Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Apr 2012
Postoperative pain associated with orthopedic shoulder and elbow surgery: a prospective study.
In the last 2 decades, extensive research in postoperative pain management has been undertaken to decrease morbidity. Orthopedic procedures tend to have increased pain compared with other procedures, but further research must be done to manage pain more efficiently. Postoperative pain morbidities and analgesic dependence continue to adversely affect health care. ⋯ PP and APP were both independent predictors of increased postoperative pain. PP was also predictive of APP. Although, overall postoperative pain was lower than APP or PP due to pain management techniques, postoperative pain was still significantly higher in patients with increased APP or PP than their counterparts. Therefore, surgeons should factor patient's APP and PP to better manage their patient's postoperative pain to decrease comorbidities.
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J Shoulder Elbow Surg · Mar 2012
Comparative StudyFunctional outcome of hemiarthroplasty compared with reverse total shoulder arthroplasty in the treatment of rotator cuff tear arthropathy.
Hemiarthroplasty was the treatment of choice for rotator cuff tear arthropathy (CTA) before the introduction of the reverse total shoulder arthroplasty (RTSA). The purpose of this study was to compare our outcomes for hemiarthroplasty with those for RTSA. ⋯ RTSA performs better than hemiarthroplasty in terms of pain relief, function, and active elevation at 2-year follow-up.
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J Shoulder Elbow Surg · Mar 2012
Comparative StudyThe influence of proximal ulnar morphology on elbow range of motion.
Physiologic dorsal apex angulation of the proximal ulna is present in 96% of the population. We hypothesize that a correlation exists between the physiologic dorsal ulnar angulation and elbow range of motion (ROM). ⋯ The increasing magnitude of the PUDA is associated with decreased maximal elbow extension and global elbow ROM.
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J Shoulder Elbow Surg · Mar 2012
Review Comparative StudyTreatment of clavicle fractures: current concepts review.
Clavicle fractures are common in adults and children. Most commonly, these fractures occur within the middle third of the clavicle and exhibit some degree of displacement. Whereas many midshaft clavicle fractures can be treated nonsurgically, recent evidence suggests that more severe fracture types exhibit higher rates of symptomatic nonunion or malunion. ⋯ Surgical intervention may be required in cases of neurovascular compromise or significant fracture displacement. In children and adolescents, these injuries mostly consist of physeal separations, which have a large healing potential and can therefore be managed conservatively. Current concepts of clavicle fracture management are discussed including surgical indications, techniques, and results.
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J Shoulder Elbow Surg · Mar 2012
Comparative StudyK-wire position in tension-band wiring technique affects stability of wires and long-term outcome in surgical treatment of olecranon fractures.
Tension-band wiring (TBW) has been accepted as the treatment of choice for displaced olecranon fractures. The aim of this study was to examine the effect of K-wire position on instability of the K-wires in relation to local complications and radiological and clinical long-term outcome. ⋯ Instability of K-wires after TBW is more common after intramedullary placement of the wires resulting in proximal migration of the K-wires and gap appearance. There was a tendency of more osteoarthritis in the group of patients where instability of K-wires was identified. We would recommend the use of transcortical placed wires, as well as to have a low threshold in removing the implants.