Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Shoulder 160 articles

Articles

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.

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.