Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Oct 2012
Comparative StudyA biomechanical comparison of multidirectional nail and locking plate fixation in unstable olecranon fractures.
The main theoretic advantage of proximal olecranon fracture intramedullary fixation is decreased soft-tissue irritation and, potentially, less subsequent hardware removal. Despite this possible benefit, questions remain as to whether intramedullary devices are capable of controlling olecranon fractures to the same extent as locking plates. This study evaluates the ability of a novel multidirectional locking nail to stabilize comminuted fractures and directly compares its biomechanical performance with that of locking olecranon plates. ⋯ In simulated comminuted olecranon fractures, the multidirectional locking intramedullary nails sustained significantly higher maximum loads than the locking plates. The two implants showed no significant differences in fragment control or number of cycles survived. Surgeons can expect the multidirectional locking nails to stabilize comminuted fractures at least as well as locking plates.
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J Shoulder Elbow Surg · Oct 2012
Comparative StudyClavicle anatomy and the applicability of intramedullary midshaft fracture fixation.
This study investigated the morphologic safety and applicability of intramedullary fixation of midshaft clavicle fractures by analyzing the pertinent clavicle anatomy using 3-dimensional computer simulation. ⋯ In most clavicles, straight intramedullary fixation appears to be a morphologically safe and effective method of fixation.
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Radial head fractures often pose therapeutic dilemmas. We present the early results of patients who underwent radial head replacement with the MoPyC prosthesis (Bioprofile, Tornier, Saint-Ismier, France). ⋯ Radial head replacement with the MoPyC pyrocarbon prosthesis (when performed in carefully selected patients) yields satisfactory results regarding range of motion and function of the elbow joint.
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J Shoulder Elbow Surg · Aug 2012
Comparative StudyClavicle hook plate fixation for displaced lateral-third clavicle fractures (Neer type II): a functional outcome study.
Controversy exists with the use of the acromioclavicular hook plate for the treatment of lateral-third clavicle fractures (Neer type II). This is thought to stem from problems associated with the hook plate causing impingement symptoms, which can cause long-term limitation of movement and pain. Our aim was to evaluate the functional outcomes of patients with lateral-third clavicle fractures treated with the hook plate. ⋯ Hook plates are an effective form of treatment for lateral third clavicle fractures. The best outcomes occur with plate removal before 6 months postoperatively, provided that the fracture has healed.
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J Shoulder Elbow Surg · Aug 2012
Comparative StudyMinimally invasive percutaneous plating of proximal humeral shaft fractures with the Proximal Humerus Internal Locking System (PHILOS).
This study evaluated our results after minimally invasive percutaneous plating of proximal humeral shaft fractures with the Proximal Humerus Internal Locking System (PHILOS, Synthes, Switzerland). ⋯ Minimally invasive percutaneous plating with the PHILOS offers a valid option in the treatment of proximal humeral shaft fractures with comparable rates of nonunion and lower rates of radial neuropathy compared with open procedures. Furthermore, the results indicate that this method is associated with lower rates of wound infection and a shorter stay in the hospital for the patient.