Clinics in Shoulder and Elbow最新文献

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Short-term outcomes of anatomic total shoulder arthroplasty with biceps augmentation of subscapularis peel repair. 解剖型全肩关节置换术与肩胛下肌剥离修复二头肌增强术的短期疗效。
IF 1.8
Clinics in Shoulder and Elbow Pub Date : 2024-11-21 DOI: 10.5397/cise.2024.00549
Mohamad Y Fares, Peter Boufadel, Jonathan Koa, Jaspal Singh, Ryan Lopez, Nabil Mehta, Kyle Achors, Joseph A Abboud
{"title":"Short-term outcomes of anatomic total shoulder arthroplasty with biceps augmentation of subscapularis peel repair.","authors":"Mohamad Y Fares, Peter Boufadel, Jonathan Koa, Jaspal Singh, Ryan Lopez, Nabil Mehta, Kyle Achors, Joseph A Abboud","doi":"10.5397/cise.2024.00549","DOIUrl":"https://doi.org/10.5397/cise.2024.00549","url":null,"abstract":"<p><strong>Background: </strong>Augmenting subscapularis peel repairs with the long head of the biceps tendon (LHBT) may provide increased strength to the repaired construct. We aimed to report on the early outcomes of anatomic total shoulder arthroplasty (aTSA) in patients whose subscapularis peel repairs were augmented with LHBT autografts.</p><p><strong>Methods: </strong>All patients who underwent aTSA with augmentation of subscapularis peel repair using LHBT were reviewed. Patients were included if they had a minimum 1-year follow-up. Preoperative demographics and intraoperative information were recorded. Primary outcomes were American Shoulder and Elbow Surgeon (ASES) scores and visual analogue scale (VAS) pain scores, which were assessed at 3, 6, and 12 months, as well as changes in range of motion values.</p><p><strong>Results: </strong>Sixteen patients with a mean age of 63.3 years and a mean follow-up of 12.4 months were included in the study. Six patients were female and 10 were male. Average LHBT length was 7.3 cm (range, 6.5-9.0 cm). Two patients were converted to reverse shoulder arthroplasty (12.5%). For the remaining 14 patients, there were statistically significant improvements exceeding the minimal clinically important difference in both ASES (34.1-92.1, P<.001) and VAS (6.3-0.9, P<.001) scores. Patients exhibited a mean improvement of 47.7° in forward elevation (P<0.001), 30.8° in abduction (P<0.001), 21.4° in external rotation (P<0.001), and a 3-level improvement for internal rotation.</p><p><strong>Conclusions: </strong>At 1-year minimum follow-up, patients who underwent aTSA with augmentation of the subscapularis peel repair with the LHBT demonstrated favorable outcomes. Level of evidence: IV.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Descriptive analysis of total elbow arthroplasty for distal humerus fractures: 30-day complications. 肱骨远端骨折全肘关节置换术的描述性分析:30天并发症。
IF 1.8
Clinics in Shoulder and Elbow Pub Date : 2024-11-19 DOI: 10.5397/cise.2024.00500
Dany El-Najjar, Apoorva Mehta, Caroline Taber, Puneet Gupta, Joel R Peterson, Brandon Rogalski, Charles M Jobin, David P Trofa
{"title":"Descriptive analysis of total elbow arthroplasty for distal humerus fractures: 30-day complications.","authors":"Dany El-Najjar, Apoorva Mehta, Caroline Taber, Puneet Gupta, Joel R Peterson, Brandon Rogalski, Charles M Jobin, David P Trofa","doi":"10.5397/cise.2024.00500","DOIUrl":"10.5397/cise.2024.00500","url":null,"abstract":"<p><strong>Background: </strong>Although functional outcomes of total elbow arthroplasty (TEA) for distal humerus fractures are satisfactory, there is a high rate of complications. This study aims to characterize the 30-day complications, readmissions, and mortality of patients with TEA for distal humerus fractures in a large registry database.</p><p><strong>Methods: </strong>Patients who underwent TEA for a distal humerus fracture were identified from the 2015 to 2020 ACS-NSQIP (American College of Surgeons National Surgical Quality Improvement Program) database. Baseline demographics, clinical characteristics, and complications including deep vein thrombosis/pulmonary embolus, infection, mortality, readmissions, and reoperations were recorded. Overall, 134 patients (mean age, 73.6 years; mean body mass index, 28.9 kg/m2 ; 88.8% females) were included.