Shoulder dislocations remain the most frequent of joint dislocations, with anterior displacement of the humeral head being the direction of dislocation seen most often (97%). Recently, the Dutch clinical guideline on shoulder dislocations has been revised on the basis of predetermined bottlenecks in clinical practice. In this paper, the guideline is translated to clinical practice by means of two fictional cases, in which the novel recommendations are incorporated.
View Article and Find Full Text PDFBackground: Primary glenohumeral osteoarthritis is associated with both excessive posterior humeral subluxation (PHS) and excessive glenoid retroversion in 40% of cases. These morphometric abnormalities are a particular issue because they may be responsible for a deterioration in long-term clinical and radiologic outcomes. The aim of this study was to perform a computed tomographic (CT) analysis of patients who underwent total shoulder arthroplasty (TSA) for primary osteoarthritis (OA) with B2-, B3-, or C-type glenoids in whom an attempt was made to correct for excessive glenoid retroversion and excessive posterior humeral subluxation intraoperatively.
View Article and Find Full Text PDFBackground: Biomechanical reduction techniques for shoulder dislocations have demonstrated high reduction success rates with a limited pain experience for the patient. We postulated that the combination of biomechanical reduction techniques with the shortest length of stay would also have the lowest pain experience and the highest first reduction success rate.
Methods: A randomized multicenter clinical trial was performed to compare different biomechanical reduction techniques in treating anterior shoulder dislocations without the use of invasive pain relief.
Am J Sports Med
July 2017
Background: There is no consensus on the choice of treatment of midshaft clavicle fractures (MCFs).
Purpose: The aims of this systematic review and meta-analysis were (1) to compare fracture healing disorders and functional outcomes of surgical versus nonsurgical treatment of MCFs and (2) to compare effect estimates obtained from randomized controlled trials (RCTs) and observational studies.
Study Design: Systematic review and meta-analysis.
Background: Although clavicle fractures are a common injury in polytrauma patients, the functional outcome of displaced midshaft clavicle fractures (DMCFs) in this population is unknown. Our hypothesis was that there would be no differences in fracture healing disorders or functional outcome in polytrauma patients with a DMCF compared with patients with an isolated DMCF, regardless of the treatment modality.
Methods: A retrospective cohort study of patients (treated at our level I trauma center) with a DMCF was performed and a follow-up questionnaire was administered.
Background: The number of displaced midshaft clavicle fractures treated surgically is increasing, and open reduction and intramedullary fixation is an emerging surgical treatment option. The study quality and scientific levels of published evidence in which possible complications of this treatment are presented vary greatly.
Methods: We performed systematic computer-based searches of EMBASE and PubMed/MEDLINE.
Background: The purposes of this study were to evaluate the association between the acromial index and full-thickness rotator cuffs and to determine if the size of the acromial index was associated with outcomes in a cohort of patients who had had arthroscopic repair of full-thickness rotator cuff tears.
Methods: The acromial index was calculated for three groups by individual researchers: 115 patients (120 shoulders) who had arthroscopically repaired full-thickness rotator cuff tears without osteoarthritis (Group I); sixty-four patients (sixty-eight shoulders) who had intact rotator cuffs with osteoarthritis (Group II); and twenty-one patients (twenty-one shoulders) who had intact rotator cuffs, without osteoarthritis, and were managed for other pathology (Group III). The acromial index is the distance between the glenoid plane and the lateral border of the acromion divided by the distance between the glenoid plane and the lateral aspect of the humeral head.
Hypothesis And Background: Narrowing of the subacromial space has been implicated in several shoulder pathologies. However, the location of the minimum distance points during clinical testing has not been defined. We sought to measure the in vivo minimum distance and location of the minimum distance points on the acromion and proximal humerus during arm elevation.
View Article and Find Full Text PDFThe glenohumeral articulation is a versatile joint that requires a complex integration of bony ligamentous, musculotendinous, and neurovascular structures for proper function. Injuries resulting from dysfunction are common and potentially debilitating. Many of these injuries can be managed nonsurgically; however, if surgical treatment is indicated, a thorough knowledge of the anatomy of the shoulder girdle is critical.
View Article and Find Full Text PDFBackground: The number of displaced midshaft clavicle fractures treated surgically is increasing and plate fixation is often the treatment modality of choice. The study quality and scientific levels of evidence at which possible complications of this treatment are presented vary greatly in literature.
Purposes: The purpose of this systematic review is to assess the prevalence of complications concerning plate fixation of dislocated midshaft clavicle fractures.