Shoulder and Elbow最新文献_第9页

Medical malpractice litigation following humeral fractures in the United States 美国肱骨骨折后的医疗事故诉讼

Shoulder and Elbow Pub Date : 2023-10-25 DOI: 10.1177/17585732231201976

Martinus Megalla, Jay M Zaifman, Zachary T Grace, Nareena Imam, Eitan M Kohan, Frank G Alberta

{"title":"Medical malpractice litigation following humeral fractures in the United States","authors":"Martinus Megalla, Jay M Zaifman, Zachary T Grace, Nareena Imam, Eitan M Kohan, Frank G Alberta","doi":"10.1177/17585732231201976","DOIUrl":"https://doi.org/10.1177/17585732231201976","url":null,"abstract":"Background The purpose of this study is to characterize malpractice claims against orthopedic surgeons treating humeral fractures and determine factors associated with plaintiff verdicts and settlements. Methods The Westlaw legal database was queried for all cases involving humeral fractures. Patient demographics, causes cited for litigation, case outcomes, and indemnity payments were collected to determine common factors that lead plaintiffs to pursue legal action. Results Fifty-seven cases were identified that met inclusion criteria. The mean plaintiff age was 52.5 years with 61% female. The most common category of negligence was treatment error, which occurred in 29 claims (51%). The most common types of damages incurred were functional limitation (40%), nerve injury (32%), and malunion/nonunion (26%). Overall, 42 cases (74%) resulted in a defense verdict. Four cases (7%) resulted in settlements and 11 cases (19%) resulted in plaintiff verdicts. Cases that resulted in plaintiff verdicts or settlements were treated with intramedullary nails more often than those with defense verdicts (27% vs. 4.8%, p = 0.036). Discussion These findings highlight the importance of effective communication with patients regarding treatment modalities, risks and benefits, and prognosis of their injury. Level of evidence IV; Case Series using Large Database; Epidemiology Study","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":"48 11","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135166066","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 efficacy of preoperative tranexamic acid administration among patients undergoing arthroscopic rotator cuff repair: A systematic review and meta-analysis of randomized controlled trials 关节镜下肩袖修复术患者术前给予氨甲环酸的疗效:随机对照试验的系统回顾和荟萃分析

Shoulder and Elbow Pub Date : 2023-10-17 DOI: 10.1177/17585732231207972

Mahdi Yousef Alyousef, Sadiq Issa Alaqaili, Mohammed Ali Alzayer, Ali Sultan Alsultan, Ammar J Abusultan, Mohammad M Alzahrani, Saad M Alqahtani

{"title":"The efficacy of preoperative tranexamic acid administration among patients undergoing arthroscopic rotator cuff repair: A systematic review and meta-analysis of randomized controlled trials","authors":"Mahdi Yousef Alyousef, Sadiq Issa Alaqaili, Mohammed Ali Alzayer, Ali Sultan Alsultan, Ammar J Abusultan, Mohammad M Alzahrani, Saad M Alqahtani","doi":"10.1177/17585732231207972","DOIUrl":"https://doi.org/10.1177/17585732231207972","url":null,"abstract":"Aim To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) that investigated the effectiveness of tranexamic acid (TXA) among patients undergoing arthroscopic rotator cuff repair (ARCR). Methods Five databases were screened until December 18, 2022. The included RCTs were assessed for risk of bias, and the endpoints were summarized as mean difference/standardized mean difference (MD/SMD) or risk ratio (RR) with the 95% confidence interval (CI) in a random-effects model. Results Seven RCTs with 510 patients (TXA = 261 and control/placebo = 249) were analyzed. The overall risk of bias was “low” and “unclear” in four and three RCTs, respectively. The mean operative time (n = 5 RCTs, MD = −9.64 min, 95% CI [−15.74, −3.54], p = 0.002) and mean postoperative pain score on postoperative day 1 (n = 5 RCTs, MD = −0.56, 95% CI [−1.06, −0.05], p = 0.03) were significantly reduced in the TXA group compared with the control group. However, there were no significant differences between both groups regarding visual clarity, amount of irrigation solution, and estimated intraoperative blood loss. Conclusion Among patients undergoing ARCR, preoperative TXA did not reduce intraoperative blood loss or improve visual clarity. However, TXA administration correlated with significant reductions (statistically) in operative time and postoperative day 1 pain score compared with the control group. Level of evidence: Level I; Systematic Review and Meta-analysis of Randomized Controlled Trials","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135994233","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

Osteoporosis in the setting of rotator cuff repair: A narrative review 骨质疏松症在肩袖修复的设置:叙述回顾

