Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Oct 2017
Randomized Controlled Trial Comparative StudyA prospective randomized controlled trial to identify the optimal postoperative pain management in shoulder arthroplasty: liposomal bupivacaine versus continuous interscalene catheter.
Shoulder arthroplasty is the fastest growing joint replacement surgery in the United States, and optimal postoperative pain management is critical to optimize outcomes for these surgeries. Liposomal bupivacaine (LB) has gained popularity for its potential to provide extended postoperative pain relief with possibly fewer side effects. The goal of this study was to assess the impact of LB compared with continuous interscalene nerve block (CISB) in terms of postoperative pain control, outpatient pain scores, and patient-reported and functional outcomes after shoulder arthroplasty surgery. ⋯ This prospective randomized controlled trial demonstrated that LB provides excellent postoperative pain relief for shoulder arthroplasty patients. In addition, LB had fewer complications and lower cost, making it a promising addition to a multimodal pain regimen for shoulder arthroplasty.
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J Shoulder Elbow Surg · Oct 2017
Retrospective analysis of proximal humeral fracture-dislocations managed with locked plates.
Fracture-dislocation is the extreme variant of injury to the proximal humerus that occurs more commonly in young adults as a result of high-velocity trauma. We evaluated the functional and radiologic outcome of fixation of proximal humeral fracture-dislocations with locked plates. ⋯ Most young patients with 3- and 4-part proximal humeral fracture-dislocations can achieve good functional outcome after fixation with locked plates.
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J Shoulder Elbow Surg · Oct 2017
What is the hardware removal rate after anteroinferior plating of the clavicle? A retrospective cohort study.
Plate position in the operative treatment of displaced midshaft clavicle fractures or nonunions is most often on the superior side. However, superior clavicular plating often results in complaints of plate prominence and local soft tissue irritation, necessitating hardware removal. We have used anteroinferior placement of the plate in the hope of increasing biomechanical stability and fixation and also of lowering complaints of plate prominence and soft tissue irritation. In this report, we set out to study the percentage of hardware removal in our group of patients treated with anteroinferior plating of the clavicle after long-term follow-up. ⋯ Anteroinferior plating of midshaft clavicle fractures, delayed unions, and nonunions resulted in low hardware removal rates in our cohort.