Shoulder & Elbow Journal Scan

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Can surgeons predict what makes a good hemiarthroplasty for fracture?

J Shoulder Elbow Surg. 2013 Jul 5;

Authors: Boileau P, Winter M, Cikes A, Han Y, Carles M, Walch G, Schwartz DG

Abstract
BACKGROUND: The purposes of this study were (1) to identify the risk factors for tuberosity complications and poor functional outcomes and (2) to compare a standard humeral stem with a fracture-specific humeral stem in hemiarthroplasty for the treatment of 3- and 4-part proximal humeral fractures.
METHODS: We retrospectively reviewed the cases of 60 consecutively operated patients (61 shoulders) using radiographs and computed tomography scans. There were 56 displaced four-part and 5 three-part fractures. The technique was standardized for prosthesis positioning in height and retroversion and for tuberosity fixation. A conventional standard stem was implanted in the first 31 shoulders (group A), and a specific fracture stem was implanted in the next 30 shoulders (group B). The sample size needed for comparison was predetermined with an a priori power analysis. The mean follow-up period was 64 months (range, 24 to 150 months).

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Endoscopic versus open release in patients with de Quervain's tenosynovitis: A randomised trial.

Bone Joint J. 2013 Jul;95-B(7):947-51

Authors: Kang HJ, Koh IH, Jang JW, Choi YR

Abstract

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Volar Ligament Release and Distal Radial Dome Osteotomy for the Correction of Madelung Deformity: Long-Term Follow-up.

J Bone Joint Surg Am. 2013 Jul 3;95(13):1198-204

Authors: Steinman S, Oishi S, Mills J, Bush P, Wheeler L, Ezaki M

Abstract
BACKGROUND: Madelung deformity is a disorder of growth of the distal aspect of the radius that is usually recognized in late adolescence near skeletal maturity. It results in a characteristic wrist deformity, decreased wrist motion, and wrist pain. The purpose of this study was to evaluate long-term results in patients treated by volar ligament release and distal radial dome osteotomy for Madelung deformity.
METHODS: Patients who had undergone volar ligament release and dome osteotomy for Madelung deformity at our institution from 1990 to 2002 and who were the subjects of a previous report on this treatment were contacted for clinical and radiographic evaluation at mid-term to long-term follow-up. Forearm and wrist motion was evaluated. Posteroanterior and lateral radiographs of both forearms were assessed for radial inclination, lunate subsidence, and arthritis changes. A Disabilities of the Arm, Shoulder and Hand (DASH) survey was completed.

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Improvement in quality of life after arthroscopic capsular release for contracture of the shoulder.

Bone Joint J. 2013 Jul;95-B(7):942-6

Authors: Dattani R, Ramasamy V, Parker R, Patel VR

Abstract

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Functional and radiographic outcomes of nonoperative treatment of displaced adolescent clavicle fractures.

J Bone Joint Surg Am. 2013 Jul 3;95(13):1159-65

Authors: Schulz J, Moor M, Roocroft J, Bastrom TP, Pennock AT

Abstract
BACKGROUND: Studies of adult patients suggest that nonoperative treatment of clavicle fractures may result in functional disability, but this has not been demonstrated in adolescents. The purpose of this study was to determine the functional outcomes after nonoperative treatment of displaced, shortened, midshaft clavicle fractures in adolescents.
METHODS: Adolescents ten to eighteen years of age with an isolated, completely displaced, shortened, midshaft clavicle fracture sustained between 2009 and 2011 were recruited for this study. Injury and final radiographs were assessed for displacement, shortening, and clavicle length. Maximal and endurance strength testing was performed with the Baltimore Therapeutic Equipment (BTE) machine, with use of the uninjured shoulder as an internal control. Shoulder range of motion and clavicle length were assessed clinically, and patient-oriented outcomes were obtained.
RESULTS: Sixteen patients (four of whom were female) with an average age (and standard deviation) of 14.2 ± 2 years and a mean duration of follow-up of 2 ± 1 years were included in the study. Fifteen patients were right-hand dominant and one was ambidextrous, and thirteen of the fractures occurred in the nondominant

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Regarding "Percutaneous balloon humeroplasty for Hill-Sachs lesions: a novel technique".

J Shoulder Elbow Surg. 2013 Aug;22(8):e18-9

Authors: Freude T, Kraus TM, Stöckle U, Ahrens P, Siebenlist S, Neumaier M, Sandmann GH, Martetschläger F

PMID: 23810492 [PubMed - in process]

Read more... http://www.ncbi.nlm.nih.gov/pubmed/23810492?dopt=Abstract

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Risk factors for nonunion after nonoperative treatment of displaced midshaft fractures of the clavicle.

J Bone Joint Surg Am. 2013 Jul 3;95(13):1153-8

Authors: Murray IR, Foster CJ, Eros A, Robinson CM

Abstract
BACKGROUND: Identification of patients at higher risk of nonunion after diaphyseal clavicular fractures is desirable to improve patient counseling and enable targeted surgical treatment.
METHODS: Seventy-nine percent (941 of 1196) of diaphyseal clavicular fractures were followed to union or nonunion. Demographic, injury, and radiographic characteristics associated with nonunion were determined with use of bivariate and multivariate statistical analyses.

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Addressing glenoid bone deficiency and asymmetric posterior erosion in shoulder arthroplasty.

J Shoulder Elbow Surg. 2013 Jun 21;

Authors: Hsu JE, Ricchetti ET, Huffman GR, Iannotti JP, Glaser DL

Abstract

Change in Quality of Life and Cost/Utility Analysis in Open Stage-related Surgical Treatment of Elbow Stiffness.

Orthopedics. 2013 Jul 1;36(7):e923-30

Authors: Giannicola G, Bullitta G, Sacchetti FM, Scacchi M, Polimanti D, Citoni G, Cinotti G

Abstract
The goals of this study were to examine the improvement in quality of life achieved after open surgical treatment of elbow stiffness and to verify the cost/utility ratio of surgery. Thirty-three patients (22 men and 11 women) underwent surgery. The etiologies of elbow stiffness were posttraumatic conditions (n=26), primary osteoarthritis (n=5), and rheumatoid arthritis (n=2). Surgery included 14 ulnohumeral arthroplasties, 6 ulnohumeral arthroplasties associated with radiocapitellar replacement, 5 ulnohumeral arthroplasties associated with radial head replacement, and 8 total elbow arthroplasties. All patients were evaluated pre- and postoperatively with the Mayo Elbow Performance Score, the Mayo Elbow Performance Index, the modified American Shoulder and Elbow Surgeons score, the Quick Disabilities of the Arm, Shoulder and Hand score, and the Short Form 36 after a mean follow-up of 26 months. Possible variables affecting clinical outcome and quality of life improvement were assessed. The cost/utility ratio was evaluated as diagnosis-related group reimbursement per quality-adjusted life year. Mayo Elbow Performance Scores and modified American Shoulder and Elbow Surgeons scores increased, on average, by 43 and 41 points, respectively (P<.0001). Quick Disabilities of the Arm, Shoulder and Hand scores decreased, on average, by 44 points (P<.0001). The improvement in the SF-36 physical and mental component