Double tendon transfer for massive rotator cuff tear: A case report.

Introduction And Importance: Repairing massive rotator cuff tears (MRCTs) can often be technically challenging due to tendon retraction, bursal fibrosis, and muscular fatty infiltration that usually occurs, often resulting in poor outcomes and an unpredictable prognosis. Although some other surgical management options have been reported, there is a lack of literature supporting tendon transfers in the presence of combined anterior and posterior-superior irreparable rotator cuff tears. We describe a case where a combined transfer of the latissimus dorsi and lower trapezius tendons was employed to treat an MRCT affecting the anterior and posterior superior portions of the rotator cuff.

Complications and clinical outcomes with minimally invasive plate osteosynthesis (MIPO) technique for midshaft clavicle fractures: a systematic review and meta-analysis.

Background: Clavicle fractures are among the most common upper limb fractures in adults, with the midshaft region being the most frequently affected site. Minimally invasive plate osteosynthesis (MIPO) has emerged as an alternative to the traditional open reduction and internal fixation (ORIF) technique, offering potential advantages. The purpose of this study was to conduct a systematic review to explore the results of this technique in the existing literature, with emphasis on the occurrence of surgical complications and functional outcomes and also to provide a comprehensive comparison of MIPO and ORIF in the management of midshaft clavicle fractures.

Latin American formal consensus on the indications for the surgical treatment of massive and irreparable rotator cuff tears.

Objectives: To implement the Formal Consensus Method among a group of experts in shoulder surgery in Latin America, in order to establish appropriate indications for the surgical treatment of massive and irreparable rotator cuff injuries.

Methods: The Formal Consensus Method was used to develop surgical treatment recommendations for massive and irreparable rotator cuff tears (MIRCT). Three independent groups of experts in shoulder surgery were confirmed.

Use of 3D-Printed Patient-Specific Guide for Latarjet Procedure in Patients With Anterior Shoulder Instability: Technical Note.

Anterior shoulder instability can lead to anterior glenoid bone loss associated with humeral posterior deformity (bipolar bone loss). Latarjet procedure is a commonly used surgical option in such cases. However, the procedure is associated with complications in up 15% of the cases often associated with inadequate positioning of coracoid bone graft and screws.

Assessment of the measurement methods in midshaft clavicle fracture.

Background: Clavicle fractures account for approximately 5% of all fractures in adults and 75% of clavicle fractures occur in the midshaft. Shortening greater than two centimeters is an indicative of surgical treatment. Radiographic exams are often used to diagnose and evaluate clavicle fractures but computed tomography (CT) scan is currently considered the best method to assess these deformities and shortening.

Computed Tomography Does Not Improve Intra- and Interobserver Agreement of Hertel Radiographic Prognostic Criteria.

Background and Objectives: Proximal humerus fractures are the second most frequent site of avascular necrosis (AVN), occurring in up to 16% of cases. The Hertel criteria have been used as a reference for the prediction of humerus head ischemia. However, these are based solely on the use of radiographs, which can make interpretation extremely difficult due to several reasons, such as the overlapping fragments, severity of the injury, and noncompliant acute pain patients.

Peri-implant distal clavicle fracture: Case report (overlaying plate fixation: Solution for peri-implant clavicle fractures).

Introduction And Importance: Surgical treatment for clavicle injuries is indicated for displaced and shortened fractures. Osteosyntheses with plate fixation may present with complications in 6.3% to 8.

Navigation in Shoulder Arthroplasty Surgery.

The indication of shoulder arthroplasties has increased progressively. Accurate positioning of the components may have significant implications for clinical results. The navigation used to aid in the performance of anatomical and reverse total arthroplasties has provided greater precision in implant placement, especially on the glenoid.

Subjective Elbow Value and Patient-rated Tennis Elbow Evaluation Applied to Patients Affected by Lateral Epicondylitis.

