Artificial intelligence in commercial fracture detection products: a systematic review and meta-analysis of diagnostic test accuracy.

Conventional radiography (CR) is primarily utilized for fracture diagnosis. Artificial intelligence (AI) for CR is a rapidly growing field aimed at enhancing efficiency and increasing diagnostic accuracy. However, the diagnostic performance of commercially available AI fracture detection solutions (CAAI-FDS) for CR in various anatomical regions, their synergy with human assessment, as well as the influence of industry funding on reported accuracy are unknown.

Effect of Insulin Dependence on Perioperative Risk in Patients With Diabetes Undergoing Total Shoulder Arthroplasty.

Background: Approximately 15% of patients who undergo total shoulder arthroplasty (TSA) have diabetes mellitus, and this group is particularly at risk for perioperative complications. The objective of this study was to quantify the effects of insulin dependence on the risk of 30-day perioperative adverse events after TSA in patients with diabetes mellitus using a large national database.

Materials And Methods: We retrospectively identified patients with diabetes mellitus who underwent TSA in the National Surgical Quality Improvement Program (NSQIP) database from 2011 to 2020.

Predicting the deltoid tuberosity index in proximal humerus fractures using fracture characteristics and patient age: development of the LBQ-PHF score.

Background: The aim of this study was to investigate (1) whether fracture pattern and age are associated with local bone quality (LBQ), and (2) whether a scoring system based on these variables is able to predict LBQ in proximal humerus fractures (PHF).

Materials And Methods: A retrospective study was performed of all acute PHF at a Level 2 trauma center with plain radiographs and CT between June 2009 and March 2022. Local bone quality was measured by using the deltoid tuberosity index (DTI).

Reverse Total Shoulder Arthroplasty for Proximal Humeral Fractures and Sequalae Compared to Non-Fracture Indications: A Matched Cohort Analysis of Outcome and Complications.

Background: With the increase in utility and popularity of the reverse total shoulder arthroplasty (RTSA) within the last decades, indications for RTSA have expanded. As well as the established indications such as cuff tear arthropathy and massive irreparable rotator cuff tears, RTSA for complex proximal humeral fractures in elderly patients has been proven to be a reliable treatment option.

Methods: A prospectively enrolled RTSA database of 1457 RTSAs implanted between September 2005 and November 2020 was reviewed.

Humeral torsional side differences after nonoperative treatment of proximal humerus fractures and humeral shaft fractures: clinical and ultrasonographic assessment.

Background: The purposes of this study were to investigate (1) sonographic humeral torsion (SHT) and side differences (∆SHT), and (2) to determine the relationship between SHT and range of rotational motion (RORM) as well as functional outcome scores of nonoperatively treated proximal humerus fractures (PHF) and humeral shaft fractures (HSF).

Methods: Between October 2020 and July 2021, consecutive patients with radiographically healed nonoperatively treated PHF and HSF were included in this analysis. Subjective perception of torsional side difference, correlation between SHT and RORM, Subjective Shoulder Value as well as absolute and adjusted Constant Score were determined.

Anti-Toothbreaker: A Novel Low-Budget Device Enabling Contactless Dental Protection and a Forbidden Technique during Direct Laryngoscopy for Endotracheal Intubation.

Background: Iatrogenic dental injury is the most common complication of conventional laryngoscopy during orotracheal intubation. The main cause is unintended pressure and leverage forces from the hard metal blade of the laryngoscope. The aim of this pilot study was to introduce and test a novel, reusable low-budget device not only providing contactless dental protection during direct laryngoscopy for endotracheal intubation, but also enabling, in contrast to established tooth protectors, active levering with conventional laryngoscopes for easier visualization of the glottis.

Ultrasonographic Measurement of Torsional Side Difference in Proximal Humerus Fractures and Humeral Shaft Fractures: Theoretical Background with Technical Notes for Clinical Implementation.

Both nonoperative and operative treatment of proximal humerus fractures (PHF) and humeral shaft fractures can result in torsional side differences. Several measurement methods are available to determine torsional malalignment. While conventional X-ray or computed tomography would entail additional radiation exposure for the patient, and while magnetic resonance imaging might be associated with higher costs and is not suitable in cases of surgically treated fractures due to metal-induced artifacts, the sonographic measurement of humeral torsion represents a readily available and quickly performable measurement method without radiation exposure.

Open latarjet procedure versus all-arthroscopic autologous tricortical iliac crest bone grafting for anterior-inferior glenohumeral instability with glenoid bone loss.

Purpose: The purpose of this study is to compare the open Latarjet procedure versus the all-arthroscopic autologous tricortical iliac crest bone grafting (AICBG) technique for recurrent anterior-inferior glenohumeral instability with glenoid bone loss.

Methods: All open Latarjet and AICBG procedures for recurrent anterior-inferior shoulder instability with glenoid bone loss performed at two institutions between September 2015 and April 2019 were retrospectively analyzed. Inclusion criteria were a traumatic etiology, a glenoid surface deficiency >13.