</p><p><strong>Results: </strong>The total complication rate was 21.6% (n=29). The most common complications were unplanned readmission (6.0%), postoperative transfusion (5.2%), unplanned reoperation (3.0%), wound disruption (2.2%), and urinary tract infection (1.5%). The composite infection rate was 3.7%. There were no 30-day events of mortality, sepsis, or cerebral vascular accident. Patients 80 years or older had higher but not significant rates of unplanned readmission (10.2% vs. 3.5%, P=0.116) and reoperation (6.1% vs. 1.2%, P=0.105).</p><p><strong>Conclusions: </strong>TEA for distal humerus fracture analyzed over 5 years had high rates of 30-day postoperative complications (21.6%), with unplanned readmission, reoperation, and infection being the most common. Level of evidence: IV.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of supraspinatus tear on subscapularis muscle atrophy and fatty infiltration. 冈上肌撕裂对肩胛下肌肉萎缩和脂肪浸润的影响。
IF 1.8
Clinics in Shoulder and Elbow Pub Date : 2024-11-15 DOI: 10.5397/cise.2024.00521
Su Cheol Kim, Seung Jin Yoo, Je Hyeong Jo, Jong Hyun Lee, Eugene Baek, Sang Min Lee, Jae Chul Yoo
{"title":"The impact of supraspinatus tear on subscapularis muscle atrophy and fatty infiltration.","authors":"Su Cheol Kim, Seung Jin Yoo, Je Hyeong Jo, Jong Hyun Lee, Eugene Baek, Sang Min Lee, Jae Chul Yoo","doi":"10.5397/cise.2024.00521","DOIUrl":"10.5397/cise.2024.00521","url":null,"abstract":"<p><strong>Background: </strong>Aimed to report the prevalence and predisposing factors affecting subscapularis muscle atrophy and fatty infiltration (MAFI) in patients without a subscapularis tear, and to analyze the effect of this condition on surgical outcomes.</p><p><strong>Methods: </strong>Between 2020 and 2022, 153 patients (mean age 58.1 ± 10.2 years; 84 men and 69 women) who underwent repair of posterosuperior cuff tears, with no subscapularis tears identified during arthroscopy were retrospectively analyzed. Baseline characteristics, preoperative and follow-up (6 months) magnetic resonance imaging findings, arthroscopic findings, and clinical outcomes (>1 year) were recorded.</p><p><strong>Results: </strong>The prevalence of subscapularis MAFI (Goutallier grade 1 or 2) was 73.9% (113/153), of which the prevalence of Goutallier grade 2 was 23.5% (36/153). From multivariable logistic regression analysis, female sex (odds ratio [OR], 5.6; 95% CI, 1.7-18.6; P=0.005), older age (OR, 1.1; 95% CI, 1.0-1.1; P=0.052), advanced supraspinatus MAFI by Goutallier grade (OR, 3.2; 95% CI, 1.5-6.9; P=0.004), and synovitis (OR, 2.8; 95% CI, 1.1-7.9; P=0.030) were identified as independent predisposing factors for subscapularis MAFI. However, patients with preoperative subscapularis MAFI exhibited similar final range of motion, pain and function, and belly press strength compared to those without preoperative subscapularis MAFI.</p><p><strong>Conclusions: </strong>Subscapularis MAFI is frequently observed conditions even in the absence of subscapularis tears, and this condition could be affected by supraspinatus MAFI, female sex, older age, and synovitis. However, because subscapularis MAFI does not affect the surgical outcome, surgeons need not be concerned about this condition when repairing posterosuperior rotator cuff tear. Level of evidence: IV.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcomes of lateralized reverse total shoulder arthroplasty versus latissimus dorsi transfer for external rotation deficit: a systematic review and meta-analysis. 外侧反向全肩关节置换术与背阔肌转移术治疗外旋缺损的疗效:系统回顾和荟萃分析。
IF 1.8
Clinics in Shoulder and Elbow Pub Date : 2024-11-15 DOI: 10.5397/cise.2024.00304
