Shoulder & Elbow Journal Scan

Related Articles

Evaluation of the role of glenosphere design and humeral component retroversion in avoiding scapular notching during reverse shoulder arthroplasty.

J Shoulder Elbow Surg. 2013 Jul 12;

Authors: Berhouet J, Garaud P, Favard L

Abstract
BACKGROUND: Scapular notching is a common observation during radiological follow-up of reverse shoulder arthroplasty. The purpose of this study was to evaluate the effect of glenosphere design and humeral component retroversion on movement amplitude in the scapular plane and inferior scapular impingement.
MATERIALS AND METHODS: The Aequalis Reversed Shoulder Prosthesis (Tornier) was implanted into 40 cadaver shoulders. On the glenoid side, 8 different combinations were tested: 36-mm glenosphere: centered (standard), eccentric, with an inferior tilt, or with the center of rotation (COR) lateralized by 5 or 7 mm; and 42-mm centered glenosphere: used alone or with the COR lateralized by 7 or 10 mm. The humeral component was positioned in 0°, 10°, 20°, 30°, and 40° of retroversion. Maximum adduction and abduction were measured when inferior impingement and superior impingement, respectively, were detected.

Related Articles

Technical pitfalls of shoulder hemiarthroplasty for fracture management.

Orthop Clin North Am. 2013 Jul;44(3):317-29

Authors: Wiesel BB, Nagda S, Williams GR

Abstract
Although most proximal humerus fractures can be treated nonoperatively, 4-part fractures and 3-part fractures/dislocations in elderly patients often require management with prosthetic arthroplasty. Reverse arthroplasty is gaining in popularity, but hemiarthroplasty still has a role in the management of 4-part and some 3-part fractures and dislocations. The 2 most important technical factors influencing functional outcome in hemiarthroplasty patients are the restoration of the patient's correct humeral head height and version, and healing of the greater and lesser tuberosities in an anatomic position. Hemiarthroplasty for proximal humerus fracture provides predictable pain relief, but functional recovery is much less predictable.

PMID: 23827835 [PubMed - in process]

Read more... http://www.ncbi.nlm.nih.gov/pubmed/23827835?dopt=Abstract

Related Articles

Diagnostic value of patient characteristics, history, and six clinical tests for traumatic anterior shoulder instability.

J Shoulder Elbow Surg. 2013 Jul 12;

Authors: van Kampen DA, van den Berg T, van der Woude HJ, Castelein RM, Terwee CB, Willems WJ

Abstract
BACKGROUND: It is unknown which combination of patient information and clinical tests might be optimal for the diagnosis of traumatic anterior shoulder instability. This study aimed to determine the diagnostic value of individual clinical tests and to develop a prediction model that combined patient characteristics, history, and clinical tests for diagnosis of traumatic anterior shoulder instability.
MATERIALS AND METHODS: This prospective cohort study included 169 consecutive patients with shoulder complaints who were examined at an orthopaedic outpatient clinic. One experienced clinician conducted 25 clinical tests; of these, 6 were considered to be specific for testing of traumatic anterior shoulder instability (apprehension, relocation, release, anterior drawer, load and shift, and hyperabduction tests). Magnetic resonance arthrography was used to determine the final diagnosis. A prediction model was developed by logistic regression analysis.

Related Articles

Disorders of the proximal and distal aspects of the biceps muscle.

J Bone Joint Surg Am. 2013 Jul 3;95(13):1235-45

Authors: McDonald LL, Dewing CC, Shupe LP, Provencher CM

Abstract
PROXIMAL ASPECT OF BICEPS  ➤ Tenodesis of the long head of the biceps may offer improved cosmesis, improved strength, and diminished activity-related pain compared with tenotomy, although comparative studies have shown similar outcomes in some patient populations. DISTAL ASPECT OF BICEPS  ➤ Operative treatment of both partial and complete distal biceps ruptures results in better outcomes compared with nonoperative care, although the optimal technique and fixation are yet to be determined. ➤ Nonoperative management is an acceptable treatment for patients willing to accept some loss of forearm supination and elbow flexion strength as well as changes in endurance and cosmesis.

PMID: 23824393 [PubMed - in process]

Read more... http://www.ncbi.nlm.nih.gov/pubmed/23824393?dopt=Abstract

Related Articles

Investigating minimal clinically important difference for Constant score in patients undergoing rotator cuff surgery.

