Journal of shoulder and elbow arthroplasty最新文献

{"title":"Short to Early-Mid Term Clinical Outcomes and Survival of Pyrocarbon Shoulder Implants: A Systematic Review and Meta-Analysis.","authors":"Edoardo Franceschetti,&nbsp;Pietro Gregori,&nbsp;Giancarlo Giurazza,&nbsp;Giuseppe Papalia,&nbsp;Auro Caraffa,&nbsp;Rocco Papalia","doi":"10.1177/24715492231152143","DOIUrl":"https://doi.org/10.1177/24715492231152143","url":null,"abstract":"<p><strong>Background: </strong>The appropriate surgical treatment option for young and active patients undergoing shoulder arthroplasty for arthritis remains questionable. Pyrolitic carbon (pyrocarbon) has been shown to improve implant longevity and decrease wear when in contact with cartilage or bone. The present systematic review aimed to evaluate clinical and radiological outcomes as well as the survivorship of pyrocarbon shoulder implants.</p><p><strong>Methods: </strong>The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. A systematic search was performed using the MEDLINE, EMBASE and Cochrane Library databases. All the studies dealing with the use of pyrolitic shoulder implants were pooled, data of interest were extracted and statistically analyzed through meta-analysis.</p><p><strong>Results: </strong>A total of 9 studies were included for a total of 477 shoulders treated. The overall mean rate of survival of the implants was 93.4 ± 5.8% and 80% ± 26.5% at 2 years and final follow up, respectively, while resulting 82.4% ± 22.1% and 92.3% ± 3.5% for PISA (pyrocarbon interposition shoulder arthroplasty) and hemi-arthroplasty/hemi-resurfacing, respectively.</p><p><strong>Conclusions: </strong>Pyrolitic carbon shoulder implants showed good survivorship and clinical outcomes at an early to early-midterm follow-up. More studies and better-designed trials are needed in order to enrich the evidence on long-term outcomes and comparison with other shoulder replacement options for young and active patients.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":"7 ","pages":"24715492231152143"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5c/45/10.1177_24715492231152143.PMC9875319.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10586734","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":"Reverse Shoulder Arthroplasty for Patients with Massive Rotator Cuff Tears or Cuff Tear Arthropathies at a Minimum Follow-up of 7 Years.","authors":"Hugues De La Selle,&nbsp;Tristan Lascar,&nbsp;Pascal Clappaz,&nbsp;Edouard Decrette,&nbsp;Floris van Rooij,&nbsp;Mo Saffarini,&nbsp;Laurent Obert","doi":"10.1177/24715492231157659","DOIUrl":"https://doi.org/10.1177/24715492231157659","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate indications and factors that influence long-term clinical outcomes and revision rates for reverse shoulder arthroplasty (RSA) in shoulders with irreparable massive rotator cuff tears (mRCTs) or cuff tear arthropathies (CTAs).</p><p><strong>Methods: </strong>The authors retrospectively evaluated a consecutive series of shoulders with no fracture sequelae that underwent primary RSA between 2011 and 2013. Independent observers collected demographic data, surgical techniques, and implant types, as well as primary outcome measures such as American Shoulder and Elbow Society (ASES) score and Constant score (CS).</p><p><strong>Study design: </strong>Case series, level IV.</p><p><strong>Results: </strong>From the initial series of 123 patients that underwent RSA, 29 patients died (24%) for reasons unrelated to the shoulder arthroplasty, 11 were lost to follow-up (9%), and 4 required revision surgery (3%). The final cohort of 79 patients comprised 55 women (70%), and 24 men (30%), aged 72.7 ± 7.0. At a final follow-up of 8.9 ± 0.6 years (range: 7.4-10.3) the absolute CS was 59.0 ± 16.2, the age-/sex-adjusted CS was 76.6 ± 41.2, and ASES was 77.1 ± 20.3. Univariable analysis revealed no associations for absolute CS, but revealed that age-/sex-adjusted CS was significantly lower for patients with high blood pressure (β = -15.8, p = .025).</p><p><strong>Conclusions: </strong>At a minimum follow-up of 7.4 years, the absolute CS was 59.0 ± 16.2, the age-/sex-adjusted CS was 87.4 ± 24.1 and ASES was 77.1 ± 20.3. When stratifying the outcomes of RSA by indication, there were no significant differences in patients with mRCTs versus CTA in terms of absolute CS, age-/sex-adjusted CS, and ASES. Univariable analysis revealed no association with absolute and age-/sex-adjusted CS for type of indication or surgical approach.