Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Sep 2002
Effects of plate location and selection on the stability of midshaft clavicle osteotomies: a biomechanical study.
Operative fixation of midshaft clavicle fractures is controversial with few biomechanical data to assist surgical decision making. The purpose of this 2-phase biomechanical investigation is to report on the effects of plate location and selection on the stability of midshaft clavicle fractures. Thirty matched pairs of human adult formalin-fixed clavicles were used. ⋯ In retained stiffness the performance of the LCDC-plated constructs significantly exceeded that of the DC plate in torsion (P <.05), whereas in load to failure the LCDC plate withstood significantly more compressive load than the reconstruction plate (P <.05). We concluded that clavicles plated at the superior aspect exhibit significantly greater biomechanical stability than those plated at the anterior aspect. Furthermore, we concluded that the LCDC plate offers significantly greater biomechanical stability than the reconstruction and DC plates.
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J Shoulder Elbow Surg · Jul 2002
Randomized Controlled Trial Comparative Study Clinical TrialCemented polyethylene versus uncemented metal-backed glenoid components in total shoulder arthroplasty: a prospective, double-blind, randomized study.
Thirty-nine patients (forty shoulders) with primary osteoarthritis consented to be randomized to receive either a cemented all-polyethylene glenoid component or a cementless metal-backed component at the time of total shoulder arthroplasty. Their mean age was 69 years. Preoperative and postoperative evaluations were completed at 3, 6, 12, 24, and 36 months by history, physical examination, radiographs, and Constant scoring system. ⋯ At a minimum of 3 years' follow-up, the results of this study clearly show that (1) the survival rate of cementless, metal-backed glenoid components is inferior to cemented all-polyethylene components and (2) the incidence of radiolucency at the glenoid-cement interface with all-polyethylene components is high and remains a concern. The high rate of loosening, because of the absence of ingrowth and/or the accelerated polyethylene wear, has led us to abandon the use of metal-backed glenoids. Efforts must continue to improve glenoid component design and fixation.
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J Shoulder Elbow Surg · May 2002
Partial medial epicondylectomy for cubital tunnel syndrome: Outcome and complications.
The results of partial medial epicondylectomy for cubital tunnel syndrome were evaluated in 60 elbows of 54 patients. Preoperatively, 8 patients were grade I, 24 grade IIA, 16 grade IIB, and 12 grade III according to the modified McGowan score (Goldberg BJ et al. JHand Surg [Am] 1989;14:182-8). ⋯ An improvement of at least 1 McGowan grade was obtained in 88.3%. The chance for complete recovery was inversely related to the initial neuropathy grade, as is consistently found throughout the literature for all types of cubital tunnel surgery. Partial medial epicondylectomy is a valuable surgical procedure for treating grade I to IIB ulnar neuropathy.