Correlation of head screw lengths in proximal humerus nailing: a CT-based study on 289 cases.

Introduction: Nailing of the proximal humerus is an established method for the treatment of proximal humerus fractures. Choice of the correct length for potentially four proximal locking screws is essential for postoperative outcome. Due to positioning of the patient, intraoperative determination of the correct length of the anteroposterior (AP) screw with the x-ray beam is particularly challenging even for experienced surgeons.

Web-Based Cognitive-Behavioral Therapy to Reduce Severe Cancer-Related Fatigue Among Survivors of Hodgkin Lymphoma: A Feasibility Study.

We investigated the feasibility of a web-based cognitive-behavioral therapy to reduce cancer-related fatigue (CRF) among survivors of Hodgkin lymphoma. In this before-and-after trial, patients were primarily recruited via the German Hodgkin Study Group (GHSG). We assessed feasibility (response and drop-out rate) and preliminary efficacy including CRF, quality of life (QoL), and depressive symptomatology.

Overlengthening of the radial column in radial head replacement: a review of the literature and presentation of a classification system.

Background: Radial head arthroplasty is a common procedure in elbow surgery. It has been shown to be of benefit for the patients, but there also are relevant complications that should be prevented if possible. One significant complication is overlengthening of the radial head prosthesis.

Medial elbow exposure: an anatomic comparison of 5 approaches.

Purpose: Several surgical approaches to the medial elbow are described; however, it remains unclear which exposure provides the optimal view of relevant medial elbow structures. The purpose of this anatomic study was to determine the visible surface area of the coronoid process, distal humerus, and radial head through 5 approaches to the medial elbow.

Methods: Eight fresh-frozen cadaveric upper extremity specimens were dissected.

Can low-profile double-plate osteosynthesis for olecranon fractures reduce implant removal? A retrospective multicenter study.

Background: Because of poor soft-tissue coverage at the proximal ulna and prominent posteriorly positioned implants, hardware removal remains the most common reason for revision surgery of olecranon fractures that were operatively treated using plate osteosynthesis. We hypothesized that low-profile double-plate osteosynthesis would reduce the number of soft tissue-related hardware removals compared with single posterior plating whereas the functional results would be comparable.

Methods: This study retrospectively included patients who were treated with low-profile double-plate osteosynthesis or a posterior 2.

Revision shoulder arthroplasty: a systematic review and comparison of North American vs. European outcomes and complications.

Background: Joint registries provide invaluable data on primary arthroplasties with revision as the endpoint; however, the revision outcomes are often excluded. Therefore, a PROSPERO registered review (CRD42015032531) of all revision studies in North America and Europe was conducted to evaluate demographics, etiologies and indications, implant manufacturer, and complications by geographic region.

Methods: The MEDLINE, EMBASE, and CENTRAL databases were searched for revision arthroplasty clinical studies with a minimum mean 24-month follow-up.

Surgical revision of radial head fractures: a multicenter retrospective analysis of 466 cases.

Background: Radial head fractures lead to persisting disability in a considerable number of cases. This study aimed to investigate their most common revision causes and procedures.

Methods: This multicenter retrospective study reviewed the cases of 466 adult patients who had undergone surgical revision after operative or nonoperative treatment of a radial head fracture.

The shape match of the olecranon tip for reconstruction of the coronoid process: influence of side and osteotomy angle.

Background: The integrity of the coronoid process is critical to maintaining elbow stability. Unreconstructible fractures and chronic coronoid deficiency are challenging clinical problems with no clear solution. The purposes of this study were to investigate the shape match of the ipsilateral and contralateral olecranon tips as graft options and to determine the influence of the osteotomy angle on fitment.

Computed Tomography Analysis of the Radial Notch of the Ulna.

Purpose: The anatomy of the radial head and capitellum has been extensively studied; however, the anatomy of the radial notch of the ulna (RNU) has received little attention. This imaging-based anatomic study characterizes the morphology of the RNU.

Methods: Ninety-eight cadaveric arms (57 male, 72 ± 14 y) were imaged with computed tomography, and 3-dimensional reconstructions of the proximal ulna were constructed.

Oral health-related quality of life of children and adolescents with and without migration background in Germany.