 To verify if the subjective elbow value (SEV) scale presents similar results to those of the Patient-rated Tennis Elbow Evaluation (PRTEE) scale in the evaluation of patients with lateral elbow epicondylitis (LEE).  Thirty-seven patients were diagnosed with LEE in the outpatient service of our hospital through clinical history, physical examination, X-ray, and ultrasonography. The SEV and PRTEE scales were used and their results were compared using a significance level ≥ 5% ( ≥0.

EVALUATION OF SURGICAL TREATMENT OF ROTATOR CUFF ANTEROSUPERIOR TEARS ARTHROSCOPICALLY.

Objective: To evaluate the functional result of arthroscopic treatment in anterosuperior rotator cuff tears.

Methods: Fifty-six patients submitted to arthroscopic repair of anterosuperior rotator cuff tears were evaluated. The follow-up time was five year and five months.

TERRIBLE TRIAD OF THE ELBOW: FUNCTIONAL RESULTS OF SURGICAL TREATMENT.

Objective: To evaluate the functional and radiographic results of patients who underwent surgical treatment for terrible triad-type elbow injuries (TTE).

Methods: We retrospectively evaluated 20 patients, including one case with bilateral injuries (total of 21 elbows) that were surgically treated from January 2004 to July 2014. We evaluated the functional results of treatment by measuring the restored range of motion (ROM) of the elbow, using the DASH (Disabilities of the Arm, Shoulder and Hand) and MEPS (Mayo Elbow Performance Score) scores.

EVALUATION OF SURGICAL TREATMENT OF PATIENTS WITH SHOULDER INSTABILITY.

Objective: To evaluate the results of arthroscopic surgery in patients with traumatic anterior shoulder dislocation.

Methods: This retrospective study analyzed 76 patients with a mean age of 28 and mean postoperative follow-up period of 62 months. Evaluation consisted of physical examination, and X-rays; results were classified according to the UCLA and Rowe scales.

Axillary nerve position in the anterosuperior approach of the shoulder: a cadaveric study.

Objective: To determine the distance between the axillary nerve and the antero-lateral (AL) edge of the acromion, its anatomical variability and relationship to humeral length and body height.

Methods: Twenty-two shoulders were dissected. The anterosuperior (AS) approach was used; the deltoid was detached from the acromion and the distance between the AL portion and the axillary nerve was measured and submitted to statistical analysis.

Evaluation of the Clinical-functional Results from Repairing Extensive Rotator Cuff Injury with Inclusion of the Tendon of the Long Head of the Biceps.

Objectives: To assess the outcomes of the arthroscopic margin convergence of the posterior cuff to the biceps tendon.

Methods: From October 2003 to December 2007, 20 patients with massive rotator cuff tear which include the rotator interval were treated with arthroscopic margin convergence of the posterior cuff to biceps tendon. Sixteen patients were female and four were male.

ARTHROSCOPIC REPAIR OF SMALL AND MEDIUM TEARS OF THE SUPRASPINATUS MUSCLE TENDON: EVALUATION OF THE CLINICAL AND FUNCTIONAL OUTCOMES AFTER TWO YEARS OF FOLLOW-UP.

Objective: To evaluate the clinical and functional outcomes from arthroscopic repairs on small and medium-sized tears of the supraspinatus muscle tendon.

Methods: 129 cases of isolated small and medium tears of the supraspinatus muscle tendon were evaluated retrospectively. The average duration of pain was 29 months.

Correlation of coracoid thickness and glenoid width: an anatomic morphometric analysis.

Background: The coracoid has been widely used as a graft to reconstruct anterior glenoid bone defects, as described by the Latarjet and Bristow procedures, with successful results. Nevertheless, at the present, there are no studies correlating the size of the coracoid graft and its relation to the glenoid.

Purpose: To assess the mediolateral (M-L) and anteroposterior (A-P) thickness of the coracoid process as well as the widest anterior-to-posterior glenoid distance (glenoid width) and to analyze the correlation between these measurements, while comparing these with the A-P coracoid process thickness.

TENOTOMY WITH OR WITHOUT TENODESIS OF THE LONG HEAD OF THE BICEPS USING REPAIR OF THE ROTATOR CUFF.