Keegan M Hones, Caroline T Gutowski, Taylor R Rakauskas, Victoria E Bindi, Trevor Simcox, Jonathan O Wright, Bradley S Schoch, Thomas W Wright, Jean-David Werthel, Joseph J King, Kevin A Hao
{"title":"Outcomes of lateralized reverse total shoulder arthroplasty versus latissimus dorsi transfer for external rotation deficit: a systematic review and meta-analysis.","authors":"Keegan M Hones, Caroline T Gutowski, Taylor R Rakauskas, Victoria E Bindi, Trevor Simcox, Jonathan O Wright, Bradley S Schoch, Thomas W Wright, Jean-David Werthel, Joseph J King, Kevin A Hao","doi":"10.5397/cise.2024.00304","DOIUrl":"10.5397/cise.2024.00304","url":null,"abstract":"<p><strong>Background: </strong>To compare clinical outcomes following lateralized reverse shoulder arthroplasty (RSA) versus RSA with latissimus dorsi transfer (LDT) in patients with poor preoperative active external rotation (ER).</p><p><strong>Methods: </strong>We performed a systematic review per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We queried PubMed/Medline, Embase, Web of Science, and Cochrane databases to identify articles reporting clinical outcomes of RSA with LDT or lateralized RSA alone performed in patients with preoperative ER ≤0°. Our primary outcomes were active ER, active forward elevation (FE), Constant score, and the incidence of complications.</p><p><strong>Results: </strong>We included 12 RSA with LDT studies with 188 shoulders and 4 lateralized RSA without transfer studies with 250 shoulders. Mean preoperative ER in RSA with LDT was -14°, while mean preoperative ER in lateralized RSA alone was -11°. Lateralized RSA alone was associated with superior postoperative ER (28° vs. 22°, P=0.010) and Constant score (69 vs. 65, P=0.014), but similar postoperative FE (P=0.590). Pre- to postoperative improvement in ER and FE was similar between cohorts. RSA with LDT had a higher incidence of nerve-related complications (2.1% vs. 0%) and dislocation (2.8% vs. 0.8%) compared to lateralized RSA alone.</p><p><strong>Conclusions: </strong>Both RSA with LDT and lateralized RSA are reliable options to restore ER in patients with significantly limited preoperative ER. Our analysis suggests that lateralized RSA alone is superior to RSA with LDT in patients with either a medialized or lateralized implant design and confers a lower risk of complications, particularly nerve injury and dislocation. However, the addition of an LDT may still be indicated in certain patient populations with very severe ER loss. Level of Evidence: IV.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Learning curve for the open Latarjet procedure: a single-surgeon study. 开放式 Latarjet 手术的学习曲线:单个外科医生的研究。
IF 1.8
Clinics in Shoulder and Elbow Pub Date : 2024-11-15 DOI: 10.5397/cise.2024.00199
Aidan G Papalia, Paul V Romeo, Matthew G Alben, Andrew Cecora, Dashaun Ragland, Mandeep S Virk
{"title":"Learning curve for the open Latarjet procedure: a single-surgeon study.","authors":"Aidan G Papalia, Paul V Romeo, Matthew G Alben, Andrew Cecora, Dashaun Ragland, Mandeep S Virk","doi":"10.5397/cise.2024.00199","DOIUrl":"10.5397/cise.2024.00199","url":null,"abstract":"<p><strong>Background: </strong>The popularity of the Latarjet procedure (LP) for the treatment of anterior shoulder instability continues to rise. However, LP is technically demanding and associated with complications. This study aims to determine the learning curve for the open LP (oLP) and the threshold for proficiency.</p><p><strong>Methods: </strong>This was a retrospective study of all oLPs performed by a single surgeon in a single institution from 2016 to 2021. Operative time, defined as time from incision to closure, was the primary outcome of this study, and 1-year postoperative complications were the secondary outcome. After listing oLP cases in chronological order, they were classified into groups of 15, and the average operative time for each group was determined. Demographics, operative duration, and postoperative complications were compared across groups.