Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Apr 2015
Results of displaced supracondylar humerus fractures treated with open reduction and internal fixation after a mean 22.4 years of follow-up.
The aim of this study was to evaluate the long-term functional and cosmetic results as well as the sagittal and coronal plane remodeling of displaced supracondylar humerus fractures treated with open reduction and internal fixation. ⋯ We identified the remodeling in the sagittal plane in supracondylar humerus fractures that had been united in flexion. Satisfactory functional and cosmetic results were obtained with the open reduction and internal fixation of displaced supracondylar fractures of the humerus, and no degenerative changes were observed at the long-term follow-up.
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J Shoulder Elbow Surg · Apr 2015
Effects of the humeral tray component positioning for onlay reverse shoulder arthroplasty design: a biomechanical analysis.
Recent shoulder prostheses have introduced a concept of a universal humeral stem component platform that has an onlay humeral tray for the reverse total shoulder arthroplasty (RTSA). No studies have reported how humeral tray positioning can affect the biomechanics of RTSA. ⋯ Positioning the humeral tray with posterior offset offers a biomechanical advantage for patients needing RTSA by decreasing superior impingement and increasing the internal rotational moment arm of the subscapularis, without creating inferior impingement.
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J Shoulder Elbow Surg · Mar 2015
Heterotopic ossification formation after fracture-dislocations of the elbow.
Heterotopic ossification (HO) is a serious complication of traumatic elbow injuries, particularly fracture-dislocations. Limited data exist in the literature regarding the risk factors associated with HO formation in these injuries. The purpose of this study was to review the incidence of HO after fracture-dislocation of the elbow and to identify potential risk factors associated with its formation. ⋯ HO developed in 77% of patients with multiple attempted closed reductions. We found a 43% incidence of HO in patients surgically treated for elbow fracture-dislocations. Neither time to surgery after the injury nor demographic or other factors relating to the manner in which associated osseous or soft tissue injuries were managed influenced the formation of HO.
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J Shoulder Elbow Surg · Mar 2015
Comparative analysis of anatomic and reverse total shoulder arthroplasty: in-hospital outcomes and costs.
The rate of shoulder arthroplasty has continued to increase at an exponential rate during the past decade in large part owing to approval by the Food and Drug Administration of reverse shoulder arthroplasty. Whereas reverse shoulder arthroplasty has resulted in expanded surgical indications, there are numerous reports of relatively high complication rates. The increased prevalence of both anatomic and reverse shoulder arthroplasty underscores the need to elucidate whether perioperative outcomes are influenced by type of total shoulder arthroplasty. The purpose of this study was to determine the impact of shoulder arthroplasty type, anatomic or reverse, with respect to perioperative adverse events, in-hospital death, prolonged hospital stay, nonroutine disposition, and hospital charges in a nationally representative sample. ⋯ Despite the expanding indications for reverse shoulder arthroplasty, it is an independent risk factor for inpatient morbidity, mortality, and hospital costs and should perhaps be offered more judiciously and performed in the hands of appropriately trained shoulder specialists.
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J Shoulder Elbow Surg · Mar 2015
Agreement of olecranon fractures before and after the exposure to four classification systems.
Although classification systems of olecranon fractures are important to help choose the best treatment and to predict prognosis, their degree of observer agreement is poorly investigated. The objective of this study was to investigate the intraobserver and interobserver reliability of currently used classification systems for olecranon fractures. Our hypothesis is that the Colton classification presents an acceptable agreement because it is simpler to use; on the other hand, considering the AO classification's complexity, we expect it to reach a lower level of agreement. ⋯ No classification system is widely accepted because it can be affected by interobserver variability, which can raise questions about its use in a research as well as in a clinical context.