Three-dimensional kinematic evaluation of scapulohumeral rhythm after reverse shoulder arthroplasty: a systematic review and meta-analysis.

Background: The movement of the arm relative to the trunk results from 3-dimensional (3D) coordinated movements of the glenohumeral (GH) and scapulothoracic (ST) joints and dictates the scapulohumeral rhythm (SHR). Alterations in SHR increase joint overload and may lead to low functional scores, pain, and failures in patients undergoing reverse total shoulder arthroplasty (RSA). The goal of this systematic review and meta-analysis was to examine 3D SHR kinematics after RSA and compare it to that of asymptomatic shoulders.

Proposal for a New Fixation Method for Pauwels Type III Femoral Neck Fracture-Metaphyseal Stem: A Finite-Element Analysis.

Objective: To evaluate the biomechanical behavior of a metaphyseal stem specifically designed for the fixation of Pauwels type-III femoral neck fractures using finite-element analysis.

Methods: Three different constructions were studied: the dynamic hip screw with a superior anti-rotation screw (DHS + ARS), multiple cannulated screws in an inverted triangle configuration (ASNIS), and the Metaphyseal Nailing System (MNS), a new implant developed by the authors. Vertical and total displacement, localized and total maximum and minimum principal, and the Von Mises peak stresses were evaluated.

Energy Required for Fracture in Synthetic Proximal Femoral Models After Synthesis Material Removal: a Biomechanical Study Using Cannulated Screws, Dynamic Hip Screws, and Proximal Femoral Nails.

 The present study aims to identify the energy required for synthetic proximal femoral fracture after removal of three implant types: cannulated screws, dynamic hip screws (DHS), and proximal femoral nail (PFN).  Twenty-five synthetic proximal femur bones were used: 10 were kept intact as the control group (CG), 5 were submitted to the placement and removal of 3 cannulated screws in an inverted triangle configuration (CSG), 5 were submitted to the placement and removal of a dynamic compression screw (DHSG), and 5 were submitted to the placement and removal of a proximal femur nail (PFNG). All samples were biomechanically analyzed simulating a fall on the greater trochanter using a servo-hydraulic machine to determine the energy (in Joules [J]) required for fracture.

New fixation method for Pauwels type III femoral neck fracture: a finite element analysis of sliding hip screw, L-shaped, and L-shaped with medial plate.

Objective: In this study, we aimed to evaluate the biomechanical behavior of three fixations for Pauwels type III fractures (sliding hip screw (SHS), L-shaped, and L-shaped with medial plate), by finite element analysis (FEM).

Methods: Three internal fixators were developed to treat Pauwels type III fracture by finite elements: SHS; L-shaped; and L-shaped with medial plate. Under the same conditions, localized and total vertical fracture displacement, maximum and minimum principal and von Mises stresses were evaluated.

Medial Hoffa Fracture: Description of a Novel Classification System and Rationale for Treatment Based on Fragment-Specific Fixation Strategy.

Purpose: This study aims to present a novel classification system and a rationale for treatment of medial Hoffa fractures.

Methods: We developed a simple comprehensive classification system for medial Hoffa fractures based on the fragment size and presence of fracture comminution. Furthermore, we propose a treatment algorithm based on two pillars: our case series of nine patients presenting medial Hoffa fractures and the best evidence-based pertinent literature.

Anterior minimally invasive plating osteosynthesis technique (MIPO) for humeral shaft fractures: an anatomical study of neuromuscular structures at risk.

Objective: The aim of this study was to evaluate the neuromuscular structures at risk during modified anterior minimally invasive plating osteosynthesis technique (Belangero-Livani) for humeral shaft fractures.

Methods: Eight fresh-frozen human specimens ranging from 38 to 82 years old were used. Specimens were positioned supine with the shoulder in 70° abduction and the forearm in full supination.

How do Orthopedic Surgeons Manage Displaced Femoral Neck Fracture in the Middle-Aged Patient? Brazilian Survey of 78 Orthopaedic Surgeons.

 The aim of the present study was to evaluate the practices and preferences of Brazilian orthopedic surgeons for the treatment of femoral neck fractures in middle-aged patients.  A survey containing 10 images of femoral neck fractures was sent to a group of 100 orthopedic surgeons, all of them members of the Brazilian Society of Orthopedics and Traumatology. The questionnaire asked the treatment option for cases of nondisplaced and displaced fractures of the femoral neck in middle-aged patients, that is, those between 50 and 69 years old.

The role of the medial plate for Pauwels type III femoral neck fracture: a comparative mechanical study using two fixations with cannulated screws.

Background: The biomechanical behavior of Pauwels type III fractures should be taken into consideration when performing internal fixation, since this repair should resist the shear force inherent in the vertical fracture line to the greatest extent possible. Recently, the use of a small fragment plate on the medial face of the femoral neck has been proposed by some authors, with satisfactory initial results. In the current study we analyze the mechanical role a medial plate used as a buttress plate for Pauwels type III femoral neck fractures, comparing the resistance of two fixation configurations using three cannulated screws.

