Obere Extremitaet-Schulter-Ellenbogen-Hand-Upper Extremity-Shoulder Elbow Hand最新文献

{"title":"Cement augmentation of humeral head screws reduces early implant-related complications after locked plating of proximal humeral fractures.","authors":"J Christoph Katthagen,&nbsp;O Lutz,&nbsp;C Voigt,&nbsp;H Lill,&nbsp;A Ellwein","doi":"10.1007/s11678-018-0440-x","DOIUrl":"https://doi.org/10.1007/s11678-018-0440-x","url":null,"abstract":"<p><strong>Background: </strong>Cement augmentation (CA) of humeral head screws in locked plating of proximal humeral fractures (PHF) was found to be biomechanically beneficial. However, clinical outcomes of this treatment have not been well evaluated to date.</p><p><strong>Objectives: </strong>To assess outcomes of locked plating of PHF with additional CA and to compare them with outcomes of conventional locked plating without CA.</p><p><strong>Methods: </strong>24 patients (mean age, 74.2 ± 10.1 years; 22 female) with displaced PHF were prospectively enrolled and treated with locked plating and additional CA. The Constant score (CS), the Simple Shoulder Test (SST), and the Simple Shoulder Value (SSV) were assessed 3 and 12 months postoperatively. Fracture healing and potential complications were evaluated on postoperative radiographs. The CS and complications were compared with the outcomes of a matched group of 24 patients (mean age, 73.9 ± 9.4 years; 22 female) with locked plating of displaced PHF without CA.</p><p><strong>Results: </strong>At the 3‑month follow-up, the mean CS was 59.9 ± 15.6 points, the mean SST was 7.5 ± 2.7 points, and the mean SSV was 63.9 ± 21.7%. All scores significantly improved by the 12-month follow-up (<i>p</i> < 0.05; CS, 72.9 ± 17.7; SST, 9.2 ± 3.2; SSV, 77.2 ± 17.3%). There were two cases (8%) of biological complications (<i>n</i> = 1 varus malunion and <i>n</i> = 1 humeral head necrosis). Compared with locked plating without CA, no significant differences were observed between the CS at the 3‑ (57.8 ± 13.4 points; <i>p</i> = 0.62) and 12-month (73.0 ± 12.8 points; <i>p</i> = 0.99) follow-up. However, patients without CA had a significantly increased risk of early loss of reduction and articular screw perforation (<i>p</i> = 0.037).</p><p><strong>Conclusion: </strong>Locked plating of proximal humeral fractures with trauma cement augmentation of humeral head screws could be translated from the ex-vivo lab setting into the clinical situation without additional complications. Locked plating of displaced PHF with additional cement augmentation showed similar clinical outcomes but reduced the rate of early implant-related complications compared to locked plating without additional CA.</p>","PeriodicalId":43682,"journal":{"name":"Obere Extremitaet-Schulter-Ellenbogen-Hand-Upper Extremity-Shoulder Elbow Hand","volume":"13 2","pages":"123-129"},"PeriodicalIF":0.4,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11678-018-0440-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36209558","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}

{"title":"Dynamic instability of the acromioclavicular joint: A new classification for acute AC joint separation.","authors":"Natascha Kraus,&nbsp;Carmen Hann,&nbsp;Christian Gerhardt,&nbsp;Markus Scheibel","doi":"10.1007/s11678-018-0469-x","DOIUrl":"https://doi.org/10.1007/s11678-018-0469-x","url":null,"abstract":"<p><strong>Background: </strong>Acute acromioclavicular (AC) dislocation is classified according to Rockwood (RW). Although of clinical relevance, dynamic horizontal translation (DHT) is not listed in this classification or in frequently used clinical evaluation tools. The aim of this study was (a) to evaluate vertical and horizontal AC joint instabilities and assess their combined occurrence and clinical appearance in a consecutive group of patients, as well as (b) to develop a new classification of acute AC joint dislocation.</p><p><strong>Method: </strong>A consecutive group of 61 patients (seven female, 54 male) with a mean age of 34.5 years (18.9-60.1) were included in the study. All patients underwent posttraumatic clinical-Taft Score (TF), Acromioclavicular Joint Instability Score (ACJI), Constant Score (CS), Subjective Shoulder Value (SSV)-and radiological (bilateral anteroposterior stress and bilateral Alexander views) evaluation.</p><p><strong>Results: </strong>According to the RW classification, the following AC dislocations were present: eight (13.1%) type I, nine (14.8%) type II, 22 (36.1%) type III, and 22 (36.1%) type V. Based on the clinical and radiographic results, a new classification is proposed: Type I instabilities show only a partial vertical displacement (≤30% coracoclavicular distance [CCD]) and type II a complete vertical displacement (>30% CCD). Both type I and II are further graded into none or partial (A) and complete DHT (B) as seen on bilateral Alexander views.</p><p><strong>Conclusion: </strong>DHT can be found in low-grade instabilities and lead to inferior clinical results in the posttraumatic situation.</p>","PeriodicalId":43682,"journal":{"name":"Obere Extremitaet-Schulter-Ellenbogen-Hand-Upper Extremity-Shoulder Elbow Hand","volume":"13 4","pages":"279-285"},"PeriodicalIF":0.4,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11678-018-0469-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36778294","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}