Objectives: To compare oral health-related quality of life (OHRQoL) in children and adolescents with and without migration background, and to assess whether potential differences in OHRQoL can be sufficiently explained by oral health characteristics.

Materials Und Methods: A consecutive sample of 112 children and adolescents was recruited in a German university-based orthodontic clinic, and a convenience sample of 313 children and adolescents of German public schools was enrolled in the study (total N = 425, age range 7-17 years). However, 29 participants were excluded due to insufficient information regarding migration background.

Factors Predictive of Sentinel Lymph Node Involvement in Primary Breast Cancer.

Background/aim: Sentinel lymph node biopsy (SLNB) has replaced axillary lymph node dissection (ALND) for axillary staging in patients with early-stage breast cancer. The need for therapeutic ALND is the subject of ongoing debate especially after the publication of the ACOSOG Z0011 trial. In a retrospective trial with univariate and multivariate analyses, factors predictive of sentinel lymph node involvement should be analyzed in order to define tumor characteristics of breast cancer patients, where SLNB should not be spared to receive important indicators for adjuvant treatment decisions (e.

Determination of Elbow Laxity in a Sequential Soft-Tissue Injury Model: A Cadaveric Study.

Background: The objective of our study was to analyze, under fluoroscopy, joint angulation of uninjured elbows and elbows with distinct induced collateral ligament injury.

Methods: Twelve elbow specimens were tested for varus and valgus joint angulation using 4 different examination methods (application of both varus and valgus stress by each of 2 examiners [Examiner 1 and Examiner 2] and application of 1 and 2 Nm of torque using a calibrated electric force scale) in 4 elbow positions (in full extension with 90° of supination and 90° of pronation, and in 30° of flexion with 90° of supination and 90° of pronation). Six elbow specimens were examined under varus stress at each of 5 sequential stages: (1) intact, (2) transection of the lateral ulnar collateral ligament (LUCL), (3) complete transection of the lateral collateral ligament complex (LCLC), (4) transection of the anterior aspect of the capsule (AC), and (5) transection of the medial collateral ligament (MCL).

Plate Osteosynthesis of Proximal Ulna Fractures-A Biomechanical Micromotion Analysis.

Purpose: Double plating has been promoted, in recent years, as an alternative treatment method for proximal ulna fractures. This study aimed to compare the biomechanical properties of double-plate osteosynthesis with posterior plate fixation using a novel investigational design utilizing a 3-dimensional camera system to analyze fracture micromotion.

Methods: Fourteen fresh-frozen specimens were available for this study.

Radial shortening osteotomy reduces radiocapitellar contact pressures while preserving valgus stability of the elbow.

Purpose: Shortening osteotomy of the proximal radius might represent a potential salvage procedure in symptomatic radiocapitellar osteoarthritis, which could decrease radiocapitellar load while preserving the native radial head. In an in-vitro biomechanical investigation, we sought to determine whether shortening osteotomy of the proximal radius (1) decreases the radiocapitellar joint pressure upon axial loading and (2) retains valgus stability of the elbow. In addition, the anatomic configuration of the lesser sigmoid notch was evaluated to assess possible contraindications.

The Circumferential Graft Technique for Treatment of Chronic Multidirectional Ligamentous Elbow Instability.

Introduction: The circumferential graft technique represents a potential option for the treatment of multidirectional ligamentous elbow instability using a single tendon graft (Video 1).

Step 1 Perform A Medial And Lateral Approach: Approach the elbow joint through either a single posterior skin incision or separate lateral and medial incisions.

Step 2 Drill The Bone Tunnels: Create humeral and ulnar bone tunnels for circumferential graft placement.

Predictors of medium-term clinical outcomes after total shoulder arthroplasty.

Purpose: The study aims to measure the relationship of potential clinical and radiographic predictors and medium-term clinical outcomes after total shoulder arthroplasty in primary osteoarthritis.

Materials And Methods: In a prospective follow-up study, preoperatively collected clinical and radiographic variables were recorded in 103 patients with an average age of 66 years (range 37-83 years) to measure their influence on the clinical outcome by use of the Constant score. The average length of follow-up was 6 years (range 3-12 years).

Expression of Kallikrein-Related Peptidase 6 in Primary Mucosal Malignant Melanoma of the Head and Neck.