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":"7 ","pages":"24715492231157659"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/90/02/10.1177_24715492231157659.PMC9941602.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10830848","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":"A Systematic Review of Shoulder Arthroplasty in Parkinson's Disease.","authors":"Patrick J Carroll,&nbsp;Ujash Sheth,&nbsp;Patrick Henry","doi":"10.1177/24715492231162302","DOIUrl":"https://doi.org/10.1177/24715492231162302","url":null,"abstract":"<p><strong>Background: </strong>Parkinson's disease is a degenerative neurological disorder that can cause both motor and nonmotor symptoms. Motor symptoms are associated with increasing the patient's falls risk. Shoulder arthroplasty surgery in this patient cohort is associated with more complications than non-Parkinsonian patients. We sought to identify any increase in complications associated with this patient cohort and any surgical considerations that ought to be taken in light of their disease process.</p><p><strong>Methods: </strong>We performed a systematic review of articles using PubMed, MEDLINE, Cochrane Central, and Google Scholar. All studies which included any shoulder arthroplasty surgery for patients with Parkinson's disease were included.</p><p><strong>Results: </strong>Complication rates were higher in patients with Parkinson's disease than in the normal arthroplasty cohort in all studies. There was significant heterogeneity between all 8 studies included in the systematic review. Complication rates ranged from 26% to 100%. Complications included subluxation, loosening, malunion, nonunion, scapular notching, stiffness, fracture, baseplate failure, dislocation, and infection. Reoperation rates ranged from 5% to 29%.</p><p><strong>Conclusion: </strong>Compared to patients without Parkinson's disease undergoing shoulder arthroplasty, patients with Parkinson's disease achieved similar reductions in pain but inferior clinical function. The range of movement was less predictable, and complication rates were significantly higher in Parkinson's disease patients. This study will aid the surgeon and patient regarding surgical intervention, informed consent, and allow the surgeon to anticipate potential complications of shoulder arthroplasty in this patient cohort.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":"7 ","pages":"24715492231162302"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10014981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9200053","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":"Post-operative Baseplate Radiographic Evaluation Using Routine pre-Operative CT","authors":"Daniel J Song, Nathan S Lanham, Rifat Ahmed, Michael L Knudsen, William N Levine, Charles M Jobin","doi":"10.1177/24715492231211122","DOIUrl":"https://doi.org/10.1177/24715492231211122","url":null,"abstract":"Background There is limited data evaluating post-operative component position and fixation in reverse shoulder arthroplasty (RSA). Therefore, the purpose of this study was to evaluate baseplate position and fixation using routine pre-operative CT and post-operative radiographs. Methods A retrospective analysis of a series consecutive patient who underwent primary RSA was performed. Pre-operative and post-operative glenoid retroversion and inclination were measured using radiographs aligned with projection silhouettes of 3D scapula models in Mimics software. Baseplate retroversion and inclination were measured followed by evaluating for the presence of radiolucent lines (RLLs). Results Twenty-four patients met inclusion criteria. The average age was 73.4 ± 10.7 years (range, 45-89 years). Radiographic follow-up was 3.4 ± 1.3 years. Post-operative glenoid baseplate retroversion was 2 ± 10 degrees (range, 30 to −9). Post-operative glenoid baseplate inclination was 3.8 ± 9.1 (range, −13 to 19). Five (21%) RSAs had baseplate retroversion &gt;10 degrees. Follow-up radiographs revealed no RLLs around the baseplate, central post, or peripheral screws in any patient. Conclusions Pre-operative CT imaging enabled evaluation of baseplate component placement and fixation on post-operative radiographs. Baseplate version was within 10 degrees of neutral in 79% (19/24) of patients. No RLLs or loss of fixation were found in any cases. Level of Evidence Level IV: Diagnostic Study.","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135508724","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}

