Shoulder kinematics and muscle activity following latissimus dorsi transfer for massive irreparable posterosuperior rotator cuff tears in shoulders with pseudoparalysis.

Background: The aim of this study was to evaluate the thoracohumeral (TH) and glenohumeral (GH) motion with muscle activity after latissimus dorsi transfer (LDT) in a shoulder with a massive irreparable posterosuperior rotator cuff tear (MIRT) and pseudoparalysis compared with the asymptomatic contralateral shoulder (ACS).

Methods: We recruited and evaluated 13 patients after LDT in a shoulder with preoperative clinical pseudoparalysis and an MIRT on magnetic resonance imaging, with a minimum follow-up period of 1 year, and with a Hamada stage of 3 or less. Three-dimensional electromagnetic tracking was used to assess shoulder active range of motion in both the LDT shoulder and the ACS.

Tenotomy or Tenodesis for Tendinopathy of the Long Head of the Biceps Brachii: An Updated Systematic Review and Meta-analysis.

Purpose: The purpose of this meta-analysis was to provide an up-to-date comparison of clinical outcomes of tenotomy and tenodesis in the surgical treatment of long head of the biceps brachii (LHB) tendinopathy.

Methods: A literature search was conducted in EMBASE, Pubmed/Medline and the Cochrane database from January 2000 to May 2020. All studies comparing clinical outcomes between LHB tenotomy and tenodesis were included.

Low level of evidence for all treatment modalities for irreparable posterosuperior rotator cuff tears.

Purpose: This systematic review assesses evidence for improvements in outcome for all reported types of treatment modalities [physical therapy, tenotomy or tenodesis of the long head of the biceps, debridement, partial repair, subacromial spacer, deltoid flap, muscle transfer, rotator cuff advancement, graft interposition, superior capsular reconstruction (SCR), and reversed shoulder arthroplasty (RSA)] used for irreparable posterosuperior rotator cuff tears without glenohumeral osteoarthritis. The primary aim was to be able to inform patients about expectations of the amount of clinical improvement after these treatments.

Methods: A systematic search was conducted in MEDLINE, EMBASE, CINAHL, and Cochrane databases for studies on irreparable posterosuperior rotator cuff lesions without glenohumeral osteoarthritis, published from January 2007 until January 2019, with minimum 2-year follow-up.

Nonoperative Treatment of Closed Extra-Articular Distal Humeral Shaft Fractures in Adults: A Comparison of Functional Bracing and Above-Elbow Casting.

Diaphyseal fractures of the distal humerus have a high rate of union when treated with a functional brace or an above-elbow cast (AEC). This study compares alignment of the humerus and motion of the elbow after functional brace or AEC treatment. One-hundred and five consecutive patients with a closed, extra-articular fracture of the distal humeral diaphysis were identified in the orthopedic trauma databases of 3 hospitals between 2003 and 2012.

Chyluria and chylothorax after posterior selective fusion for adolescent idiopathic scoliosis.

Purpose: To describe and discuss the diagnostic and treatment complexity of lymphatic system complications after scoliosis surgery.

Methods: Surgery for adolescent idiopathic scoliosis is very commonly performed with posterior pedicle screw instrumentation. Complications of the anteriorly based lymphatic system are, therefore, rare.

[Scapula alata following a gunshot injury].

Background: The clinical condition "winged scapula" (scapula alata) is frequently not recognized as such. The accompanying symptoms are often attributed to more frequently occurring shoulder disorders, which can lead to unnecessary surgical procedures.

Case Description: A 41-year-old man was shot during a robbery 3 years ago, resulting in a complete paraplegia from the fourth thoracic vertebra downwards.

Injury patterns and outcomes of open fractures of the proximal ulna do not differ from closed fractures.

Background: The incidence and injury patterns of open fractures of the proximal ulna are poorly elucidated and little evidence exists to guide management.

Questions/purposes: The purpose of this study was to compare the (1) bony injury patterns; (2) range of motion (ROM) and frequency of union; and (3) postoperative complications between open and closed fractures of the proximal ulna.

Methods: Seventy-nine consecutive open fractures of the proximal ulna were identified.

Psychological factors predict disability and pain intensity after skeletal trauma.

Background: The aims of this study were to (1) estimate the prevalence of clinical depression and posttraumatic stress disorder (PTSD) one to two months (Time 1) and five to eight months (Time 2) after musculoskeletal trauma and (2) determine the cross-sectional and longitudinal relationship of psychological variables (depression, PTSD, catastrophic thinking, and pain anxiety) at Time 1 to musculoskeletal disability and pain intensity at Time 1 and Time 2, after accounting for injury characteristics and demographic variables.

Methods: Patients with one or more fractures that had been treated operatively completed measures of depression, PTSD, pain anxiety, catastrophic thinking, musculoskeletal disability (the Short Musculoskeletal Function Assessment [SMFA]), and pain (the Numerical Rating Scale) at rest and during activity at Time 1 (152 patients) and at Time 2 (136 patients). Additional explanatory variables included injury severity, use of opioid pain medication at Time 1, and multiple or single injuries.

Day-to-day variability in spot urine albumin-creatinine ratio.

Background: Accurate quantification of albuminuria is important in the diagnosis and management of chronic kidney disease. The reference test, a timed urinary albumin excretion, is cumbersome and prone to collection errors. Spot urine albumin-creatinine ratio (ACR) is convenient and commonly used, but random day-to-day variability in ACR measurements has not been assessed.

Latissimus dorsi transfer for treatment of irreparable rotator cuff tears.

Massive rotator cuff tendon ruptures are not uncommon in older patients. We propose the transfer of the latissimus dorsi muscle for treatment of irreparable ruptures associated with functional impairment and chronic pain. Five women and 11 men were so treated and reviewed with an average follow-up of 26 months.