735 results match your criteria: "Osteonecrosis Shoulder"

There is no consensus in the literature regarding the optimal treatment for complex proximal humerus fractures (PHFs). The aim of this study is to evaluate the clinical, functional, and radiological outcomes, and complications, associated with the Bilboquet implant in the treatment of PHFs. The search was conducted from the first description of the Bilboquet device in 1994 to June 2024, across PubMed, Web of Science, and Google Scholar, using specific keywords such as ("Bilboquet" OR "Bilboquet prosthesis" OR "Bilboquet device") AND ("proximal humerus fracture" OR "shoulder fracture"), along with Boolean operators.

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Proximal humerus fractures are prevalent in older adults, particularly women, primarily due to osteoporosis and increased fall risk. These fractures often result from low-energy falls in elderly patients, while in younger individuals, they are more likely to occur with high-energy trauma, which may involve additional injuries to soft tissue and neurovascular structures. Proper anatomical understanding, including key structures and blood supply, is crucial for effective management and to prevent complications.

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Predicting Proximal Humerus Fracture Mechanical Complications: Are Computed Tomography Hounsfield Units the Answer?

J Am Acad Orthop Surg

October 2024

From the Department of Orthopedic Surgery, Division of Orthopedic Trauma, NYU Langone Orthopedic Hospital, New York, NY.

Introduction: The purpose was to determine whether computed tomography (CT) Hounsfield units (HU) as a proxy for bone quality can predict postoperative complications following surgical treatment of proximal humerus fractures.

Methods: Sixty-six patients with 2-, 3-, or 4-part proximal humerus fractures who underwent surgical fixation at single institution and had complete radiographic data available were included. Radiographic measurements included the deltoid tuberosity index (DTI) on preoperative anterior-posterior shoulder radiographs, and the HU value from the surgical proximal humerus was determined by measuring the humeral head at the midaxial/coronal/sagittal CT image using a circle-type region of interest (≥35 mm2).

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Introduction: Proximal humerus fractures (PHF) are common in the elderly, accounting for significant morbidity and mortality. Non-surgical treatment is a common option for low-demand elderly patients, but it can lead to unsatisfactory functional outcomes in some cases. The identification of predictive factors for poor prognosis in non-surgical management remains unclear.

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Avascular necrosis (AVN) is a prevalent and progressive complication in young patients with sickle cell disease (SCD), but no study evaluated the long-term subjective and objective outcome measures. Oxford hip score (OHS) and Oxford shoulder scores (OSS) are validated joint-specific patient-reported outcome measures (PROMs). In this prospective multicentre study, 47 SCD patients with pre-existing diagnosis of AVN occurred at a median age of 35.

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Post-traumatic missing talus is a rare and severe injury that often results in poor functional outcomes, with no consensus on the optimal treatment approach as strategies vary based on injury severity. We present the case of a 44-year-old male who sustained a missing talus following a high-energy motorcycle accident. After initial wound management and application of an external fixator, the patient underwent size-matched, fresh-frozen talus allograft transplantation combined with subtalar fusion.

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Background: This study evaluated the radiological and clinical outcomes of bone grafts using fourth and fifth extensor compartmental arteries (4+5 ECAs) for the treatment of Kienböck's disease.

Materials And Methods: In total, 21 patients (12 men and 9 women; mean age, 41 years; range, 19-59 years) were followed for a mean of 33 months. Radiological images were analyzed for the Lichtman stage, carpal height ratio, radioscaphoid angle, and Stahl's index.

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Background: Understanding vascularity and assessing the risk of post-traumatic avascular necrosis are crucial for predicting outcomes and identifying optimal treatment options in proximal humerus fractures (PHFs). Until now, Hertel et al have been the only researchers to evaluate the intraoperative perfusion of the humeral head after fracture using Doppler flowmetry in a central single drill hole within the head. This pilot study aims to standardize the evaluation of intraoperative perfusion measurements in different areas of the humeral head in patients with PHF.

