How to Use Fluoroscopic Imaging to Prevent Intraarticular Screw Perforation During Locked Plating of Proximal Humerus Fractures: A Cadaveric Study.

Objective: Intraarticular screw perforation is a common complication of open reduction and internal fixation of proximal humerus fractures. The purpose of this study was to (1) determine the sensitivity and specificity of the fluoroscopic images used to evaluate whether a screw tip has perforated into the glenohumeral joint, and (2) determine the specific fluoroscopic views that best evaluate screw position in the humeral head.

Methods: Twenty-two proximal humeri in 11 lightly embalmed cadavers were instrumented.

A cost analysis of internal fixation versus nonoperative treatment in adult midshaft clavicle fractures using multiple randomized controlled trials.

Background: To determine whether the cost of nonoperative treatment, including those who require delayed operative treatment, is less than those receiving initial operative management.

Methods: We identified 4 recent randomized controlled trials comparing operative and nonoperative treatment of displaced midshaft clavicle fractures in adults with a minimum of 1-year follow-up. A decision tree was then created from these data using reoperation for those treated with surgery or delayed operative treatment of those treated nonoperatively as end points.