{"title":"Lower trapezius transfer with Achilles tendon augmentation: indication and clinical results.","authors":"William R Aibinder,&nbsp;Bassem T Elhassan","doi":"10.1007/s11678-018-0489-6","DOIUrl":"https://doi.org/10.1007/s11678-018-0489-6","url":null,"abstract":"<p><p>Lower trapezius tendon transfer with Achilles tendon allograft augmentation may be used to treat patients with lack of active external rotation following shoulder paralysis or massive irreparable posterosuperior rotator cuff tears. In the setting of shoulder paralysis, the integrity of the ipsilateral lower trapezius may be compromised. In this instance, the contralateral lower trapezius may be used with reasonable results. In the setting of irreparable rotator cuff tears, the procedure may be performed through an open or arthroscopically assisted technique. The latter avoids the need for an acromial osteotomy and risk of nonunion associated with repair of the osteotomy. Both are effective in reversing pseudoparesis or pseudoparalysis. Advanced degenerative changes have an effect on outcomes, resulting in less pain improvement, decreased range of motion, and greater need for reoperation with conversion to reverse total shoulder arthroplasty. Nonetheless, the lower trapezius tendon transfer is an effective option for restoring active external rotation with relatively consistent results.</p>","PeriodicalId":43682,"journal":{"name":"Obere Extremitaet-Schulter-Ellenbogen-Hand-Upper Extremity-Shoulder Elbow Hand","volume":"13 4","pages":"269-272"},"PeriodicalIF":0.4,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11678-018-0489-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36778292","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}

{"title":"Rehabilitation following rotator cuff repair: A work of the Commission Rehabilitation of the German Society of Shoulder and Elbow Surgery e. V. (DVSE) in collaboration with the German Association for Physiotherapy (ZVK) e. V., the Association Physical Therapy, Association for Physical Professions (VPT) e. V. and the Section Rehabilitation-Physical Therapy of the German Society for Orthopaedics and Trauma e. V. (DGOU).","authors":"Christian Jung,&nbsp;Lena Tepohl,&nbsp;Reina Tholen,&nbsp;Knut Beitzel,&nbsp;Stefan Buchmann,&nbsp;Thomas Gottfried,&nbsp;Casper Grim,&nbsp;Bettina Mauch,&nbsp;Gert Krischak,&nbsp;Hans Ortmann,&nbsp;Christian Schoch,&nbsp;Frieder Mauch","doi":"10.1007/s11678-018-0448-2","DOIUrl":"https://doi.org/10.1007/s11678-018-0448-2","url":null,"abstract":"<p><strong>Background: </strong>Tears and lesions of the rotator cuff are a frequent cause of shoulder pain and disability. Surgical repair of the rotator cuff is a valuable procedure to improve shoulder function and decrease pain. However, there is no consensus concerning the rehabilitation protocol following surgery.</p><p><strong>Objectives: </strong>To review and evaluate current rehabilitation contents and protocols after rotator cuff repair by reviewing the existing scientific literature and providing an overview of the clinical practice of selected German Society of Shoulder and Elbow Surgery e. V. (DVSE) shoulder experts.</p><p><strong>Materials and methods: </strong>A literature search for the years 2004-2014 was conducted in relevant databases and bibliographies including the Guidelines International Network, National Guidelines, PubMed, Cochrane CentralRegister of Controlled Trials, Cochrane Database of Systematic Reviews, and the Physiotherapy Evidence Database. In addition, 63 DVSE experts were contacted via online questionnaire.</p><p><strong>Results: </strong>A total of 17 studies, four reviews and one guideline fulfilled the inclusion criteria. Based on these results and the obtained expert opinions, a four-phase rehabilitation protocol could be developed.</p>","PeriodicalId":43682,"journal":{"name":"Obere Extremitaet-Schulter-Ellenbogen-Hand-Upper Extremity-Shoulder Elbow Hand","volume":"13 1","pages":"45-61"},"PeriodicalIF":0.4,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11678-018-0448-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35902692","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}

