Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Shoulder 160 articles

Articles

Is Reverse Shoulder Arthroplasty Appropriate for the Treatment of Fractures in the Older Patient?: Early Observations

Christopher Lenarz MD, Yousef Shishani MD, Christopher McCrum, Robert J. Nowinski DO, T. Bradley Edwards MD, Reuben Gobezie MD

The treatment of comminuted proximal humerus fractures in older patients is challenging. Variable values of functional outcomes scores, ROMs, patient satisfaction, and bony healing have been reported with conventional techniques, including open reduction and internal fixation, percutaneous pinning, and hemiarthroplasty. Another alternative is reverse total shoulder arthroplasty, although it is unclear whether this provides better ROM or function.

Case Report: Floating-clavicle from the 17th Century: The Oldest Case?

Josep Liria MD, Susana Carrascal MS, Mariano Fernández-Fairén PhD, Assumpció Malgosa PhD, Albert Isidro PhD

Dislocation of both ends of the clavicle is a rare traumatic lesion and the mechanism of the lesion is usually related to major trauma. The first case was described in 1831.

Analysis of Operative versus Nonoperative Treatment of Displaced Scapular Fractures

Clifford B. Jones MD, FACS, Debra L. Sietsema PhD

Operative indications for displaced scapular fractures have been controversial and inconsistent. Surgeons have been dissuaded to operate on these uncommon fractures because of the complex anatomy, approaches, and fracture patterns. It is unclear whether return to work, pain, or complications differ in patients with scapular fractures treated nonoperatively or operatively.

Precontoured Superior Locked Plating of Distal Clavicle Fractures: A New Strategy

Jaron R. Andersen MD, Matt P. Willis MD, Ryan Nelson DO, Mark A. Mighell MD

The ideal management of fractures of the distal third of the clavicle remains a topic of debate. Locked plating is a new treatment method but is not yet widely studied.

Is Selective Arthroscopic Revision Beneficial for Treating Recurrent Anterior Shoulder Instability?

Guillermo Arce MD, Francisco Arcuri MD, Diego Ferro MD, Enrique Pereira MD

Surgeons have traditionally treated recurrent shoulder dislocation by open methods. With the advent of arthroscopic repair techniques some surgeons reported higher recurrence rates than with open methods but some of those reports included patients with a variety of problems, including bone loss and those continuing in contact sports. It is unclear whether recurrence rates would be higher in patients without bone loss and those willing to forego contact sports.

Do Patients With Traumatic Recurrent Anterior Shoulder Instability Have Generalized Joint Laxity?

Maximiliano Ranalletta MD, Santiago Bongiovanni MD, Federico Suarez MD, Juan Manuel Lopez Ovenza MD, Gaston Maignon MD

A number of studies suggest a relationship between generalized joint laxity (GJL) and increased risk of some musculoskeletal injuries. However, there are conflicting data on the association between GJL and traumatic recurrent shoulder instability (RSI).

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.