Shoulder and Elbow Pub Date : 2023-10-17 DOI: 10.1177/17585732231207338

Mohammad Daher, Ziad Zalaquett, Mohamad Y Fares, Peter Boufadel, Akshay Khanna, Joseph A Abboud

引用次数: 0

Successful reverse total shoulder replacement in a patient with Apert syndrome Apert综合征患者成功的反向全肩关节置换术

Shoulder and Elbow Pub Date : 2023-10-13 DOI: 10.1177/17585732231207365

Codey Burton, Denis P Koong, Kurt Seagrave, Milos Spasojevic, Sam Mackenzie, Ben Cass

{"title":"Successful reverse total shoulder replacement in a patient with Apert syndrome","authors":"Codey Burton, Denis P Koong, Kurt Seagrave, Milos Spasojevic, Sam Mackenzie, Ben Cass","doi":"10.1177/17585732231207365","DOIUrl":"https://doi.org/10.1177/17585732231207365","url":null,"abstract":"Apert syndrome, first described in the literature by a French pediatrician Eugene Apert, is a rare congenital form of acrocephalodactyly with autosomal dominant inheritance. Classically, this syndrome is characterized by craniosynostosis, midface hypoplasia, and symmetrical syndactyly of hands and feet resulting from embryonic anomalies during the third week of gestation. It is also associated with a variety of abnormalities of the viscera, involving the neurological, genitourinary, and cardiorespiratory systems. Glenohumeral manifestations of Apert syndrome include glenoid dysplasia, an oblong humeral head with a prominence of the greater tuberosity, acromial prominence, and inferior subluxation of the glenohumeral joint. This pathological anatomy results in progressive degenerative changes, synchondrosis, and restriction in shoulder joint mobility, particularly in flexion and abduction. While surgical options for the accompanying deformities of the feet and spine are described, interventions for shoulder pathology are not well-defined. Joint replacement surgery could offer such patients pain relief and improved function. Reverse total shoulder arthroplasty is yet to be described in Apert syndrome and this case report presents the outcome in a 48-year-old male. Level of evidence: IV case report.","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135853985","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

Return to play following operative management of anterior shoulder instability in overhead athletes—A systematic review 手术治疗头顶运动员前肩不稳后恢复比赛-系统回顾

Shoulder and Elbow Pub Date : 2023-10-03 DOI: 10.1177/17585732231205175

Eoghan T Hurley, Kiera Lunn, Mikhail Bethell, Jay Levin, Ignacio Pasqualini, Salvatore Frangiamore, Oke Anakwenze, Christopher S Klifto

{"title":"Return to play following operative management of anterior shoulder instability in overhead athletes—A systematic review","authors":"Eoghan T Hurley, Kiera Lunn, Mikhail Bethell, Jay Levin, Ignacio Pasqualini, Salvatore Frangiamore, Oke Anakwenze, Christopher S Klifto","doi":"10.1177/17585732231205175","DOIUrl":"https://doi.org/10.1177/17585732231205175","url":null,"abstract":"Background The purpose of this study was to systematically review the rate and timing of return to play in overhead athletes following operative management of anterior shoulder instability. Methods A systematic literature search based on PRISMA guidelines, utilizing the EMBASE, MEDLINE, and The Cochrane Library Databases. Eligible for inclusion were clinical studies reporting on return to play among overhead athletes following arthroscopic Bankart repair, open Latarjet procedure or Remplissage procedure. Results There are 23 studies included with 961 patients. Among those undergoing arthroscopic Bankart repair, the rate of return to play was 86.2%, with 70.6% returning to the same level of play and the mean time to return to play was 7.1 months. Among those undergoing an open Latarjet procedure, the rate of return to play was 80.9%, with 77.7% returning to the same level of play and the mean time to return to play was 5.1 months. Among those undergoing a Remplissage procedure, the rate of return to play was 70.6%, with 70.0% returning to the same level of play or mean time to return to play. Discussion Overall, there were high rates of return to play following operative management of anterior shoulder instability in overhead athletes.","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":"139 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135695969","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 N-brace trial: Does arm position during immobilisation of proximal humerus fractures influence outcome - A preliminary study. N型支架试验：肱骨近端骨折固定期间的手臂位置是否影响结果——一项初步研究。

IF 1.5

Shoulder and Elbow Pub Date : 2023-10-01 Epub Date: 2022-12-07 DOI: 10.1177/17585732221142505