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Article Synopsis
  • The objective of the study was to systematically review the effectiveness and safety of platelet-rich plasma (PRP) in treating frozen shoulder through a meta-analysis, aiming to provide solid medical evidence on PRP's benefits.
  • The researchers conducted an extensive search in multiple international and Chinese databases for relevant clinical studies published until January 2024, and they meticulously selected literature that met specific inclusion criteria for analysis.
  • The analysis included 14 randomized controlled trials with over 1,000 patients, revealing that PRP significantly improved pain and function scores compared to control groups, demonstrating its efficacy in alleviating symptoms and enhancing mobility in patients with frozen shoulder.
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Map-Like Magnetic Resonance Imaging Changes in HIV-Positive Patient with Multiple Osteonecrosis: A Case Report.

Infect Drug Resist

August 2024

Department of Orthopaedics, Beijing Ditan Hospital, Capital Medical University, Beijing, National Center for Infectious Diseases, Beijing, People's Republic of China.

Background: Osteonecrosis is a common complication, particularly in HIV-infected patients undergoing long-term glucocorticoid therapy. This case report aims to highlight the unique "map-like" magnetic resonance imaging (MRI) changes observed in an HIV-positive patient with multiple osteonecrosis due to glucocorticoid overdose, emphasizing the importance of recognizing and managing this complication in this high-risk population.

Case Presentation: A 29-year-old HIV-positive male patient developed extensive multi-joint osteonecrosis involving 7 joint sites (right shoulder, bilateral hips, bilateral knees, and bilateral ankles) after 6 months of high-dose glucocorticoid treatment for an opportunistic pneumonia associated with his HIV status.

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Rotator Cuff Tears, Repairs, and Shoulder Arthroplasties Among Workers' Compensation Claimants: A 16-Year Longitudinal Study at a National Workers' Compensation Insurance Carrier.

J Occup Environ Med

November 2024

From the AF Group, Lansing, MI (D.L.H.); Division of Occupational and Environmental Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland (E.J.B., N.F.T., N.K., L.Y., N.L., X.G.T.); General Electric, Norwalk, CT (N.K.); Texas Mutual, Workers' Compensation Insurance, Austin, Texas (N.F.T., N.L.); University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (J.G.-M.); and Ortho, Creve Coeur, Missouri (P.M.).

Background: Rotator cuff repair (RCR) is increasingly being performed for both acute traumatic and degenerative tears of the rotator cuff, whereas total shoulder arthroplasty (TSA) is reserved for osteonecrosis of the humeral head, arthritis of the glenohumeral joint, and failed RCR.

Objective: This study aimed to assess the incidence and patient characteristics of rotator cuff tears (RCTs), RCRs, and TSAs among workers' compensation claimants.

Methods: A total of 8347 RCTs indemnity claims filed to Accident Fund Group from 2007 to 2022 were studied.

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Purpose: Humeral head osteonecrosis in the pediatric patients most often occurs in patients with underlying hemoglobinopathies, exposure to chronic corticosteroids, or after trauma. The purpose of this study was to perform a systematic review evaluating the prevalence, clinical characteristics, and management of humeral head osteonecrosis in the pediatric population.

Methods: PubMed, Ovid MEDLINE, and Scopus were screened with the terms "osteonecrosis," "avascular necrosis," "pediatric," and "proximal humerus" on January 10, 2024.

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Results of transosseous suture fixation in four-part valgus impacted fractures of the proximal humerus.

Injury

June 2024

Department A of Orthopaedic Surgery and Traumatology, Niort Hospital, 40 avenue Charles de Gaulle BP 70600, 79021 Niort Cedex, France.

Background: The osteonecrosis ratio in valgus impacted fractures of the proximal humerus is low (<10 %), giving osteosynthesis all its meaning. However, the optimal fixation technique remains controversial. After recentering the humeral head, osteosuture is stable enough to allow bone healing in an adequate position as well as a good long-term shoulder functionality.

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Perilunate Fracture-Dislocation: Results at Mean Follow-Up of 7 Years after ORIF.

J Hand Surg Asian Pac Vol

August 2024

Department of Hand Surgery, Plastic and Reconstructive Surgery, Centre Chirurgical Emile Gallé, CHRU de Nancy, France.