{"title":"Increasing Rate of Shoulder Arthroplasty for Geriatric Proximal Humerus Fractures in the United States, 2010-2019.","authors":"Brendan Y Shi,&nbsp;Alexander Upfill-Brown,&nbsp;Benjamin V Kelley,&nbsp;Dane J Brodke,&nbsp;Erik N Mayer,&nbsp;Sai K Devana,&nbsp;Thomas J Kremen,&nbsp;Christopher Lee","doi":"10.1177/24715492221137186","DOIUrl":"https://doi.org/10.1177/24715492221137186","url":null,"abstract":"<p><strong>Introduction: </strong>The two historically dominant surgical options for displaced geriatric proximal humerus (PHFx) fractures are open reduction internal fixation (ORIF) and hemiarthroplasty (HA). However, shoulder arthroplasty (SA), predominantly in the form of reverse total shoulder arthroplasty (RTSA), has emerged as an attractive treatment option. We aim to compare the utilization trends, complications, and costs associated with surgical management of geriatric proximal humerus fractures (PHFs) between 2010 and 2019. We hypothesized that 1) the proportion of patients undergoing SA would increase over time, 2) the short-term complication rate in patients undergoing SA would decline over time, and 3) hospital related costs would decline for SA patients over time.</p><p><strong>Patients and methods: </strong>The National Inpatient Sample was queried from 2010 to 2019 to identify all PHFx in patients aged 65 or older that underwent ORIF, SA, or HA. Multivariable regression was used to evaluate differences between fixation methods regarding health care utilization metrics, hospital costs, and index hospital complications. The primary outcome of interest was the method of surgical management utilized in the treatment of geriatric PHFs, and secondary outcomes of interest included hospitalization cost, length of stay (LOS), discharge destination and index hospitalization complications.</p><p><strong>Results: </strong>A total of 105 886 geriatric patients that underwent surgical management of PHFx were identified. While the proportion undergoing ORIF decreased from 59% to 29%, the proportion undergoing SA increased from 9% to 67%. Hospital costs decreased over time for patients treated with SA and increased for those treated with ORIF. Compared to ORIF, SA was associated with higher cost, decreased length of stay, and lower mortality and complication rates.</p><p><strong>Conclusion: </strong>Over the last decade, SA has become the most common surgical treatment modality performed for geriatric PHFx. Index hospital complications are reduced in SA patients compared to ORIF patients, driven largely by a lower rate of blood transfusion. Although costs are decreasing and average length of stay is now lower in SA patients compared to ORIF patients, SA remains associated with higher hospital costs overall.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":" ","pages":"24715492221137186"},"PeriodicalIF":0.0,"publicationDate":"2022-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b1/f5/10.1177_24715492221137186.PMC9677166.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40702409","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":"Anatomic and Reverse Stemless Shoulder Arthroplasty: Functional and Radiological Evaluation.","authors":"Mohamed S Galhoum,&nbsp;Ahmed A Elsheikh,&nbsp;Amanda Wood,&nbsp;Qi Yin,&nbsp;Simon P Frostick","doi":"10.1177/24715492221118765","DOIUrl":"https://doi.org/10.1177/24715492221118765","url":null,"abstract":"<p><strong>Background: </strong>Stemless shoulder arthroplasty was developed to restore the glenohumeral centre of rotation without violation of the humeral shaft. It allows the preservation of humeral bone stock. Complications related to stem malalignment and periprosthetic fractures can be avoided.</p><p><strong>Patient and methods: </strong>This is a prospective observational study that reports outcomes of 46 patients who received stemless shoulder arthroplasty \"Comprehensive Nano implant ®.\" The series includes Group (A): 30 anatomic and one hemiarthroplasty. Group (B): 15 reverse stemless replacement. Functional outcomes were assessed by visual analog score (VAS), satisfaction, range motion, Constant score, and American Shoulder and Elbow Score (ASES).