</p><p><strong>Results: </strong>Seventy-five oLPs were included in this study, and operative times decreased after the first 15 procedures. While operative times continued to decrease with increasing case number, the learning curve began to plateau after 30 procedures. After 75 procedures, there was a total decrease in average operative time of 31.5 minutes relative to that of the first 15 cases. There were no differences in complication or revision rates among procedure groups.</p><p><strong>Conclusions: </strong>Establishing learning curves provides important insight into the complexity of surgical procedures. Our study demonstrates that the oLP has a steep learning curve with significant improvement in operative time after the first 15 cases. Operative time plateaus after 30 cases, indicating proficiency in this procedure. Level of evidence: IV.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reconsidering the clinical outcomes of the stemless reverse total shoulder arthroplasty design implant. 重新考虑无茎反向全肩关节成形术设计植入物的临床效果。
IF 1.8
Clinics in Shoulder and Elbow Pub Date : 2024-11-15 DOI: 10.5397/cise.2024.00836
Bo-Seoung Kim, Jong-Hun Ji
{"title":"Reconsidering the clinical outcomes of the stemless reverse total shoulder arthroplasty design implant.","authors":"Bo-Seoung Kim, Jong-Hun Ji","doi":"10.5397/cise.2024.00836","DOIUrl":"10.5397/cise.2024.00836","url":null,"abstract":"","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factors affecting healing of rotator cuff repairs: microfracture of the greater tuberosity. 影响肩袖修复愈合的因素:大结节微骨折。
IF 1.8
Clinics in Shoulder and Elbow Pub Date : 2024-11-08 DOI: 10.5397/cise.2024.00290
Gwan Kyu Son, Myung Seo Kim
{"title":"Factors affecting healing of rotator cuff repairs: microfracture of the greater tuberosity.","authors":"Gwan Kyu Son, Myung Seo Kim","doi":"10.5397/cise.2024.00290","DOIUrl":"https://doi.org/10.5397/cise.2024.00290","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the impact of microfractures generated within the footprint of the greater tuberosity (GT) on postoperative cuff healing following arthroscopic rotator cuff repair (ARCR).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients who underwent ARCR for full-thickness rotator cuff tear (FTRCT) between April 2020 and October 2023 at our institution. A total of 73 patients was categorized into two groups based on the presence of microfractures: a microfracture group (group M, n=33) and a non-microfracture group (group N, n=40). Six months post-surgery, magnetic resonance imaging was performed to assess cuff healing and retear rates between the two groups. Furthermore, patients were stratified into retear and healing groups based on cuff integrity to analyze the factors influencing retear. Statistical analyses were performed to assess the associations between various demographic data (e.g., age) and radiologic parameters (tear size mediolateral [ML], anteroposterior [AP], and fatty infiltration [FI] of the rotator cuff muscle), including microfracture, with retear.</p><p><strong>Results: </strong>There was no significant difference in retear rates between groups M and N (18.2% vs. 10.0%, P=0.332). Among demographic factors, age showed a significant difference between the retear and healing groups (67.4±8.5 vs. 61.6±6.1, P=0.044). ML tear size (3.1±1.7 vs. 2.0±1.1, P=0.015), AP tear size (2.4±1.2 vs. 1.6±1.0, P=0.332), FI of the supraspinatus (2.3±1.3 vs. 1.4±1.0, P=0.029), and FI of the infraspinatus (1.6±1.3 vs. 0.9±0.8, P=0.015) exhibited significant differences between the retear and healing groups. Multivariate logistic regression analysis identified age (odds ratio [OR], 1.153; 95% CI, 1.026-1.295; P=0.016) and tear size (OR, 1.988; 95% CI, 1.103-3.582; P=0.022) as independent risk factors for retear.</p><p><strong>Conclusions: </strong>ARCR with concurrent microfracture of the GT footprint did not significantly impact cuff healing in patients with FTRCT. However, older age and larger ML tear size were associated with an increased risk of retear. Level of evidence: III.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A prospective cohort study: promising results with minimally invasive plate osteosynthesis of anterior bridge plating in adult humeral shaft fractures. 一项前瞻性队列研究:成人肱骨骨干骨折前桥钢板微创骨合成术效果良好。