{"title":"Rate of avascular necrosis after fracture dislocations of the proximal humerus: Timing of surgery.","authors":"Marc Schnetzke,&nbsp;Julia Bockmeyer,&nbsp;Markus Loew,&nbsp;Stefan Studier-Fischer,&nbsp;Paul-Alfred Grützner,&nbsp;Thorsten Guehring","doi":"10.1007/s11678-018-0452-6","DOIUrl":"https://doi.org/10.1007/s11678-018-0452-6","url":null,"abstract":"<p><strong>Background: </strong>Avascular necrosis (AVN) of the humeral head is a severe complication after proximal humerus fracture dislocations, and leads to a poorer clinical outcome and subsequent revision surgeries. The aim of the current study was to analyze the influence of time to surgery on the AVN rate after locked plating of dislocation fractures of the proximal humerus.</p><p><strong>Patients and methods: </strong>This retrospective study included 30 patients with a mean age of 63 ± 14 years with dislocation fractures of the proximal humerus type B3 or C3 according the AO/OTA classification. The rates of AVN of the humeral head were determined clinically and radiographically. In addition, the clinical outcome was determined using the Constant score (CS), the age- and sex-adjusted Constant score (CS%), Disabilities of the Arm, Shoulder, and Hand (DASH) score, the range of motion, and complication and revision rates. Patients were subdivided into groups of subjects operated on early (≤48 h after trauma) and those with late surgery (>48 h after trauma), and the relative risk (RR) for complications and revisions was determined for both groups.</p><p><strong>Results: </strong>After a mean follow-up of 37 months (range: 12-66 month) the mean CS% was 60 ± 24 and the mean DASH score was 32 ± 24 points. Ten patients (33%) developed a symptomatic AVN, and ten patients underwent revision surgery. Early surgery was performed on 25 patients while five patients underwent late surgery. After late surgery, all five patients developed AVN, and patients had a fivefold increased RR for AVN (<i>p</i> = 0.002) and subsequent associated surgical revision (RR = 3.3, <i>p</i> = 0.031).</p><p><strong>Conclusion: </strong>In fracture dislocations of the proximal humerus, early surgery within 48 h of trauma significantly decreases the risk of AVN and subsequent surgery.</p>","PeriodicalId":43682,"journal":{"name":"Obere Extremitaet-Schulter-Ellenbogen-Hand-Upper Extremity-Shoulder Elbow Hand","volume":"13 4","pages":"273-278"},"PeriodicalIF":0.4,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11678-018-0452-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36778293","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}

{"title":"Reasons for surgical revision after conservatively treated radial head fractures-retrospective study of 70 patients.","authors":"R Nietschke,&nbsp;K J Burkhart,&nbsp;B Hollinger,&nbsp;F I Dehlinger,&nbsp;A Zimmerer,&nbsp;M M Schneider","doi":"10.1007/s11678-018-0456-2","DOIUrl":"https://doi.org/10.1007/s11678-018-0456-2","url":null,"abstract":"<p><strong>Background: </strong>An inadequate clinical outcome after conservatively treated radial head fractures is not uncommon. We analyzed the subjective limitations, objective complaints, and surgical procedures for radial head fractures initially treated conservatively.</p><p><strong>Patients and method: </strong>Between 2007 and 2016, 70 patients (42 men, 28 women) who suffered from fracture sequelae after conservatively treated radial head fractures were examined. Demographic (age, 41.8 years, range, 16-75 years) and clinical data (pain, range of motion, instability) were retrospectively evaluated.</p><p><strong>Results: </strong>The average time to surgery after trauma was 50 months (range, 5-360 months). In 38 cases, radial head fractures were initially treated with immobilization for 3.4 weeks (range, 1-8 weeks). Physiotherapeutic treatment was performed in 39 cases. In only half of the cases was retrospective Mason classification possible: 20 type I, 8 type II, 5 type III, and 2 type IV. Of the 70 patients, 53 had posttraumatic elbow stiffness; 34 had isolated lateral and four patients isolated medial ligament instability. There were eight cases with a combination of lateral and medial ligament instability and 27 cases of elbow stiffness combined with instability. An average of 1.2 (range, 1-4) surgical procedures per patient were performed. In all, 64 patients underwent elbow arthroscopy with arthrolysis and additional treatment depending on other injuries. The range of motion improved on average from preoperative flexion/extension of 131-15-0° to postoperative flexion/extension of 135-5-0° (gain in flexion: 4.2° and extension: 10.6°).</p><p><strong>Conclusion: </strong>Conservative treatment of radial head fractures does not always yield good results. Reasons for a poor outcome include chronic instability, cartilage damage, stiffness, or a combination thereof. Improved outcomes can be achieved via arthroscopic arthrolysis.</p>","PeriodicalId":43682,"journal":{"name":"Obere Extremitaet-Schulter-Ellenbogen-Hand-Upper Extremity-Shoulder Elbow Hand","volume":"13 2","pages":"112-120"},"PeriodicalIF":0.4,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11678-018-0456-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36209557","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}