Self-Reduction in Proximal Humerus Fractures through Upright Patient Positioning: Is It up to Gravity?

Background: The self-reduction in proximal humerus fractures (PHFs) remains a poorly explored myth, and it was rarely investigated in the past. One of the oldest hypotheses suggests that gravity and the weight of the affected arm alone are driving forces, which facilitate a self-reducing potential in PHFs. However, thus far, clear radiographic evidence for this theory is missing in the literature.

Conflicts of interest among patients: do they exist and can they bias patient-reported outcome measures? A survey of shoulder and elbow patients.

Background: Potential conflicts of interest (COIs) are common among physicians and may bias physician-reported outcome assessment in orthopedic research. It is unclear whether patients have COIs and whether these COIs could affect patient-reported outcome measures (PROMs). The purposes of this study were to investigate (1) the existence of COIs among patients and (2) the potential of these COIs to bias PROMs with a pseudonymized survey among consecutive shoulder and elbow patients.

Inter- and intraobserver reliability of morphological Mutch classification for greater tuberosity fractures of the proximal humerus: A comparison of x-ray, two-, and three-dimensional CT imaging.

Background: The objective of this study was to investigate inter- and intraobserver reliability of the morphological Mutch classification for greater tuberosity (GT) fragments in consecutive proximal humerus fractures (PHF) regardless of the number of parts according to the Codman classification system for three different imaging modalities (plain radiographs, two-dimensional [2-D] computed tomography [CT], and reformatted, three-dimensional [3-D] CT reconstruction).

Materials And Methods: One hundred thirty-eight consecutive PHF with GT involvement were identified between January 2018 and December 2018 in a supraregional Level 1 trauma center. GT morphology was classified by three blinded observers according to the morphological Mutch classification using the picture archiving and communication software Visage 7.

[Transosseous reconstruction of triceps tendon rupture : Surgical technique].

Objective: Transosseous reconstruction of the triceps tendon.

Indications: All tears of the triceps tendon that allow a tension-free reconstruction.

Contraindications: Retracted triceps tendon tears that do not allow a tension-free reconstruction after mobilization.

Nonsensus in the treatment of proximal humerus fractures: uncontrolled, blinded, comparative behavioural analysis between Homo chirurgicus accidentus and Macaca sylvanus.

Objective: To investigate the inter-rater reliability of Barbary macaques compared with an expert group of surgeons for the choice of treatment and predicted outcome of proximal humerus fractures.

Design: Uncontrolled, blinded, comparative behavioural analysis.

Setting: Germany and United States.

Biomechanical Assessment of Three Osteosynthesis Constructs by Periprosthetic Humerus Fractures.

Background: Biomechanical stability assessment of 3 different constructs for proximal fixation of a locking compression plate (LCP) in treating a Worland type C periprosthetic fracture after total shoulder arthroplasty.

Methods: 27 Worland type C fractures after shoulder arthroplasty in synthetic humeri were treated with 14-hole LCP that is proximally fixed using the following: (1) 1 × 1.5 mm cerclage wires and 2x unicortical-locking screws, (2) 3 × 1.

Conservative treatment of displaced isolated proximal humerus greater tuberosity fractures: preliminary results of a prospective, CT-based registry study.

Background: Isolated greater tuberosity fractures are uncommon and account for approximately 2-19% [Emerg Radiol. 2018;25(3):235-246] of all proximal humerus fractures. Surgical treatment is the prevailing recommendation in cases of displacement of more than 5 mm for the general healthy population, while conservative treatment is considered to result in inferior outcomes and is not recommended.

Distal Biceps Tendon Repair Using a Modified Double-Incision Technique: Patient-Reported Outcomes With 10-Year Follow-up.

Background: In the setting of complete distal biceps tendon rupture, surgical repair has become the standard of care to restore optimal elbow function, but the optimal approach and method of tendon fixation are still subjects of debate and have remained controversial for more than half a century.

Purpose: To evaluate patient-reported long-term outcomes after distal biceps tendon repair using a modified double-incision technique.

Study Design: Case series; Level of evidence, 4.

Correlation between Oxford Elbow Score and Single Assessment Numeric Evaluation: Is one simple question enough?

Background: The aim of this study is to evaluate the correlation between the Oxford Elbow Score (OES) and Single Assessment Numeric Evaluation (SANE). To date, there has been no study investigating a correlation between this patient-reported outcome measure and SANE.

Methods: Between December 2018 and February 2019, all patients who underwent consultation for elbow pathology and completed the OES and SANE were retrospectively analyzed.

Axillary Artery Dissection and Thrombosis after Closed Proximal Humerus Fracture - a Rare Interdisciplinary Challenge.

Background: Proximal humerus fractures account for 4 - 6% of all fractures and are a common result of low-energy trauma in the elderly. Concomitant neurovascular injury of the neighboring axillary artery and brachial plexus is a rarity, but has enormous impact on therapy, rehabilitation and prognosis. Diagnosis of axillary artery injury may be delayed due to its varied clinical presentation and lead to prolonged ischemia, distal necrosis and even loss of limb.