The Influence of Incision Type on Patient Satisfaction After Plate Fixation of Clavicle Fractures.

Background: Open reduction and internal fixation (ORIF) of the clavicle is a common procedure that has been shown to have improved outcomes over nonoperative treatment. Several incisions can be used to approach clavicle fractures, the decision of which is variable among surgeons.

Purpose: To compare patient satisfaction and subjective outcomes between patients with a longitudinal incision versus those with a necklace incision for the treatment of diaphyseal clavicle fractures.

Effectiveness of replacement arthroplasty with calcar grafting and avoidance of greater tuberosity osteotomy for the treatment of humeral surgical neck nonunions.

A retrospective review was conducted on 12 patients (mean age, 63 years) undergoing replacement arthroplasty with calcar grafting for humeral surgical neck nonunions. Patients were evaluated preoperatively for pain and range of motion and postoperatively by use of the American Shoulder and Elbow Surgeons and Constant scores. Indications included severe pain, disability, humeral head destruction, and inadequate bone stock.

Tumors of the shoulder girdle: a review of 194 cases.

The upper extremity is the third most common site of primary bone and soft-tissue tumors. The purpose of this study was to determine the types and prevalence of bone and soft-tissue tumors that occur in the shoulder girdle and to identify physical findings that may be indicative of malignancy. This is a retrospective review of 194 consecutive neoplasms of the shoulder girdle seen by the senior author from 1996 through 2000.

Septic arthritis of the glenohumeral joint: a review of 23 cases.

Infection of the glenohumeral joint is an uncommon yet devastating condition. The objective of this study was to review the incidence, risk factors, presentation, and treatment for this disorder. Twenty-three culture-positive cases of septic arthritis of the glenohumeral joint were identified and treated at the authors' institution between 1986 and 2000.

A cadaveric study on the anatomy of the deltoid insertion and its relationship to the deltopectoral approach to the proximal humerus.

Elevation of the deltoid insertion (DI) has been recommended, but little is known about its anatomy or importance for deltoid function. The purpose of this study is to determine the dimensions of the DI with specific reference to the deltopectoral approach. The deltoid was exposed and detached at its origin in 36 cadaveric shoulders.

Releases of subscapularis contracture: an anatomic and clinical study.

Correction of anterior subscapularis contracture is an important step in soft-tissue balancing at the time of total shoulder replacement (TSR). An anatomic and clinical investigation was undertaken to investigate the effect of steps involved in subscapularis release. In 14 cadaveric shoulders studied, the subscapularis insertion consisted of three regions: a thick superior tubular tendon (STT), a flat middle tendon, and an inferior portion where the muscle fibers insert directly into the humerus.

Anatomy of the posterior rotator interval: implications for cuff mobilization.

Release of the posterior rotator interval between the supraspinatus and infraspinatus tendons may be necessary to obtain appropriate mobilization for an anatomic rotator cuff repair. Ten cadaver shoulders were dissected to expose the region between the infraspinatus and supraspinatus from the spinoglenoid notch to the greater tuberosity. Measurements were made from the spinoglenoid notch to the glenoid rim, the glenoid rim to the confluence of the supraspinatus and infraspinatus musculotendinous junction, and from the confluence of the tendons to the insertion on the humerus.

Comparison of intra-articular lidocaine and intravenous sedation for reduction of shoulder dislocations: a randomized, prospective study.

Background: Acute anterior glenohumeral dislocations have been commonly treated with closed reduction and the use of intravenous sedation. Recently, the use of intra-articular lidocaine has been advocated as an alternative to sedation, since intravenous access and patient monitoring are not required. The purpose of this study was to evaluate the value of local anesthesia compared with that of the commonly used intravenous sedation during the performance of a standardized reduction technique.