The Natural History of Full-Thickness Rotator Cuff Tears in Randomized Controlled Trials: A Systematic Review and Meta-analysis.

Background: Rotator cuff tears are the most common tendon injury in the adult population, resulting in substantial morbidity. The optimum management for these patients is not known.

Purpose: To assess the overall treatment response to all interventions in full-thickness rotator cuff tears among patients enrolled in randomized clinical trials.

Distal Biceps and Triceps Injuries.

Background: Rupture of the distal biceps and triceps tendons are relatively uncommon injuries typically occurring in middle-aged males as a result of eccentric loading of the tendon.

Methods: A literature search was performed and the authors' personal experiences reported.

Results: This review discusses the diagnosis, indications and guidelines for management of these injuries and provides a description of the authors' preferred operative techniques.

Distal Humeral Fractures-Current Concepts.

Background: Distal humerus fractures constitute 2% of all fractures in the adult population. Although historically, these injuries have been treated non-operatively, advances in implant design and surgical technique have led to improved outcomes following operative fixation.

Methods: A literature search was performed and the authors' personal experiences are reported.

Current concepts in the management of recurrent anterior gleno-humeral joint instability with bone loss.

The management of recurrent anterior gleno-humeral joint instability is challenging in the presence of bone loss. It is often seen in young athletic patients and dislocations related to epileptic seizures and may involve glenoid bone deficiency, humeral bone deficiency or combined bipolar lesions. It is critical to accurately identify and assess the amount and position of bone loss in order to select the most appropriate treatment and reduce the risk of recurrent instability after surgery.

Microvascular blood flow in normal and pathologic rotator cuffs.

Background: Microvascular blood flow in the tendon plays an important role in the pathogenesis of rotator cuff abnormalities. There are conflicting views about the presence of a hypovascular zone in the supraspinatus tendon. Besides, no studies have looked at the pattern of blood flow around a partial-thickness tear.

The frequency and risk factors for subsequent surgery after a simple elbow dislocation.

Introduction: Simple elbow dislocations treated by closed reduction are thought to result in a satisfactory return of function in most patients. Little, however, is known about how many patients ultimately proceed to subsequent surgical treatment due to the low patient numbers and significant loss to follow-up in the current literature. The purpose of this study was to establish the rate of and risk factors for subsequent surgical treatment after closed reduction of a simple elbow dislocation at a population level.

The epidemiology of closed reduction for simple elbow dislocations and the incidence of early subsequent open reduction.

Background: Simple elbow dislocations are often treated with closed reduction (CR); however, the rate of CR failure and factors that may predict failure have been largely underinvestigated. The objectives of this study were (1) to determine the incidence of elbow dislocations treated by CR in a universal health care system and (2) to identify patient characteristics associated with failed CR, defined as the subsequent need for open reduction.

Methods: Patients ≥16 years old who underwent elbow CR by a physician between 1994 and 2010 were identified from administrative databases.

A review of management options for proximal humeral fractures.

Proximal humeral fractures are common and although the majority can be managed non-operatively, the optimal treatment of displaced or complex fractures remains controversial. Non-operative treatment is typically selected for minimally displaced fractures where union rates are high and good or excellent outcomes can be expected in approximately 80% of cases. The aims of surgical fixation are to restore articular surface congruency, alignment and the relationship between the tuberosities and the humeral head.

Mid-term results of Copeland shoulder cementless surface replacement arthroplasty from an independent centre.

Background: The present study reports our experience of Copeland shoulder cementless surface replacement arthroplasty (CSRA) and whether glenoid microfracture influences the progression of glenoid erosion.

Methods: One-hundred-and-twelve CSRAs were performed in 101 patients between 2002 and 2007. Eighty-three patients were alive at the median follow-up time of 72 months (range 9 to 121 months; interquartile range 46 to 93 months).

Factors that influence the choice to undergo surgery for shoulder and elbow conditions.

Background: Knowledge of the factors that influence the willingness of patients considering elective orthopaedic surgery is essential for patient-centered care. To date, however, these factors remain undefined in the orthopaedic population with shoulder and elbow disorders.