{"title":"Valgus instability of the elbow: acute and chronic form.","authors":"Laurent Willemot,&nbsp;Filip R Hendrikx,&nbsp;Ann-Maria Byrne,&nbsp;Roger P van Riet","doi":"10.1007/s11678-018-0465-1","DOIUrl":"https://doi.org/10.1007/s11678-018-0465-1","url":null,"abstract":"<p><p>There has been an increase in thrower-specific elbow injuries in recent years. High valgus stresses during the late cocking and acceleration phases of throwing need to be compensated by the flexor pronator muscles as these can exceed the tensile strength of the medial collateral ligament complex. Prevention of injuries is the priority, with a focus on strengthening, reducing throwing frequency, decreasing force, and promoting a technique. The spectrum of thrower injuries ranges from a simple sprain to complete failure of the valgus stabilizing factors. The medial collateral ligament can stretch, leading to posteromedial impingement and radiocapitellar compression forces. This in turn can result in arthrosis and the formation of osteophytes. Ligament failure may eventually occur, making it impossible for the athlete to continue their throwing activities. The outcome of conservative treatment with strengthening, improvement of technique, and relative rest is often disappointing. Direct repair may no longer be possible in these acute-on-chronic injuries and a reconstruction with a tendon graft may be necessary.</p>","PeriodicalId":43682,"journal":{"name":"Obere Extremitaet-Schulter-Ellenbogen-Hand-Upper Extremity-Shoulder Elbow Hand","volume":"13 3","pages":"173-179"},"PeriodicalIF":0.4,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11678-018-0465-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36496152","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}

{"title":"Lower trapezius transfer with semitendinosus tendon augmentation: Indication, technique, results.","authors":"Philippe Valenti,&nbsp;Jean-David Werthel","doi":"10.1007/s11678-018-0495-8","DOIUrl":"https://doi.org/10.1007/s11678-018-0495-8","url":null,"abstract":"<p><strong>Background: </strong>Lower trapezius transfer can restore external rotation in brachial plexus palsies. In some cuff tear arthropathies, there is lack of active external rotation with a preservation of forward elevation. We evaluated the clinical outcomes of a lower trapezius transfer extended with a semitendinosus tendon and fixed to the insertion of the infraspinatus via arthroscopy.</p><p><strong>Methods: </strong>Between 2013 and 2016, we operated on 14 patients (8 men, 6 women; mean age of 62 years, range: 50-70) to reconstruct irreparable posterosuperior rotator cuff tear. A vertical incision of 6 cm following the medial border of the spine was made to harvest the lower trapezius in extension with the semitendinosus tendon. The extension band of the lower trapezius was fixed laterally via arthroscopy on the great tuberosity at the level of the insertion of the infraspinatus. The proximal stump of this extension band was then fixed medially into the muscle of the lower trapezius with the arm in maximum external rotation. Outcomes were evaluated with the Constant-Murley score, simple shoulder test (SST), and subjective shoulder value (SSV).</p><p><strong>Results: </strong>Over a mean follow-up of 24 months (range: 12-36 months), the gain in external rotation with the arm at the side was 24° and 40° in 90° of abduction. The Constant-Murley score improved from 35 to 60 points, the SST from 3.5 to 7.5, the SSV from 30 to 60%, and the pain decreased from 7 to 2 (visual analogue scale, 0-10). Both the lag sign and hornblower sign were negative after this transfer. There were two cases of hematomas, and one was revised because of infection.</p><p><strong>Conclusion: </strong>Lower trapezius transfer is a therapeutic option for irreparable posterosuperior cuff tears with a lack of active external rotation and a good subscapularis. Patients can expect improvements in pain and in active external rotation without any loss of active anterior elevation.</p>","PeriodicalId":43682,"journal":{"name":"Obere Extremitaet-Schulter-Ellenbogen-Hand-Upper Extremity-Shoulder Elbow Hand","volume":"13 4","pages":"261-268"},"PeriodicalIF":0.4,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11678-018-0495-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36778291","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}