Mucosal melanomas of the head and neck (MMHN) are aggressive tumors with poor prognosis, different opposed to cutaneous melanoma. In this study, we characterized primary mucosal malignant melanoma for the expression of Kallikrein-related peptidase 6 (KLK6), a member of the KLK family with relevance to the malignant phenotype in various cancer types including cutaneous melanoma. Paraffin-embedded MMHN of 22 patients were stained immunohistochemically for KLK6 and results were correlated with clinical and pathological data.

Annular ligament reconstruction with the superficial head of the brachialis: surgical technique and biomechanical evaluation.

Purpose: The purpose of this study was to perform biomechanical testing of annular ligament (AL) reconstruction using the superficial head of the brachialis tendon (SHBT) as a distally based tendon graft. We hypothesized that posterior translation of the radial head following AL reconstruction with an SHBT graft does not significantly differ from intact specimens.

Methods: Six fresh-frozen elbow specimens were used.

Total shoulder arthroplasty: risk factors for intraoperative and postoperative complications in patients with primary arthritis.

Background: This study evaluated and identified risk factors for the development of intraoperative and postoperative surgical complications in total shoulder arthroplasty in patients with primary osteoarthritis.

Methods: We evaluated patient-specific factors, including age, sex, body mass index, prior nonarthroplasty surgery, smoking, alcohol consumption, and the American Society of Anesthesiologists (ASA) Physical Status Classification System in 275 patients (76 men, 199 women) with an average age of 68 years (range, 51-85 years). We categorized the number and severity of all complications and correlated these results with the patient-specific factors RESULTS: Twenty-seven complications (9.

Suture button reconstruction of the central band of the interosseous membrane in Essex-Lopresti lesions: a comparative biomechanical investigation.

Unlabelled: Surgical reconstruction of the interosseous membrane may restore longitudinal forearm stability in Essex-Lopresti lesions. This study aimed to compare the longitudinal stability of the intact forearm with a single-bundle and a double-bundle reconstruction of the central band of the interosseous membrane using digital image correlation with a three-dimensional camera system. Single and cyclic axial loading of eight fresh-frozen forearm specimens was carried out in the intact state, after creation of an Essex-Lopresti lesion, after a single-bundle and after a double-bundle reconstruction of the central band using a TightRope (Arthrex GmbH, Munich, Germany) construct.

The cortical irregularity in the transition zone of the radial head and neck: a reliable radiographic sign of an occult radial head fracture.

Purpose: Exclusion or detection of non-displaced radial head fractures can be difficult in radiographs, because they might lack conclusive radiographic signs, such as fracture lines or distracted articular fragments. Based on the typical injury mechanism of a radial head fracture, causing the head to hit the capitulum and leading to a depression of the anterolateral border of the radial head, we hypothesized that even slight cortical irregularities in the transition zone of the radial neck and head result from that depression and may be a reliable radiographic sign of an underlying radial head fracture. Secondarily, we tested the null hypothesis that the lack of cortical irregularities is sufficient to exclude a fracture of the radial head.

Functional anatomy of the lateral collateral ligament of the elbow.

Introduction: The aim of this study was to analyze the functional anatomy of the lateral collateral ligament complex (LCLC) and the surrounding forearm extensors.

Materials And Methods: Using 81 human cadaveric upper extremities, the anatomy of the forearm extensors-especially the anconeus, supinator and extensor carpi ulnaris (ECU)-was analyzed. After removal of aforementioned extensors the functional anatomy of the LCLC was analyzed.

Identification and clinical relevance of PD-L1 expression in primary mucosal malignant melanoma of the head and neck.

Mucosal melanoma of the head and neck is a rare and aggressive tumor entity with a poor prognosis. The standard treatment is radical tumor resection, with or without adjuvant radiation, where conventional chemotherapies in advanced stage or recurrent diseases have shown little benefit. Overexpression of the programmed cell death ligand 1 (PD-L1) is a common feature in human cancer.

From radial head to radiocapitellar to total elbow replacement: A case report.

Introduction: Radiocapitellar arthroplasty represents a possible treatment option for isolated osteoarthritis of the radial column. We report the first case of early failure of this procedure.

Presentation Of Case: We present the case of a 41-year old male who sustained a terrible triad injury to his right elbow and subsequently underwent radial head arthroplasty.