Objective: To compare the functional results among patients undergoing tenotomy with or without tenodesis of the long head of the biceps associated with arthroscopic repair of rotator cuff injuries, with a minimum two-year follow-up.

Method: This was a retrospective non-randomized trial with evidence level III, in which the medical files of 77 patients with lesions of the long head of the biceps were reviewed and clinically reassessed. Among these, 55 patients underwent tenotomy without tenodesis and 22 underwent tenotomy with tenodesis, with outpatient follow-up for at least two years.

RESULTS FROM BI-CONTACT(®) TOTAL ELBOW ARTHROPLASTY: MULTICENTER STUDY.

Objective: To describe the initial experience of four orthopedic clinics from using Bi-Contact(®) total elbow arthroplasty (TEA), reporting the results and complications of the procedure.

Methods: This was a retrospective study, through analysis on the medical records of patients who underwent primary TEA using a prosthesis model developed in conjunction with IOT-HCFMUSP. Forty-six elbows (45 patients) that were operated at four orthopedic clinics between 2000 and 2009 were evaluated.

RESULTS FROM LATARJET SURGERY FOR TREATING TRAUMATIC ANTERIOR SHOULDER INSTABILITY ASSOCIATED WITH BONE EROSION IN THE GLENOID CAVITY, AFTER MINIMUM FOLLOW-UP OF ONE YEAR.

Objective: Evaluate the results from the Latarjet procedure in patients with anterior recurrent dislocation of the shoulder who present bone loss of the glenoid cavity greater than 25%.

Methods: Twenty six male patients underwent the Latarjet procedure, The bone loss was evaluated by means of radiography using the Bernageau view and by means of CAT scan. The patients were evaluated with regard to range of motion, using the Rowe and UCLA scales, before and after the operation, and by radiographs to assess the presence of arthrosis, position and consolidation of the graft and positioning of the screws.

ANTERIOR GLENOID RIM EROSION MEASURED BY X-RAY EXAM: A SIMPLE WAY TO PERFORM THE BERNAGEAU PROFILE VIEW.

Objective: To analyze whether the Bernageau radiographic view is adequate for studying the anterior glenoid rim and to determine the distance between the posterior and anterior glenoid rims.

Methods: Fifty patients (31 males) with a mean age of 34 years were evaluated by positioning their arm at 160° forward flexion and body at 70° to the x-ray chassis, while positioning the x-ray tube at 30° craniocaudally, centered on the scapula spine. Three of the authors measured the distance between the posterior and anterior glenoid rim three times.

PROSPECTIVE RANDOMIZED STUDY COMPARING TWO ANESTHETIC METHODS FOR SHOULDER SURGERY.

Objective: To evaluate the efficacy of suprascapular nerve block in combination with infusion of anesthetic into the subacromial space, compared with interscalene block.

Methods: Forty-five patients with small or medium-sized isolated supraspinatus tendon lesions who underwent arthroscopic repair were prospectively and comparatively evaluated through random assignation to three groups of 15, each with a different combination of anesthetic methods. The efficacy of postoperative analgesia was measured using the visual analogue scale for pain and the analgesic, anti-inflammatory and opioid drug consumption.

RECURRENT SHOULDER DISLOCATION: ASPECTS BETWEEN THE FIRST EPISODE AND SURGICAL TREATMENT.

Objective: To determine: 1) whether the patients had been oriented to use immobilization for at least four weeks and which type of immobilization was prescribed, 2) how many dislocations occurred until the patient received information about the need of surgery, 3) How long it takes for patients to have an appointment with a shoulder surgeon, 4) How many dislocations the patient had at the time of surgery.

Material And Methods: Of the 100 patients surgically treated or waiting for surgery at outpatient facilities, we interviewed 61 patients with questions related to the mechanism of dislocation, emergency service sites, guidelines for acute event treatment and follow-up, time elapsed until surgery and follow-up. Collected data were submitted to analysis.