Perilunate fracture-dislocations are frequently associated with a high risk of developing post-traumatic arthritis. Current studies indicate that during mid-term follow-ups, radiological signs of arthritis do not appear to correspond with functional score. The aim of this study was to assess the occurrence of posttraumatic arthritis and the wrist function after perilunate dislocations (PLD) and fracture dislocations at a mid-term follow-up of 7 years.

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Article Synopsis
  • This study aimed to analyze how common existing joint bone issues are in patients with hip or knee pain from osteoarthritis (OA) who were screened for fasinumab clinical trials.
  • Out of 27,633 screened participants, 21,997 underwent imaging, and 5.5% were excluded due to severe articular bone problems noted in X-rays or MRIs, such as bone fragmentation and osteonecrosis.
  • The results suggest that around 5% of OA patients who qualified for the clinical trials ended up being excluded because of serious preexisting joint conditions detected during imaging tests.
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Aims: To systematically review the predominant complication rates and changes to patient-reported outcome measures (PROMs) following osteochondral allograft (OCA) transplantation for shoulder instability.

Methods: This systematic review, following PRISMA guidelines and registered in PROSPERO, involved a comprehensive literature search using PubMed, Embase, Web of Science, and Scopus. Key search terms included "allograft", "shoulder", "humerus", and "glenoid".

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Purpose: Comminuted coronal shear fractures of the distal humerus represent rare injuries and are difficult to treat, especially comminuted capitellum and trochlear fractures (Dubberley Type III). The on-table reconstruction technique of comminuted articular fractures may be an option, although it has not been reported in the coronal shear fracture of the distal humerus. The aim of the present case series is to determine the functional and radiological outcomes of on-table reconstructed Dubberley III fractures.

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Introduction: Osteonecrosis (ON) of the humeral head is defined as "avascular" when the death of bone is due to a disrupted blood supply. It is a known complication following proximal humeral fractures and can lead to poor long-term outcomes and even additional revision surgeries.

Case Report: Patient AP developed symptomatic ON, 3 years following repair of a 4-part valgus impacted proximal humerus fracture.

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: The treatment of complex proximal humerus fractures in elderly patients is not yet fully elucidated. Of all treatment options, reverse shoulder arthroplasty (RSA) and non-operative treatment (NOT) appear to provide the best results. Evidence to guide the choice between the two is sparse.

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Background And Purpose: Knowledge concerning the use AI models for the classification of glenohumeral osteoarthritis (GHOA) and avascular necrosis (AVN) of the humeral head is lacking. We aimed to analyze how a deep learning (DL) model trained to identify and grade GHOA on plain radiographs performs. Our secondary aim was to train a DL model to identify and grade AVN on plain radiographs.

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Background: Acquired acromial compromise, including thinning (less than 30% of the normal acromion) or fragmentation resulting from acromiohumeral impingement or previous acromioplasty, is a concern in reverse shoulder arthroplasty (RSA). This condition may lead to shoulder pain and difficulties in arm elevation because of acromial insufficiency fracture.

Questions/purposes: (1) Do patients with acromial compromise (thinning less than 30% of normal acromion or fragmentation) have worse functional outcome scores, ROM, and strength after RSA compared with patients without acromial compromise? (2) Are patients with acromial compromise at a higher risk of complications such as acromial insufficiency fracture after RSA? (3) Do patients who develop acromial insufficiency fracture have predisposing associated factors and worse clinical outcomes?

Methods: Between January 1, 2016, and December 31, 2020, we treated 398 patients with RSA, and all patients were considered potentially eligible for this study.

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Background: Avascular necrosis (AVN) of the humeral head is characterized by osteonecrosis secondary to disrupted blood flow to the glenohumeral joint. Following collapse of the humeral head, arthroplasty, namely, total shoulder arthroplasty (TSA) or humeral head arthroplasty (hemiarthroplasty), is recommended standard of care. The literature is limited to underpowered and small sample sizes in comparing arthroplasty modalities.

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Phosphaturic mesenchymal tumors (PMT) are rare and distinctive tumors that typically result in paraneoplastic syndrome known as tumor-induced osteomalacia (TIO). We report a case of bilateral osteoporotic femoral neck fracture caused by PMT. PMT was surgically resected, followed by sequential treatment of bilateral femoral neck fractures with total hip arthroplasty (THA).

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