Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Shoulder 154 articles

Articles

Surgical Technique: A Minimally Invasive Approach to Scapula Neck and Body Fractures

Erich M. Gauger MD, Peter A. Cole MD

The approach of choice for open reduction internal fixation of displaced fractures involving the scapula neck or body is from posterior. We describe a new approach that minimizes the surgical insult to the soft tissues but preserves the ability to restore alignment and stability to the fracture.

Endosteal Strut Augment Reduces Complications Associated With Proximal Humeral Locking Plates

Andrew S. Neviaser MD, Carolyn M. Hettrich MD, Brandon S. Beamer MD, Joshua S. Dines MD, Dean G. Lorich MD

Locking-plate technology has renewed interest in plate fixation for treating proximal humerus fractures. Complications associated with these devices, including loss of reduction, screw cutout, and intra-articular penetration, are frequent. Establishing a second column of support may reduce complications and improve clinical outcome scores.

Thromboembolic Events Are Uncommon After Open Treatment of Proximal Humerus Fractures Using Aspirin and Compression Devices

Benjamin J. Widmer MD, Rocco Bassora MD, William J. Warrender BS, Joseph A. Abboud MD

Thromboembolic phenomena have long been recognized as a major cause of morbidity and mortality in hospitalized patients, especially those undergoing reconstructive surgery. We have been empirically treating patients with aspirin, early ambulation, and mechanoprophylaxis after operative management of proximal humerus fractures. However, we have not established the incidence of postoperative deep vein thrombosis and pulmonary embolism in this population.

Locked Plating of Proximal Humeral Fractures: Is Function Affected by Age, Time, and Fracture Patterns?

Clifford B. Jones MD, FACS, Debra L. Sietsema PhD, Daniel K. Williams MD

Locking plate fixation of proximal humeral fractures improves biomechanical stability. It has expanded the indications of traditional open reduction internal fixation and become increasingly common for treating unstable, displaced proximal humeral fractures. Despite improved stability it is unclear whether these improve function and if so for which patients.

Shoulder Arthroplasty for Fracture: Does a Fracture-specific Stem Make a Difference?

Sumant G. Krishnan MD, John R. Reineck MD, Philip D. Bennion MD, Leanne Feher BS, Wayne Z. Burkhead MD

Arthroplasty for shoulder fractures is a technically challenging and unpredictable procedure and its use is controversial.

Function Plateaus by One Year in Patients With Surgically Treated Displaced Midshaft Clavicle Fractures

Laura A. Schemitsch, Emil H. Schemitsch MD, FRCS(C), Christian Veillette MD, MSc, FRCS(C), Rad Zdero PhD, Michael D. McKee MD, FRCS(C)

Based on short-term (1 year or less) followup, primary fixation of displaced midshaft clavicle fractures reportedly results in better function compared with that reported for nonoperative methods. Whether better function persists beyond 1 year is unclear.

A Radiographic Classification of Massive Rotator Cuff Tear Arthritis

Kazutoshi Hamada MD, PhD, Kaoru Yamanaka MD, PhD, Yoshiyasu Uchiyama MD, PhD, Takahiko Mikasa MD, Motohiko Mikasa MD, PhD

In 1990, Hamada et al. radiographically classified massive rotator cuff tears into five grades. Walch et al. subsequently subdivided Grade 4 to reflect the presence/absence of subacromial arthritis and emphasize glenohumeral arthritis as a characteristic of Grade 4.

Scapula Fractures After Reverse Total Shoulder Arthroplasty: Classification and Treatment

Lynn A. Crosby MD, Adam Hamilton MD, Todd Twiss MD

Reverse total shoulder arthroplasty (RTSA) implants have been developed to treat patients with deficient rotator cuffs. The nature of this procedure’s complications and how these complications should be managed continues to evolve. Fractures of the scapula after RTSA have been described, but the incidence and best methods of treatment are unclear.

Precontoured Plating of Clavicle Fractures: Decreased Hardware-related Complications?

Corinne VanBeek MD, Karen J. Boselli MD, Edwin R. Cadet MD, Christopher S. Ahmad MD, William N. Levine MD

Operative treatment of displaced midshaft clavicle fractures reportedly decreases the risk of symptomatic malunion, nonunion, and residual shoulder disability. Plating these fractures, however, may trade these complications for hardware-related problems. Low-profile anatomically precontoured plates may reduce the rates of plate prominence and hardware removal.