</p><p><strong>Results: </strong>The mean follow-up was 40.4  ±  12 months (range, 24 months to 60 months). Group (A): VAS and satisfaction improved by 5.3 and 67.5 points respectively. Constant score significantly improved from 28.5  ±  14.5 to 62.5  ±  23 P = <0.001. The radiological assessment showed the mean centre of rotation (COR) deviation was 2.8  ±  1.9 mm. 27% of patients have COR discrepancy of more than 4 mm. In Group (B), patients reported a significant improvement in VAS, Satisfaction, and ASES P  =  0.002, 0.002, and 0.003, respectively.Complications include shoulder pain with progressive loss of movements, aseptic loosening early subscapularis rupture, glenohumeral dislocations, and humeral component migration.</p><p><strong>Conclusion: </strong>Anatomic Stemless total shoulder arthroplasty offers acceptable results and improvement of overall functional outcomes.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":" ","pages":"24715492221118765"},"PeriodicalIF":0.0,"publicationDate":"2022-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ad/33/10.1177_24715492221118765.PMC9411739.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33444969","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":"Iatrogenic Injury to the Suprascapular Nerve Following Reverse Shoulder Arthroplasty: A Case Report.","authors":"Jason Long,&nbsp;Jordan Liles,&nbsp;Oke Anakwenze,&nbsp;Christopher Klifto","doi":"10.1177/24715492221103518","DOIUrl":"https://doi.org/10.1177/24715492221103518","url":null,"abstract":"<p><p>The location and course of the suprascapular nerve (SSN) to the glenohumeral joint places this nerve at risk when operating around the shoulder. Iatrogenic injury to the suprascapular nerve has been described in several different procedures including, rotator cuff repairs, posterior capsulorraphy, Bankart repairs, SLAP lesion repairs, Latarjet procedures, and shoulder arthroplasty. We present a case of iatrogenic suprascapular nerve injury due to superior glenoid baseplate screw placement following primary reverse shoulder arthroplasty (RSA), a novel approach to diagnosis of nerve injury, and treatment.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":" ","pages":"24715492221103518"},"PeriodicalIF":0.0,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fb/f6/10.1177_24715492221103518.PMC9386855.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40716767","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":"Specific Design of a Press Fit Humeral Stem Provides low Stress Shielding in Reverse Shoulder Arthroplasty at minimum 5 Years FU.","authors":"Geoffroy Nourissat,&nbsp;Simon Corsia,&nbsp;Howard W Harris,&nbsp;Pierre-Alban Bouché","doi":"10.1177/24715492221112543","DOIUrl":"https://doi.org/10.1177/24715492221112543","url":null,"abstract":"<p><p>Press fit fixation is becoming more popular in RSA to preserve, in theory, bone capital. Several studies report that bone resorption can be very high around humeral stems depending on their size, shape and mode of fixation. The aim of the current study is to mid-term follow-up clinical and radiological result of a press fit ovoid regular stem RSA in non acute trauma cases.</p><p><strong>Materials and methods: </strong>We performed a retrospective monocentric study of patients continuously implanted with the Humeris® stem RSA for degenerative change of the shoulder. Nineteen shoulders, in eighteen patients (74.6 y.o (from 69 to 81)), were available at minimum five years follow-up.</p><p><strong>Results: </strong>The mean final adjusted Constant score was 111.9 (65 to 130), and the mean ASES score was 49.82 (10 to 60). Humeral resorption was observed in 21% of cases. We found a statistically significant (<i>p</i> = .014) lower adjusted Constant score in patients presenting with resorption on post-operative X-rays compared to those without resorption (115.6 vs. 98.25). Half cases of patients presenting a resorption underwent L'Episcopo procedure during surgery. Humeral resorption occurs the first year after surgery and do not increase even 8 years after surgery. Analysis demonstrated no correlation between the value of filling ratios and bone resorption.</p><p><strong>Conclusion: </strong>The current study confirms a low rate of stress shielding around the studied stem, with rare bony resorption and no osteopenia around the humeral stem. This study highlights the importance of choosing the appropriate proximal shape and length of the humeral stem for press fit fixation in RSA.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":" ","pages":"24715492221112543"},"PeriodicalIF":0.0,"publicationDate":"2022-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c1/d9/10.1177_24715492221112543.PMC9272197.