A Method to Facilitate Improved Positioning of a Reverse Prosthesis Stem During Arthroplasty Surgery: The Metaphyseal-centering Technique.

Because humeral head offset values vary widely from patient to patient, the final position of the proximal portion of a stemmed humeral prosthesis will sometimes not align well with respect to the center of rotation of the humeral head. This is especially notable when a humeral component with limited modularity is used. To address this problem, a prosthesis-specific method is presented for orienting a reverse shoulder humeral component (AltiVate Reverse, DJO Surgical, Austin, TX).

Spherical versus elliptical prosthetic humeral heads: a comparison of anatomic fit.

Background: The aim of this study was to quantify the influence of prosthetic humeral head shape, as well as the number of available prosthetic head sizes, on replicating the normal humeral head anatomy during shoulder reconstructive surgery.

Methods: Computer modeling software was used to create virtual sets of both spherical and elliptical prosthetic heads, which were virtually implanted into 3-dimensional computed tomography scan-based models of 79 proximal humeri. Anatomic replication was considered successful if the measured parameters (diameters of the base of the head in the frontal and sagittal planes, radii of curvature in the frontal and sagittal planes, and humeral head height) were all reproduced within 3 mm.

An anthropometric analysis to derive formulae for calculating the dimensions of anatomically shaped humeral heads.

Background: The elliptical shape of the humeral head has been vaguely described, but a more detailed mathematical description is lacking. The primary goal of this study was to create formulae to describe the mathematical relationships between the various dimensions of anatomically shaped humeral heads.

Methods: Three-dimensional computer models of 79 proximal humeri derived from computed tomography scans (white subjects, 47 male and 32 female; ages, 17-87 years) were studied.

Reduction in hospital reattendance due to improved preoperative patient education following hemorrhoidectomy.

Introduction: To improve quality of healthcare, patient information must be thorough and easy to understand. This is important in day surgery where patients are seen less often by health practitioners. We looked at the impact of improving patient information in the setting of day-case hemorrhoidectomy in terms of patient satisfaction and whether medical attention was sought after the operation.

Key attributes of a modern surgical trainer: perspectives from consultants and trainees in the United kingdom.

Objective: This study identifies key attributes of a modern surgical trainer as defined by individual trainees and consultant training faculty members.

Design: Using a collaborative inquiry process, we conducted focus groups and semistructured interviews with 32 trainees and 10 consultant trainers in general surgery. This study was undertaken in a single postgraduate deanery in the United Kingdom.

Rare case of ER positive colorectal stricture demonstrating improvement with letrozole.

The authors present a rare case of a patient with an estrogen receptor (ER) positive malignant colorectal stricture, with no identifiable primary breast carcinoma. There was demonstrated endoscopic and symptomatic improvement after treatment with letrozole. Gastrointestinal metastases from breast cancer usually present with a previous history of breast cancer, however our patient had no prior or current proven history of breast cancer.

Optimizing glenosphere position and fixation in reverse shoulder arthroplasty, Part One: The twelve-mm rule.

The Aequalis Reversed Shoulder Prosthesis (Tornier, Inc., Edina, MN) is a successful treatment option for older, low-demand patients with rotator cuff arthropathy. Scapular notching is the most common radiographic complication and is associated with poorer intermediate-term clinical outcomes.

Optimizing glenosphere position and fixation in reverse shoulder arthroplasty, Part Two: The three-column concept.

Scapular geometry is complex, and a screw-placement technique for optimizing glenoid component fixation with an Aequalis Reversed Shoulder Prosthesis (Tornier, Inc., Edina, MN) has not yet been described. Ten cadaveric human scapulae were implanted with 2 types of reverse arthroplasty baseplates, 1 with fixed-angle locking screw holes and 1 with multidirectional locking screw holes.

A patient satisfaction survey of a nurse-led colorectal clinic.

A new service was set up to achieve government targets to see patients with signs or symptoms of a possible colorectal cancer within two weeks of referral from their GP. The new clinics were nurse-led. A patient satisfaction survey was used to assess patients' opinions about the clinic.

Case reports: osteonecrosis of the capitate: a pediatric case report.

We present what we think is the first documented occurrence of osteonecrosis of the capitate in a skeletally immature patient. Atraumatic osteonecrosis of the capitate is rare, and all reported cases have occurred in adults. Our pediatric patient was treated with observation and limited immobilization.