Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Shoulder 156 articles

Articles

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.

Three- and Four-part Fractures Have Poorer Function Than One-part Proximal Humerus Fractures

Crispin Ong MD, Christopher Bechtel BA, Michael Walsh PhD, Joseph D. Zuckerman MD, Kenneth A. Egol MD

Locking plates have become a commonly used fixation device in the operative treatment of three- and four-part proximal humerus fractures. Examining function in patients treated nonoperatively and operatively should help determine whether and when surgery is appropriate in these difficult-to-treat fractures.

Surgical Technique: The Anterosuperior Approach for Reverse Shoulder Arthroplasty

Daniel Molé MD, Frank Wein MD, Charles Dézaly MD, Philippe Valenti MD, François Sirveaux MD

The anterosuperior approach used for reverse shoulder arthroplasty is an intermediate between the transacromial approach originally proposed by Paul Grammont and the anterosuperior approach described by D. B. Mackenzie for shoulder arthroplasty. As an alternative to the deltopectoral approach, the anterosuperior approach has the advantages of simplicity and postoperative stability.

Can Complications of Titanium Elastic Nailing With End Cap for Clavicular Fractures Be Reduced?

Arno Frigg MD, Paavo Rillmann MD, Christian Ryf MD, Richard Glaab MD, Lisa Reissner MD

We found treatment of clavicular midshaft fractures using titanium elastic nails (TENs) in combination with postoperative free ROM was associated with a complication rate of 78%. The use of end caps reduced the rate to 60%, which we still considered unacceptably high. Thus, we explored an alternative approach.

Do Less Medialized Reverse Shoulder Prostheses Increase Motion and Reduce Notching?

Philippe Valenti MD, Philippe Sauzières MD, Denis Katz MD, Ibrahim Kalouche MD, Alexandre Sahin Kilinc MD

Cuff tear arthropathy is the primary indication for total reverse shoulder arthroplasty. In patients with pseudoparalytic shoulders secondary to irreparable rotator cuff tear, reverse shoulder arthroplasty allows restoration of active anterior elevation and painless shoulder. High rates of glenoid notching have also been reported. We designed a new reverse shoulder arthroplasty with a center of rotation more lateral than the Delta prosthesis to address this problem.

Reverse Prostheses in Arthropathies With Cuff Tear: Are Survivorship and Function Maintained Over Time?

Luc Favard MD, Christophe Levigne MD, Cécile Nerot MD, Christian Gerber MD, Lieven Wilde MD, Daniel Mole MD

The use of reverse shoulder arthroplasty has considerably increased since first introduced in 1985. Despite demonstrating early improvement of function and pain, there is limited information regarding the durability and longer-term outcomes of this prosthesis.

A Reliable Radiographic Measurement Technique for Extra-articular Scapular Fractures

Jack Anavian MD, Joseph M. Conflitti MD, Gaurav Khanna MD, S. Trent Guthrie MD, Peter A. Cole MD

Currently, neither well-defined nor standardized measurement techniques exist for assessing deformity of extra-articular scapular fractures. To properly evaluate these injuries, compare observations across studies, and make clinical decisions, a validated measurement protocol for evaluating scapular fractures is needed.

A Complication-based Learning Curve From 200 Reverse Shoulder Arthroplasties

Laurence B. Kempton MD, Elizabeth Ankerson BS, J. Michael Wiater MD

Reported early complication rates in reverse total shoulder arthroplasty have widely varied from 0% to 75% in part due to a lack of standard inclusion criteria. In addition, it is unclear whether revision arthroplasty is associated with a higher rate of complications than primary arthroplasty.

Bony Increased-offset Reversed Shoulder Arthroplasty: Minimizing Scapular Impingement While Maximizing Glenoid Fixation

Pascal Boileau MD, Grégory Moineau MD, Yannick Roussanne MD, Kieran O’Shea FRCSI

Scapular notching, prosthetic instability, limited shoulder rotation and loss of shoulder contour are associated with conventional medialized design reverse shoulder arthroplasty. Prosthetic (ie, metallic) lateralization increases torque at the baseplate-glenoid interface potentially leading to failure.