Journal of shoulder and elbow surgery
-
J Shoulder Elbow Surg · Jun 2015
The effect of glenosphere diameter in reverse shoulder arthroplasty on muscle force, joint load, and range of motion.
Little is known about the effects of glenosphere diameter on shoulder joint loads. The purpose of this biomechanical study was to investigate the effects of glenosphere diameter on joint load, load angle, and total deltoid force required for active abduction and range of motion in internal/external rotation and abduction. ⋯ Although increasing glenosphere diameter significantly increased joint load and deltoid force, the clinical impact of these changes is presently unclear. Internal rotation, however, was reduced, which contradicts previous bone modeling studies, which we postulate is due to increased posterior capsular tension as it is forced to wrap around a larger 42 mm implant assembly.
-
J Shoulder Elbow Surg · Jun 2015
Locked plate osteosynthesis of humeral head-splitting fractures in young adults.
Humeral head-splitting fractures occur in younger patients and can be associated with poor outcome. We decided to study the functional outcome and complications in simple and complex humeral head-splitting fractures. We hypothesized that simple head-splitting fractures will perform better compared with complex head-splitting fractures. ⋯ Locked plating achieves satisfactory results in simple head-splitting fractures. Complex fractures are associated with higher rates of nonunion, avascular necrosis, and inferior shoulder function.
-
J Shoulder Elbow Surg · Jun 2015
Comparative StudyArthroscopic repair of a significant (>50%) partial-thickness subscapularis tear concomitant with a full-thickness supraspinatus tear: technical considerations for subscapularis repair (transtendon technique versus tear completion).
The purpose of this study was to compare clinical outcomes and structural integrity of arthroscopic repair by either transtendon repair or tear completion for a significant (>50%) partial-thickness articular-side subscapularis tear associated with a full-thickness supraspinatus tear. ⋯ Arthroscopic repair of partial-thickness subscapularis tears associated with full-thickness supraspinatus tears using either the transtendon technique or tear completion resulted in significant functional improvements in both groups except for postoperative external rotation in group T, and there were no significant differences between groups. The retear rates were also not significantly different between groups. However, after subscapularis repair using the transtendon technique, some patients may have decreased external rotation.
-
J Shoulder Elbow Surg · Jun 2015
Propionibacterium acnes infection in shoulder arthroscopy patients with postoperative pain.
Recent studies have identified Propionibacterium acnes as the causal organism in an increasing number of postoperative shoulder infections. Most reports have found a high rate of P acnes infection after open surgery, particularly shoulder arthroplasty. However, there are limited data regarding P acnes infections after shoulder arthroscopy. ⋯ The rate of P acnes infection in patients undergoing revision shoulder arthroscopy is higher than previously published and should be considered in cases characterized by refractory postoperative pain and stiffness.
-
J Shoulder Elbow Surg · May 2015
Which parameters affect medium- to long-term results after angular stable plate fixation for proximal humeral fractures?
Very little information on medium- to long-term results is available for surgically treated proximal humeral fractures. The aim of this prospective treatment study was to present long-term results after angular stable plate fixation of displaced proximal humeral fractures and to detect which specific patient- and fracture-related parameters affect the clinical outcome. ⋯ Good medium- to long-term results after angular stable plate fixation of displaced proximal humeral fracture can be expected. A reconstruction within a range of 15° in both anteroposterior and axillary views and <5-mm tuberosity displacement should be the aim of head-preserving surgery to prevent complications, such as secondary fracture displacement and screw perforation, and a less favorable long-term result.