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40503485","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":"A Biomechanical Analysis of Shoulder Muscle Excursions During Abduction, After the Treatment of Massive Irreparable Rotator Cuff Tears Using Superior Capsular Reconstruction (SCR), Bursal Acromial Reconstruction (BAR), and SCR with BAR.","authors":"Michael Labib,&nbsp;Farid Amirouche,&nbsp;Sonia Pradhan,&nbsp;Aimee Bobko,&nbsp;Jason Koh","doi":"10.1177/24715492221109001","DOIUrl":"https://doi.org/10.1177/24715492221109001","url":null,"abstract":"<p><strong>Introduction: </strong>Current understanding of the biomechanical effects of treatment options for irreparable rotator cuff (RC) tears is lacking. This study examines how shoulder muscle lengths and excursions are affected by superior capsular reconstruction (SCR), bursal acromial reconstruction (BAR), and SCR with BAR, following a complete supraspinatus tear.</p><p><strong>Method: </strong>Six fresh-frozen cadaveric shoulders were examined. Deltoid and RC muscle lengths were measured at 0, 30, 45, 60, and 90° of shoulder abduction under six conditions: (1) intact, (2) partially torn supraspinatus, (3) completely torn supraspinatus, (4) SCR, (5) SCR with BAR, and (6) BAR. Muscle excursions from 0-90° of abduction were then calculated.</p><p><strong>Results: </strong>Subscapularis muscle lengths after SCR, BAR, and SCR with BAR were significantly greater (post-hoc Tukey HSD test; <i>p </i>< .01) compared to the other conditions. Supraspinatus, infraspinatus, teres minor, and deltoid lengths were not significantly different (ANOVA test; <i>p </i>> .01) between the conditions. All muscle excursions remained statistically similar between the conditions (ANOVA test; <i>p </i>> .01).</p><p><strong>Conclusion: </strong>These findings demonstrate that the use of SCR, BAR, or SCR with BAR for a complete supraspinatus tear, may increase subscapularis muscle length while maintaining other shoulder muscle lengths. An increase in subscapularis length can allow for more effective subscapularis muscle strengthening and increased compensatory function in the long term. Additionally, all shoulder muscle excursions are preserved after partial or complete supraspinatus tears and after SCR, BAR, or SCR with BAR. Therefore, these surgical treatments can initially normalize shoulder muscle function during 0-90° of abduction, after an irreparable supraspinatus tear.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":" ","pages":"24715492221109001"},"PeriodicalIF":0.0,"publicationDate":"2022-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/41/e7/10.1177_24715492221109001.PMC9240589.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40579669","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":"Long-stemmed Hemiarthroplasty with Cerclage Wiring for the Treatment of Split-Head Fractures of the Proximal Humerus with Metaphyseal Extension: A Report of 2 Cases.","authors":"A Panagopoulos,&nbsp;K Solou,&nbsp;A Kouzelis,&nbsp;S Papagiannis,&nbsp;I Tatani,&nbsp;Z T Kokkalis","doi":"10.1177/24715492221108285","DOIUrl":"https://doi.org/10.1177/24715492221108285","url":null,"abstract":"<p><strong>Introduction: </strong>Complex fractures of the proximal humerus with splitting-head component and metaphyseal propagation are very rare injuries that are difficult to treat. Preservation of the humeral head is always considered except in cases with severe comminution and compromised vascularity where shoulder hemiarthroplasty is an alternative option.</p><p><strong>Case report: </strong>We present two male patients, 57- and 62-years-old who sustained such a complex proximal humeral fracture after a high-energy injury. They both managed with long-stemmed shoulder hemiarthroplasty and cerclage wiring of the metaphyseal area. They both demonstrated good clinical and radiological outcome at 32- and 24-months postoperatively.</p><p><strong>Conclusion: </strong>We report the functional and radiological outcomes of two cases of a rare proximal humeral fracture's pattern - combination of splitting-head and metaphyseal comminution - that were managed with long-stemmed hemiarthroplasty and cerclage wire and demonstrated good midterm clinical outcome.</p>","PeriodicalId":73942,"journal":{"name":"Journal of shoulder and elbow arthroplasty","volume":" ","pages":"24715492221108285"},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2e/04/10.1177_24715492221108285.PMC9203719.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40012598","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}