Kishan Gokaraju, Philip Ahrens, Pascal Boileau, Tobias Baring

{"title":"The N-brace trial: Does arm position during immobilisation of proximal humerus fractures influence outcome - A preliminary study.","authors":"Kishan Gokaraju, Philip Ahrens, Pascal Boileau, Tobias Baring","doi":"10.1177/17585732221142505","DOIUrl":"10.1177/17585732221142505","url":null,"abstract":"Background: Traditional initial management of proximal humerus fractures (PHF) involves arm immobilisation in a simple sling (SS) in an internally rotated position. We believe this risks fracture displacement and imbalance of soft tissues, encouraging malunion and stiffness. A neutral-rotation brace (NRB) maintains an arm position which may prevent this, leading to quicker and superior recovery.Methods: We randomised patients with two- to four-part PHF into 4 weeks of immobilisation with either a SS or NRB, independent of surgery. Range of motion (ROM), subjective shoulder value (SSV), DASH, Constant-Murley (CMS) and Oxford Shoulder (OSS) scores were assessed at 6-weeks, 3-months and 1-year post-injury.Results: The SS group included 11 patients vs 9 in the NRB group. At final follow-up, the SS and NRB groups had mean DASH scores of 42 vs 35, OSS 42 vs 46, CMS 71 vs 86, SSV 84% vs 92%, respectively. ROM was superior with the NRB (elevation 159°, ER 47° and IR score 8 vs 140°, 37° and 7 with SS).Conclusions: Despite being a small series, our results demonstrate a trend towards NRB providing better outcomes. This feasibility study supports the need for a larger multi-centre randomised controlled trial comparing these immobilisation methods for PHF.","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":"15 5","pages":"513-521"},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10557930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41142630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgeon-administered intraoperative brachial plexus block for open shoulder surgery - a novel and safe technique. 外科医生在肩部开放手术中使用臂丛神经阻滞——一种新的安全技术。

IF 1.5

Shoulder and Elbow Pub Date : 2023-10-01 Epub Date: 2022-09-21 DOI: 10.1177/17585732221127432

Srinath Kamineni, Naga Suresh Cheppalli

{"title":"Surgeon-administered intraoperative brachial plexus block for open shoulder surgery - a novel and safe technique.","authors":"Srinath Kamineni, Naga Suresh Cheppalli","doi":"10.1177/17585732221127432","DOIUrl":"10.1177/17585732221127432","url":null,"abstract":"In the era of outpatient shoulder surgery, bundled payment, safe, predictable, and time-efficient pain management strategies for shoulder arthroplasty (SA) are important. Ultrasound-guided interscalene blocks (ISBs), currently the gold standard for postoperative pain management after shoulder surgery, can be highly operator dependent, time-consuming, and not without complications. We developed a new surgical technique of surgeon-administered intraoperative brachial plexus block in patients undergoing SA open shoulder surgery using the deltopectoral approach. This procedure could be performed after the exposure, either at the beginning or end of the bony work. This procedure is simple, safe, and effective. We did not notice any complications that are typically seen with ISB-like respiratory depression secondary to phrenic nerve palsy, rebound pain after the block wore off, and pain related conversion of outpatient SA to inpatient, over the period of four years (2018-2022). This technique has additional advantages over the established \"gold standard\" ISB in terms of time and cost savings and improved operating room efficiency.","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":"15 5","pages":"571-576"},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10557931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41149051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gender does not impact clinical outcomes following SLAP repair. 性别不会影响SLAP修复后的临床结果。

IF 1.5

Shoulder and Elbow Pub Date : 2023-10-01 Epub Date: 2022-03-29 DOI: 10.1177/17585732221089286

Danielle H Markus, Eoghan T Hurley, Nathan Lorentz, Christopher A Colasanti, Kirk A Campbell, Cordelia W Carter, Eric J Strauss

{"title":"Gender does not impact clinical outcomes following SLAP repair.","authors":"Danielle H Markus, Eoghan T Hurley, Nathan Lorentz, Christopher A Colasanti, Kirk A Campbell, Cordelia W Carter, Eric J Strauss","doi":"10.1177/17585732221089286","DOIUrl":"10.1177/17585732221089286","url":null,"abstract":"Background: The purpose of the current study was to investigate whether pain, function, satisfaction, return to play (RTP), or psychological readiness to RTP differ between sexes post-operatively following SLAP repair.Methods: A retrospective review of patients who underwent arthroscopic repair of a SLAP tear was performed. The American Shoulder & Elbow Surgeons (ASES) score, Visual Analogue Scale (VAS), Subjective Shoulder Value (SSV), patient satisfaction, willingness to undergo surgery again, revisions, and return to play (RTP) were evaluated. Clinical outcomes were compared between male and female patients.Results: Our study included 169 patients treated with SLAP repair, 133 of them male (78.7%) and 36 of them female (21.3%), with an average age of 32.3 ± 8.3 and 33.4 ± 6.8 respectively. The mean follow-up duration was 5.8 years. At final follow up, there was no difference between treatment groups in any of the functional outcome measures assessed (p > 0.05).Conclusion: There is no difference in clinical outcomes, function, satisfaction, or revision procedures in mid- to long-term follow-up after SLAP repair between male and female patients. This data is useful in the preoperative counselling of patients undergoing arthroscopic management of symptomatic superior labral pathology.Level of evidence: III.","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":"15 5","pages":"566-570"},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10557936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41151443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Smoking cessation prior to total shoulder arthroplasty: A systematic review of outcomes and complications. 全肩关节置换术前戒烟：结果和并发症的系统回顾。

