient-specific drill guide for glenoid baseplate placement in reverse shoulder arthroplasty. ⋯ The use of patient-specific glenoid baseplate guides is highly accurate in reproducing a virtual 3-dimensional preoperative plan. This technique delivers the accuracy observed using computerized navigation without any additional surgical steps or technical challenges.