{"title":"Nonoperative treatment of five common shoulder injuries: A critical analysis.","authors":"Jonas Pogorzelski,&nbsp;Erik M Fritz,&nbsp;Jonathan A Godin,&nbsp;Andreas B Imhoff,&nbsp;Peter J Millett","doi":"10.1007/s11678-018-0449-1","DOIUrl":"https://doi.org/10.1007/s11678-018-0449-1","url":null,"abstract":"<p><p>Economic pressure highlights the critical need for appropriate diagnosis and treatment of various shoulder pathologies since under-diagnosis and under-treatment can result in increased costs to society in the form of disability and lost production. On the other hand, aggressive over-treatment can further inflate already burgeoning health-care costs and potentially harm the patient. Therefore, it is crucial to distinguish the indications between operative and nonoperative management, especially in common shoulder pathologies such as rotator cuff tears, anterior shoulder instability, biceps tendinitis, lesions to the acromioclavicular joint, and proximal humeral fractures. As a result, a detailed analysis of individual risk factors for potential failures should be performed and treatment should be based on individualized care with consideration given to each patient's particular injury pattern, functional demands, and long-term goals.</p>","PeriodicalId":43682,"journal":{"name":"Obere Extremitaet-Schulter-Ellenbogen-Hand-Upper Extremity-Shoulder Elbow Hand","volume":"13 2","pages":"89-97"},"PeriodicalIF":0.4,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11678-018-0449-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36209555","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}

{"title":"Fractures of the capitellum humeri and their associated injuries.","authors":"Valentin Rausch,&nbsp;Matthias Königshausen,&nbsp;Thomas A Schildhauer,&nbsp;Jan Gessmann,&nbsp;Dominik Seybold","doi":"10.1007/s11678-018-0441-9","DOIUrl":"https://doi.org/10.1007/s11678-018-0441-9","url":null,"abstract":"<p><strong>Objective: </strong>Fractures of the capitellum are rare injuries but are often more complex and of a greater extent than assumed from conventional radiographs. Classification is usually based on their extension in relation to the trochlea the trochlea and on the number of fragments. Information on associated injuries is limited and only reported in small case series. The aim of this retrospective study was to report on our experience with capitellar fractures and their associated injuries.</p><p><strong>Methods: </strong>We retrospectively reviewed all patients treated for fractures of the capitellum humeri at our institute between 2005 and 2017. Fractures were classified according to the Bryan-Morrey and the Dubberley classification and analyzed for their associated injuries depending on the fracture type using the chi-squared test.</p><p><strong>Results: </strong>A total of 27 capitellar fractures were treated at our institute between 2005 and 2017. The median age of the patients was 57 years (range, 4-78) and they were all treated operatively. Associated injuries of the elbow were found in 12 cases (ten radial head fractures, two elbow dislocations, two tears of the radial collateral ligament). The injury mechanism was known for 26 patients (four fell on their outstretched arm, 19 suffered a direct blow to their elbow, two had a traffic accident).</p><p><strong>Conclusion: </strong>The incidence of radial head fractures is high in patients with capitellar fractures. Patients suffering a fracture of the capitellum humeri should be thoroughly examined for such associated injuries since a missed diagnosis can lead to poor outcomes.</p>","PeriodicalId":43682,"journal":{"name":"Obere Extremitaet-Schulter-Ellenbogen-Hand-Upper Extremity-Shoulder Elbow Hand","volume":"13 1","pages":"33-37"},"PeriodicalIF":0.4,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11678-018-0441-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35902235","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}