IF 1.5

Shoulder and Elbow Pub Date : 2023-10-01 Epub Date: 2022-10-17 DOI: 10.1177/17585732221131916

Sai A Kamma, Rajeev K Pathapati, Jeremy S Somerson

{"title":"Smoking cessation prior to total shoulder arthroplasty: A systematic review of outcomes and complications.","authors":"Sai A Kamma, Rajeev K Pathapati, Jeremy S Somerson","doi":"10.1177/17585732221131916","DOIUrl":"10.1177/17585732221131916","url":null,"abstract":"Background: We conducted a review of current literature to examine the effects of smoking and smoking cessation on shoulder arthroplasty surgery.Methods: A literature search was performed using the search terms \"shoulder arthroplasty AND [smoke OR smoking OR tobacco OR nicotine].\" Studies included English-language clinical outcomes studies on anatomic total shoulder arthroplasty (TSA), reverse TSA, and partial shoulder arthroplasty with evidence levels 1 through 4. Descriptive statistics calculated in the included studies were used during the analysis. Categorical variables were reported as proportions, while continuous variables were reported as means with minimum to maximum absolute ranges.Results: Twenty-four studies were included and analyzed. Following TSA, patients who quit smoking at least 1 month preoperatively had improved outcomes compared to current smokers. Current smokers had statistically significant higher pain scores or opioid use. Five studies found increased rates of revision surgery in smokers. Smokers were significantly (p < 0.05) more likely to have increased rates of surgical, wound, superficial, and deep surgical site complications.Discussion: Former smokers had lower complication rates and visual analog scale scores when compared to current users. A period of four weeks or more of preoperative smoking cessation is recommended.Level of evidence: Level III, Systematic Review.","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":"15 5","pages":"484-496"},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10557933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41180167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Post-operative rehabilitation following traumatic anterior shoulder dislocation: A systematic scoping review. 创伤性肩前脱位术后康复：一项系统的范围界定综述。

IF 1.5

Shoulder and Elbow Pub Date : 2023-10-01 Epub Date: 2022-03-31 DOI: 10.1177/17585732221089636

Martha Coyle, Anju Jaggi, Lewis Weatherburn, Helena DanielI, Rachel Chester

{"title":"Post-operative rehabilitation following traumatic anterior shoulder dislocation: A systematic scoping review.","authors":"Martha Coyle, Anju Jaggi, Lewis Weatherburn, Helena DanielI, Rachel Chester","doi":"10.1177/17585732221089636","DOIUrl":"10.1177/17585732221089636","url":null,"abstract":"Background: This systematic scoping review aimed to describe the content of post-operative rehabilitation programmes, and outcome measures selection following stabilisation surgery for traumatic anterior shoulder dislocation (TASD).Methods: An electronic search of Medline, EMBASE, CINAHL and AMED was conducted (2000-2021). Any cohort or clinical trial of patients receiving post-operative TASD rehabilitation were included. Study selection, data extraction and quality appraisal were undertaken by two independent reviewers.Results: Twelve studies including fourteen treatment programmes were eligible. Period of post-operative immobilisation ranged from 1 day to 6 weeks, with exercise introduced between 1 and 7 weeks. Strengthening exercises were introduced between 1 and 12 weeks. Two studies described \"accelerated\" rehabilitation programmes, differing in immobilisation period and exercise milestones. No increased recurrence was reported in professional footballers. Two studies compared rehabilitation programmes, one not randomised, the other 18 years old. There was variability in selected outcomes measures, with only 4 studies using a common measure.Discussion: There is minimal evidence to guide post-operative rehabilitation, variability in immobilisation periods and when exercise is introduced. There is no consensus on the definition of accelerated rehabilitation, or outcome measure selection. Clinical consensus of standardised terminology and stages of rehabilitation is required prior to efficacy studies.","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":"15 5","pages":"554-565"},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10557935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41178676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0