IF 1.8
Clinics in Shoulder and Elbow Pub Date : 2024-11-08 DOI: 10.5397/cise.2024.00423
Gur-Aziz Singh Sidhu, Deepak Jain, Harpal Singh Selhi, Harjot Kaur, Sergio Rowinski, Saphalya Pattnaik, Neil Ashwood
{"title":"A prospective cohort study: promising results with minimally invasive plate osteosynthesis of anterior bridge plating in adult humeral shaft fractures.","authors":"Gur-Aziz Singh Sidhu, Deepak Jain, Harpal Singh Selhi, Harjot Kaur, Sergio Rowinski, Saphalya Pattnaik, Neil Ashwood","doi":"10.5397/cise.2024.00423","DOIUrl":"https://doi.org/10.5397/cise.2024.00423","url":null,"abstract":"<p><strong>Background: </strong>Adult humeral shaft fractures have traditionally been managed conservatively, but surgical intervention is considered for displaced fractures or when conservative treatment is unlikely to be successful. The optimal surgical approach remains controversial, with open reduction and internal fixation (ORIF) using plates and screws considered the gold standard. However, concerns about soft tissue damage have led to the development of less invasive techniques, such as anterior bridge plating using minimally invasive plate osteosynthesis (MIPO). This study aimed to evaluate the outcomes of MIPO for humeral shaft fractures.</p><p><strong>Methods: </strong>A prospective cohort study included 43 patients who underwent anterior bridge plating with MIPO for closed, displaced humeral shaft fractures. Forty patients had full follow-up (functional and radiological) and three patients were lost to follow-up. Fractures were classified using the AO classification system. Surgical technique involved incision, reduction, and fixation with locking compression plates. Follow-up assessments were conducted at various intervals, and functional outcomes were evaluated.</p><p><strong>Results: </strong>Fracture union was achieved in 38 of 40 patients (95%). Two patients required secondary bone grafts for non-union. The mean time to union was between 12 and 16 weeks. Excellent shoulder function was observed in 82.5% of patients, and excellent elbow function in 77.5%. The range of motion on the operated side differed statistically significantly from the non-operated side but was not clinically significant.</p><p><strong>Conclusions: </strong>MIPO with anterior bridge plating is a viable option for the surgical management of humeral shaft fractures. It offers good fracture healing rates and satisfactory functional outcomes and avoids extensive soft tissue dissection associated with ORIF. Level of evidence: II.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Surgical treatment options of displaced midshaft fractures of the clavicle in young adults: plate fixation versus intramedullary nailing. 青壮年锁骨中轴移位骨折的手术治疗方案:钢板固定与髓内钉。
IF 1.8
Clinics in Shoulder and Elbow Pub Date : 2024-11-08 DOI: 10.5397/cise.2024.00605
Ji Un Kim, Ji Young Yoon, Hyung Jun Park, Jung Ho Park
{"title":"Surgical treatment options of displaced midshaft fractures of the clavicle in young adults: plate fixation versus intramedullary nailing.","authors":"Ji Un Kim, Ji Young Yoon, Hyung Jun Park, Jung Ho Park","doi":"10.5397/cise.2024.00605","DOIUrl":"https://doi.org/10.5397/cise.2024.00605","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the outcomes and complications of active young adults undergoing open reduction and plate fixation (ORPF) and intramedullary nailing (IMN) for displaced midshaft clavicle fractures (MCFs).