Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Apr 2013
Randomized Controlled TrialEfficacies of corticosteroid injection at different sites of the shoulder for the treatment of adhesive capsulitis.
A corticosteroid injection in the glenohumeral joint conducted blindly is technically demanding with a low rate of accuracy despite satisfactory clinical outcomes in the treatment for adhesive capsulitis. This study prospectively compared the clinical outcomes of patients with idiopathic adhesive capsulitis treated by a single corticosteroid injection in different locations of the shoulder. ⋯ The efficacy of a single corticosteroid injection was not found to be related to the site of injection. However, a single corticosteroid injection provided faster pain relief, a higher level of patient satisfaction, and an earlier improvement in shoulder motion and function than medication in patients with adhesive capsulitis.
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J Shoulder Elbow Surg · Apr 2013
Comparative StudyBiomechanical analysis of a novel locking plate with smooth pegs versus a conventional locking plate with threaded screws for proximal humerus fractures.
Repair of proximal humeral fractures with locking plates has greatly improved outcomes. However, an alarming rate of complications including screw cutout and impingement under the acromion has recently been reported. A novel locking plate with smooth pegs was developed to reduce these risks. The purpose of this study was to compare these 2 fixation methods with a cadaveric biomechanical study. ⋯ The SP group demonstrated superior biomechanical characteristics to the TS group in regards to cyclic bending.
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J Shoulder Elbow Surg · Apr 2013
The AO Foundation and Orthopaedic Trauma Association (AO/OTA) scapula fracture classification system: focus on glenoid fossa involvement.
Fractures of the glenoid frequently require surgical treatment. A comprehensive and reliable scapula classification system involving the glenoid fracture patterns is needed to describe the underlying pathology. The AO Scapula Classification Group introduces an appropriate novel system that is presented along with its inter-rater reliability and accuracy. ⋯ This new system for scapular glenoid fractures has proved to be sufficiently reliable and accurate when applied by experienced shoulder surgeons. Further validation of the most detailed system, as well as involvement of surgeons with different levels of training in the framework of clinical routine and research, however, should be considered.
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J Shoulder Elbow Surg · Mar 2013
Meta Analysis Comparative StudyPlate versus intramedullary nail fixation in the treatment of humeral shaft fractures: an updated meta-analysis.
Regarding the treatment of humeral shaft fractures, the choice of plating or intramedullary nailing remains controversial. Previous randomized controlled trials and meta-analyses failed to draw a unanimous conclusion. To guide clinical decision making, we conducted an updated meta-analysis on the optimal treatment of humeral shaft fractures. ⋯ Level II, Meta-analysis of prospective comparative trials.
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J Shoulder Elbow Surg · Mar 2013
Randomized Controlled Trial Comparative StudyDiaphragm function after interscalene brachial plexus block: a double-blind, randomized comparison of 0.25% and 0.125% bupivacaine.
Interscalene brachial plexus block (ISBPB) provides excellent analgesia after rotator cuff surgery but is associated with diaphragm dysfunction. In this study, ISBPB with 20 mL of 0.125% or 0.25% bupivacaine were compared to assess the effect on diaphragm function, oxygen saturation, pain control, opioid requirements, and patient satisfaction. ⋯ In this randomized, double-blind comparison of ISBPB performed with 20 mL of 0.125% or 0.25% bupivacaine, diaphragm function and oxygen saturation were superior in patients treated with more dilute bupivacaine. Furthermore, there were no clinically significant differences in pain scores, and no statistically significant differences in opioid requirements and patient satisfaction.