Asymptomatic Dysplasia Epiphysealis Hemimelica of the Shoulder in a Skeletally Mature Patient with Normal Function.

Dysplasia epiphysealis hemimelica is a rare osteocartilaginous overgrowth syndrome of bone epiphysis, mostly encountered in the lower limbs of immature skeleton patients. We report a case of proximal humerus presentation in an adult male, with neither articular involvement nor clinical dysfunction. This case highlights the importance of stratification into intra- and extra-articular lesions, as this distinction ultimately influences both symptoms and treatment outcome.

Metastatic tumor of the hand of unknown primary origin.

Acral metastases in the hand are exceedingly rare. We present the unusual case of a metastatic tumor of the hand of unknown primary site in a 77-year-old man with no known cancer history. The patient presented with pain and swelling in the tip of the left ring finger, which had previously been diagnosed as gout at another clinic.

General principles for treatment of femoral head fractures.

Femoral head fractures occur almost exclusively as a result of a traumatic hip dislocation. Treatment is typically an emergency and includes the reduction of the dislocated hip under anesthesia. As a rule, the earlier the reduction, the better the outcome.

A Survey of Current Practices and Preferences for Internal Fixation of Trochanteric Fractures of the Femur in Brazil.

Objective The primary aim of this study was to survey current practices and preferences behind internal fixation of trochanteric femoral fractures among Brazilian orthopedic surgeons. The secondary aim was to identify the main reason for these preferences. Methods A survey containing 20 images of trochanteric fractures of the femur was presented to a group of 62 orthopedists, all members of the Brazilian Society of Orthopedics and Traumatology (SBOT).

Stability of L-shaped and inverted triangle fixation assemblies in treating Pauwels type II femoral neck fracture: a comparative mechanical study.

Purpose: The aim of our study is to compare the mechanical resistance of two screw configurations in fixating type II Pauwels femoral neck fractures.

Methods: Fifteen synthetic models of femur bones in young adults were divided into three equal groups: intact (G1), models with fixation of a 5.0-mm failure zone created in the posterior cortex of the femoral neck using an L-shaped screw arrangement (G2, n = 5), and models with an identical failure zone fixated using an inverted triangle assembly (G3, n = 5).

Comparative radiographic analysis on the anatomical axis in knee osteoarthritis cases: inter and intraobserver evaluation.

Objective: To make a comparative inter and intraobserver analysis on measurements of the anatomical axis between panoramic radiographs of the lower limbs in anteroposterior (AP) view with bipedal weight-bearing, on short film.

Methods: An accuracy study comparing radiographic measurements on 47 knees of patients attending the knee surgery outpatient clinic due to osteoarthritis. The radiographic evaluation used was as standardized for the total knee arthroplasty program, including panoramic AP views of the lower limbs and short radiographs of the knees in AP and lateral views, all with bipedal weight-bearing.

Positioning of the acetabular component in cemented prostheses - radiographic calculation.

Objective: to assess the reliability of the inclination angle and anteversion of acetabular cup component in patients with idiopatic osteoarthritis of the hip, aseptic necrosis and hip neck fracture using trigonometric formula and plain radiographs.

Methods: 66 patients underwent cemented total arthroplasty of 72 hips. The inclination of acetabular component was measured using plain radiograph.

Functional Outcome after Operative Treatment of Displaced Fractures of the Acetabulum: A 12-month to 5-year Follow-up Investigation.

Purpose: To review our experience with 82 surgically treated displaced acetabular fractures over a 4-year period.

Patients And Methods: Ninety-three consecutive displaced acetabular fractures were consecutively operated on at Level I Trauma Center from January 1, 2000 through December 31, 2003, and 82 were available for review with a minimum of 12-month follow-up. Clinical (Merle D'Aubigné modified by Matta et al.

Compression of the medial branch of the deep peroneal nerve, relieved by excision of an os intermetatarseum. A case report.

The authors report a case of direct compression of the medial branch of the deep peroneal nerve by an os intermetatarseum in a 52-year-old female patient who was referred to their Institution because of pain over the dorsum of her left foot associated with paraesthesias in the first web space. Examination disclosed a positive Tinel sign over the dorsal aspect of the first metatarsal bone. Plain radiographs revealed a small, irregular accessory ossicle on the dorsum of the left foot, between the medial cuneiform and first and second metatarsals.

Effect of tenoxicam on fracture healing in rat tibiae.

Background: Nonsteroidal anti-inflammatory drugs have been implicated in the development of delayed unions and nonunion after fractures in animal models. Previous investigations have identified two important factors as determinants of delayed fracture healing: early drug administration and a dose-dependent effect.

Objective: The purpose of this investigation was to study the effect of tenoxicam, a nonsteroidal anti-inflammatory drug, on the fracture healing process in rat tibiae.