</p><p><strong>Methods: </strong>A retrospective review was performed on all patients undergoing ORPF and IMN of complete MCFs at a single center between 2018 and 2022. Patients who were younger than 60 years with radiographic follow-up until union were included in the study. The mean age of the patients was 33.1 years. Outcome measures were achievement of union, time to healing, residual deformity, complications, and need for additional procedures.</p><p><strong>Results: </strong>Of 39 patients, 29 underwent ORPF and 10 underwent IMN. Plate fixation provided faster functional recovery in the first 6 months, but no difference was observed after 1 year. All fractures in the IMN group healed (100%), compared to 90% in the ORPF group (P=0.08). Mean time to union was 21±8.9 weeks and was significantly different between the two groups (P<0.01), with the ORPF group averaging 23.1 weeks and the IMN group 20.8 weeks. Nonunion rates were higher in the ORPF group (10.3%) than in the IMN group (0.0%), but the difference was not significant (P=0.10).</p><p><strong>Conclusions: </strong>Both methods restored patients to their pre-injury functional levels. However, IMN, with its higher healing rate, fewer required revision surgeries, and lower incisional numbness, appears to be the preferred method for treating MSFs without comminution in young adults. Level of evidence: III.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is partial excision of the radial head safe and effective in all-arthroscopic treatment of terrible triad fractures? 在全关节镜下治疗可怕的三联症骨折时,桡骨头部分切除术是否安全有效?
IF 1.8
Clinics in Shoulder and Elbow Pub Date : 2024-11-05 DOI: 10.5397/cise.2024.00703
Hyung Gyu Cho, Gyeong Hoon Lim, Min Su Joo, Jae Won Kim, Jun Ho Park, Jeong Woo Kim
{"title":"Is partial excision of the radial head safe and effective in all-arthroscopic treatment of terrible triad fractures?","authors":"Hyung Gyu Cho, Gyeong Hoon Lim, Min Su Joo, Jae Won Kim, Jun Ho Park, Jeong Woo Kim","doi":"10.5397/cise.2024.00703","DOIUrl":"https://doi.org/10.5397/cise.2024.00703","url":null,"abstract":"<p><strong>Background: </strong>Our study aimed to evaluate the clinical and radiologic results of all-arthroscopic treatment of terrible triad injuries followed-up for a minimum of 5 years and investigate how arthroscopic partial excision for radial head fractures affects the results at the final follow-up.</p><p><strong>Methods: </strong>We retrospectively reviewed consecutive patients with terrible triad injuries who underwent all-arthroscopic treatment between January 2011 and June 2018. In group I, we performed conservative or arthroscopic fixation of stable radial head fractures, while in group II, arthroscopic partial excision of unstable radial head fractures involving <30%-50% of the articular surface area was performed. Clinical outcomes were measured by visual analog scale score and assessment of instability, range of motion (ROM), and Mayo Elbow Performance Score. Radiological outcomes were evaluated using x-rays, and the integrity of the repaired lateral collateral ligament complex was confirmed through magnetic resonance imaging.</p><p><strong>Results: </strong>Thirty-two patients with an average age of 49.5±16.2 years met the inclusion criteria and were followed-up for a mean of 82.7±22.2 months. Twenty patients were assigned to group I and 12 patients to group II. Clinical outcomes showed no significant differences between the two groups at the final follow-up (P>0.05). On radiological evaluation, more heterotopic ossifications were found in the radial head excision group (group II, 66.7% versus group I, 35%, P=0.02); however, there was no significant difference in ROM between the two groups (P>0.05).</p><p><strong>Conclusions: </strong>In all-arthroscopic treatment of terrible triad injuries, arthroscopic partial excision of the radial head did not seem to have a significant impact on elbow joint stability. Level of evidence: III.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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