Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Feb 2014
Three-dimensional suitability assessment of three types of osteochondral autograft for ulnar coronoid process reconstruction.
Osteochondral autografts with use of the olecranon tip, lateral radial head, or proximal radial head have been employed for coronoid process reconstruction. However, it is unclear which autograft is most suitable for coronoid articular configuration. We assessed 3-dimensional articular facet suitability of 3 osteochondral autografts for coronoid process reconstruction. ⋯ An olecranon graft was most suitable for defects of the coronoid process involving the tip, and a proximal radial head graft was most suitable for defects of the coronoid process involving the anteromedial rim. The use of an olecranon graft for reconstruction of 50% of the height of the coronoid process does not cause concern for gross elbow instability.
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J Shoulder Elbow Surg · Dec 2013
Review Comparative StudyReverse shoulder arthroplasty for treatment of proximal humeral fractures in older adults: a systematic review.
Displaced proximal humeral fractures have traditionally been treated with hemiarthroplasty in older adults, but sometimes hemiarthroplasty results in poor functional outcomes due to rotator cuff deficiency. Reverse shoulder arthroplasty (RSA) can offer potentially improved outcomes in these situations. We assessed the functional outcomes of older adults treated with RSA for proximal humeral fractures compared with hemiarthroplasty. ⋯ Level IV, systematic review.
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J Shoulder Elbow Surg · Dec 2013
Obstructive sleep apnea as a risk factor after shoulder arthroplasty.
Obstructive sleep apnea (OSA) has been identified as an important risk factor in perioperative orthopaedic surgery outcomes despite limited evidence. Screening systems are being instituted in increasing frequency to prevent morbidity and mortality. Our objective was to determine if patients with OSA have a higher likelihood of postoperative in-hospital complications, length of stay, or increased costs after shoulder arthroplasty. ⋯ This study does not support OSA as a significant risk factor for in-hospital morbidity and mortality following shoulder arthroplasty. Our results suggest that a diagnosis of OSA does not increase perioperative morbidity and mortality including perioperative complications. Given the results of this study, further research is warranted to attempt to keep patient screening costs down while optimizing outcomes.
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J Shoulder Elbow Surg · Dec 2013
Clinical usefulness of proximal ulnar and radial fracture-dislocation comprehensive classification system (PURCCS): prospective study of 39 cases.
Complex fracture-dislocations of the proximal ulna and radius represent a challenge even for expert orthopaedic surgeons. A new comprehensive classification, the proximal ulnar and radial fracture-dislocation comprehensive classification system (PURCCS), was recently proposed. The aim of this study was to analyze the clinical usefulness of this classification in a large series of patients. ⋯ Level IV, case series, treatment study.