Questions/purposes: In a cohort of patients seeking surgical consultation for shoulder or elbow conditions, we sought to identify factors that influenced the willingness and decision to undergo surgery.

Accuracy of abduction-external rotation MRA versus standard MRA in the diagnosis of intra-articular shoulder pathology.

The goal of this study was to compare the accuracy of abduction-external rotation magnetic resonance arthrography (ABERMRA) with standard MRA in the diagnosis of intra-articular shoulder pathology.One hundred three consecutive patients undergoing preoperative direct MRA and subsequent arthroscopic examination were included in the study. Seventy-eight patients underwent standard MRA and 25 underwent ABERMRA.

Treatment of deformational plagiocephaly and torticollis using a weight distribution ring: a report of three cases.

Plagiocephaly, from the Greek 'plagios' (slanting) and 'kephale' (head), refers to a condition of an infant's head deformation by forces acting upon a malleable cranium. Marked plagiocephaly causes distress and stigma towards the baby and their family and has knock-on effects with craniofacial abnormalities, visual-field defects and delay in motor skills, and may also cause developmental difficulties. Current treatment methods have multiple drawbacks.

Distal femoral varus osteotomy for lateral compartment osteoarthritis in the valgus knee. A systematic review of the literature.

The primary objectives of this systematic review were to define the indications, functional outcomes, survivorship and complications associated with distal femoral varus osteotomy (DFVO).Cumulative survival with arthroplasty as the endpoint ranged from 64 to 82% at 10 years, and 45% at 15 years. The mean pre-operative HSS score ranged from 46 to 65 and this improved at latest follow up to means of between 72 and 88.

Partial-thickness articular surface rotator cuff tears in patients over the age of 35: Etiology and intra-articular associations.

Purpose: Partial-thickness articular-sided rotator cuff tears have a multifactorial etiology and are associated with degeneration of the tendon. They are often described as an injury of the young athlete, although they are also found in the older population. The aim of this study was to investigate the frequency and associations of partial-thickness articular-sided tears in patients over the age of 35 years.

Computer-simulation training for knee and shoulder arthroscopic surgery.

Purpose: The aim of this systematic review was to identify the evidence as to whether computer simulators are able to teach and assess arthroscopic skills in a valid and reliable manner and whether these skills can be transferred to the operating theater.

Methods: Multiple databases were searched by use of strict eligibility criteria to obtain the best evidence available. The studies were critically appraised by independent reviewers with narrative data synthesis.

Dynamic and static external fixation for distal radius fractures--a systematic review.

Introduction: External fixation of distal radius fractures may be static (wrist-bridging) or dynamic (wrist-bridging with mobile hinge or non-bridging). The aim of this systematic review is to investigate the effectiveness of different methods of external fixation for unstable distal radius fractures.

Methods: A Medline database search was performed with strict eligibility criteria to obtain the highest quality evidence from meta-analyses, RCTs and comparative studies.

Reconstruction of humeral head defect for locked posterior shoulder dislocation.

Locked posterior shoulder dislocation is a rare injury and is often missed on examination, usually due to inadequate imaging and potentially resulting in significant loss of shoulder function. An important feature of the physical examination is identification of the patient's inability to externally rotate their arm. These injuries are associated with defects in the humeral head articular surface, also known as reverse Hill-Sachs lesions.

Operative versus nonoperative treatment of acute undisplaced and minimally displaced scaphoid waist fractures--a systematic review.

Introduction: Undisplaced and minimally displaced scaphoid waist fractures can be managed either operatively (percutaneous or ORIF) or non-operatively with both methods obtaining high rates of fracture union and subsequent return of function. The aim of this systematic review is to identify and evaluate the best available evidence to determine whether they should be managed operatively or non-operatively.

Materials And Methods: A Medline and journal hand search was performed with strict eligibility criteria to obtain the highest quality evidence from meta-analyses, randomised controlled trials (RCT) and comparative studies.