J Shoulder Elbow Surg. 2013 Jul 12;

Authors: Kukkonen J, Kauko T, Vahlberg T, Joukainen A, Aärimaa V

Abstract
BACKGROUND: The minimal clinically important difference (MCID) is increasingly used to evaluate treatment effectiveness. The MCID for the Constant score has not been previously reported.
MATERIALS AND METHODS: A prospectively collected cohort of 802 consecutive shoulders with arthroscopically treated partial- or full-thickness rotator cuff tears was analyzed. The Constant score was measured preoperatively and at 3 months and 1 year postoperatively. At follow-up visits, the patients were asked a simple 2-stage question: Is the shoulder better or worse after the operation compared with the preoperative state? This single 2-level question was used as an indicator of patient satisfaction and as an anchor to calculate the MCID for the Constant score.
RESULTS: At 1 year, 781 (97.4%) patients (474 men, 307 women) were available for follow-up. The preoperative Constant score was 53.1 (SD 17.2) in all patients, 56.2 (SD 17.4) in male patients, and 48.2 (SD 15.6) in female patients. Postoperatively at 3 months, the scores were 61.7 (SD 16.4) in all patients, 65.1 (SD 16.1) in male patients, and 56.8 (SD 15.5) in female patients. At 1 year, the scores were 75.9 (SD 15.2) in all patients, 79.0 (SD 14.9) in

Effect of Elbow Flexion on the Proximity of the PIN During 2-incision Distal Biceps Repair.

Orthopedics. 2013 Jul 1;36(7):e931-5

Authors: Jones JA, Jones CM, Grossman MG

Abstract
The posterior interosseous nerve (PIN) is at risk for injury during surgical dissection for distal biceps repair, yet the optimal position of elbow flexion to avoid a PIN injury has never been established for the 2-incision approach. The purpose of this study was to determine the proximity of the PIN to the radial tuberosity during surgical dissection in different degrees of elbow flexion. Ten cadaveric specimens with an intact elbow and forearm were dissected in full pronation using a modified Boyd-Anderson approach. Half of the dissections were completed in 90° of flexion and the other half were completed in maximal flexion. To simulate the location of the PIN during a single-incision biceps repair, the distance of the PIN to the radial tuberosity was recorded in full extension and supination. Results from these measurements were assessed for differences using paired t tests, with differences deemed significant for P values less than .05. The PIN was not identified in any of the 2-incision surgical dissections. Based on these findings, the proximity of the PIN to the radial tuberosity is not significantly affected by the degree of elbow flexion in the muscle-splitting 2-incision approach. In addition, a safe zone exists for avoiding PIN injury in a single-incision technique for distal biceps repair because a drill bit exiting the radial tuberosity greater than 1 cm in a distal-radial direction would place the PIN at risk.

PMID: 23823052 [PubMed - in process]

Read more... http://www.ncbi.nlm.nih.gov/pubmed/23823052?dopt=Abstract

Related Articles

Patient expectations before arthroscopic shoulder surgery: correlation with patients' reasons for seeking treatment.

J Shoulder Elbow Surg. 2013 Jul 11;

Authors: Warth RJ, Briggs KK, Dornan GJ, Horan MP, Millett PJ

Abstract
BACKGROUND: Elevated expectations before orthopaedic procedures appear to correlate with inferior preoperative subjective measures. The purpose of this study was to evaluate preoperative patient expectations before arthroscopic shoulder surgery and to correlate them with preoperative subjective measures and patients' reasons for seeking treatment.
METHODS: We prospectively collected and retrospectively analyzed data from patients before elective arthroscopic shoulder surgery for a wide range of pathologic processes. Preoperative subjective data included QuickDASH scores, pain and functional components of the American Shoulder and Elbow Surgeons (ASES) score, and mental and physical components of the SF-12 score. Expectations data were collected and grouped on the basis of the reasons for seeking of medical treatment and ranked according to their relative importance.

Effectiveness of locking versus dynamic compression plates for diaphyseal forearm fractures.

Orthopedics. 2013 Jul 1;36(7):e917-22

Authors: Azboy I, Demirtas A, Uçar BY, Bulut M, Alemdar C, Ozkul E

Abstract

Related Articles

Reconstruction of the chronic anterior unstable sternoclavicular joint using a tendon autograft: medium-term to long-term follow-up results.

J Shoulder Elbow Surg. 2013 Jul 10;

Authors: Bak K, Fogh K

Abstract
BACKGROUND: Chronic symptomatic anterior sternoclavicular (SC) instability is a rare condition with sparse treatment options. Owing to the rarity of the condition and the potential risk of fatal complications, only a few reports on treatment of this condition have been published. We evaluated a prospective series of patients with chronic anterior SC instability who underwent minimally open reconstruction with an autologous tendon graft.
METHODS: From 2002 to 2010, 32 consecutive patients underwent minimally open SC ligament reconstruction using a tendon autograft. A palmaris longus was used in 7 patients and a gracilis tendon autograft was used in 25. All patients with at least 2 years of follow-up were reviewed. Five were lost to follow-up. The remaining 27 patients (84.4%) were a median age of 35 years (range, 11-61 years) at surgery. Patients were evaluated with the Western Ontario Shoulder Instability (WOSI) score preoperatively and at follow-up at a median 54 months (range, 24-120 months) postoperatively.