Does the upward migration index predict function and quality of life in arthroscopic rotator cuff repair?

Background: Although upward humeral head migration is a well-recognized phenomenon in patients with tears of the cuff, it is unclear whether it relates to patient function after cuff repair. The upward migration index (UMI) assesses proximal migration of the humeral head while controlling for patients' bony morphologic features.

Questions/purposes: We asked whether functional and quality-of-life (QOL) improvement occurs longitudinally in patients with low, moderate, or high degrees of proximal humeral migration after arthroscopic cuff repair and whether differences occur between groups.

Scapula fractures.

Fractures of the scapula are rare and the diagnosis and treatment may be unfamiliar to some surgeons. This article outlines a diagnostic work-up and treatment approach for the various types of scapular fractures. The approach helps guide decision making on operative versus nonoperative treatment based on what is known regarding prognosis and outcomes of management.

Infraspinatus delamination does not affect supraspinatus tear repair.

Supraspinatus full-thickness tears with associated infraspinatus delamination are a frequent lesion, although the results of repair have not been reported. We retrospectively identified 35 patients treated for this cuff lesion among 378 open repaired full-thickness cuff tears. The aim of the study was to assess the subjective, objective, and anatomic outcomes of a subset of patients with supraspinatus tears involving delamination of the whole infraspinatus tendon.

Prospective evaluation of two diagnostic apprehension signs for posterolateral instability of the elbow.

Posterolateral rotatory instability (PLRI) of the elbow occurs from attrition of the lateral ulnohumeral collateral ligament of the elbow after elbow dislocation. Diagnosis by physical examination can be difficult in the awake patient. The goals of this study were to define two active apprehension signs for the physical diagnosis of PLRI and to perform a prospective evaluation of the signs in a series of patients with PLRI.

Arthroscopic debridement of the elbow for arthrofibrosis resulting from nondisplaced fracture of the radial head.

Purpose: Mason type I fractures of the radial head consist of fractures that occur without displacement. Arthrofibrosis is a rarely reported complication of Mason I radial head fractures. Symptoms include pain, stiffness, and crepitus.

The effect of the wafer procedure on pressure in the distal radioulnar joint.

Purpose: To investigate the effect of the wafer procedure on pressure within the distal radioulnar joint.

Methods: The effect of increasing transverse distal ulnar head resection with preservation of the ulnar styloid was evaluated in 4 fresh frozen cadaver arms. Specimens were tested in neutral rotation.

Analysis of a school bus collision: mechanism of injury in the unrestrained child.

Introduction: The most common type of school bus crash resulting in injury and death involves the "rollover" mechanism, which may be linked to bus design. To investigate this possibility, we carried out a detailed investigation of a severe school bus crash.

Methods: The crash involved 12 children, passengers in the school bus.