Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Nov 2013
Randomized Controlled Trial Comparative StudyUltrasound evaluation of arthroscopic full-thickness supraspinatus rotator cuff repair: single-row versus double-row suture bridge (transosseous equivalent) fixation. Results of a prospective, randomized study.
The purpose of this study was to compare the structural outcomes of a single-row rotator cuff repair and double-row suture bridge fixation after arthroscopic repair of a full-thickness supraspinatus rotator cuff tear. ⋯ Arthroscopic double-row suture bridge repair (transosseous equivalent) of an isolated supraspinatus rotator cuff tear resulted in a significantly higher tendon healing rate (as determined by ultrasound examination) when compared to arthroscopic single-row repair.
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J Shoulder Elbow Surg · Nov 2013
Comparative StudyA comparative analysis of fatty infiltration and muscle atrophy in patients with chronic rotator cuff tears and suprascapular neuropathy.
Little is known of the mechanisms that lead to the muscle changes associated with rotator cuff disorders. We have observed that the magnetic resonance imaging (MRI) appearance of fatty infiltration (FI) and muscle atrophy (MA) differ between chronic cuff tears and suprascapular neuropathy, suggesting different pathophysiology. This study compares the different MRI changes that occur in chronic cuff tears and suprascapular neuropathy. ⋯ Chronic rotator cuff tendon tears and suprascapular neuropathy are both associated with FI and MA of the rotator cuff muscles. The pattern of FI is markedly different in the 2 situations. These findings have diagnostic potential and may serve as a basis for further research concerning type, severity, and evolution of FI under different conditions and after treatment.
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J Shoulder Elbow Surg · Nov 2013
Locking plate fixation of proximal humeral fractures with impaction of the fracture site to restore medial column support: a biomechanical study.
Despite the advent of locking plate techniques, proximal humeral fracture fixation can fail due to varus collapse, especially in osteoporotic bone with medial cortex comminution. This study investigated the effect of restoring the integrity of the medial column by fracture impaction and shaft medialization with locking plate fixation. This construct was compared with a traditional locking plate construct under conditions of varus cyclical loading. ⋯ Fracture impaction increased the ability of the locking plate to withstand repetitive varus loading. This technique provides a construct biomechanically superior to locking plate fixation alone.
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J Shoulder Elbow Surg · Nov 2013
Scapular fractures after reverse shoulder arthroplasty: evaluation of risk factors and the reliability of a proposed classification.
The aims were to determine the sensitivity of plain radiographs to detect scapular fractures after reverse shoulder arthroplasty (RSA), to test the reliability of a proposed classification, and to evaluate risk factors. ⋯ Osteoporosis is a significant risk factor for scapular fractures after RSA. The current classification has only moderate reliability, suggesting that an alternative classification method is needed. Decreasing AT distance and increasing acromial tilt on consecutive radiographs may improve fracture detection. Advanced imaging may be needed to confirm the diagnosis. Whereas most scapular spine fractures occurred from a screw, the surgical technique did not increase the relative risk.
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J Shoulder Elbow Surg · Nov 2013
Prediction of the location of the anterior branch of the axillary nerve, using correlations with physical factors: a cadaveric study.
Although axillary nerve injury is a catastrophic surgical complication, there is little data for precise prediction of the location of that nerve's anterior branch. To address that, the authors searched for a useful correlation between the acromion-axillary nerve distance (AAND) and one or more physical factors. ⋯ There is a strong correlation between AAND and humeral length. In clinical practice, humeral length and ANI are useful for predicting the location of the anterior branch of the axillary nerve, when the arm is positioned at the side in neutral rotation.