Journal of shoulder and elbow surgery
-
J Shoulder Elbow Surg · Mar 2018
What happens to patients when we do not repair their cuff tears? Five-year rotator cuff quality-of-life index outcomes following nonoperative treatment of patients with full-thickness rotator cuff tears.
The purpose of this study was to examine 5-year outcomes in a prospective cohort of patients previously enrolled in a nonoperative rotator cuff tear treatment program. ⋯ Nonoperative treatment is an effective and lasting option for many patients with a chronic, full-thickness rotator cuff tear. While some clinicians may argue that nonoperative treatment delays inevitable surgical repair, our study shows that patients can do very well over time.
-
J Shoulder Elbow Surg · Feb 2018
Review Meta AnalysisOpen reduction-internal fixation versus intramedullary nailing for humeral shaft fractures: an expected value decision analysis.
Previous randomized controlled studies and meta-analyses have failed to collectively favor either open reduction-internal fixation (ORIF) or intramedullary nailing (IMN) fixation. The purpose of our investigation was to elucidate the optimal decision between ORIF and IMN for acute traumatic operative humeral shaft fractures through an expected value decision analysis. ⋯ Our expected value decision analysis demonstrates that patients favor ORIF over IMN as the optimal treatment decision for an acute traumatic humeral shaft fracture.
-
J Shoulder Elbow Surg · Feb 2018
Osteosynthesis of AO/OTA 13-C3 distal humeral fractures in patients older than 70 years.
The purpose of this retrospective case series was to examine the AO Foundation and Orthopaedic Trauma Association (AO/OTA) 13-C3 distal humeral fractures treated with open reduction-internal fixation (ORIF) in patients older than 70 years. ⋯ ORIF remains a reliable option for treatment of AO/OTA 13-C3 distal humeral fractures in elderly patients. Excellent clinical outcomes can be achieved with preservation of motion and arm function through anatomic reduction, rigid internal fixation, and early mobilization.
-
J Shoulder Elbow Surg · Feb 2018
Multicenter StudyEpidemiology of glenohumeral dislocation and subsequent instability in an urban population.
Glenohumeral dislocation is the most commonly encountered adult joint instability. The epidemiology in the United Kingdom and worldwide is unclear and often limited to young, active groups that are not representative of general populations. Information regarding epidemiology and outcome from a first dislocation is useful for trauma service planning and patient counseling. We calculated the incidence of shoulder instability after a first dislocation in our urban population and investigated predictors of recurrent instability. ⋯ We demonstrate a previously unreported burden of dislocation in older age groups and suggest a rate of recurrence lower than previously reported in the United Kingdom. The group aged 15 to 19 years was at the highest risk of recurrent dislocation and instability. Gender was not a significant predictor of instability.
-
J Shoulder Elbow Surg · Jan 2018
Multicenter StudyAdolescent clavicle nonunions: potential risk factors and surgical management.
Clavicle nonunions in adolescent patients are exceedingly rare. The purpose of this study was to evaluate a series of clavicle nonunions from a pediatric multicenter study group to assess potential risk factors and treatment outcomes. ⋯ Clavicle nonunions can occur in the adolescent population but are an uncommon clinical entity. The majority occur in male patients with displaced fractures, many of whom have sustained previous fractures of the same clavicle. High rates of union were achieved with plate fixation and the use of bone graft.