Posttraumatic locked dislocation of congenital pseudarthrosis of the clavicle.
Explore the source record for details and available documents.
Accidents, Traffic↗
Biomedical subjects
Ofer Levy
Publications and source records attributed to Ofer Levy.
Inferior capsular shift for multidirectional instability following failed laser-assisted capsular shrinkage.
This report is a prospective study of 10 consecutive patients treated by open inferior capsular shift following failed laser-assisted capsular shrinkage. Six patients had true multidirectional instability, 2 had anteroinferior instability with multidirectional laxity, and 2 had posteroinferior instability with multidirectional laxity. An anterior approach was used and a humeral-side capsular shift performed. The mean period of follow-up was 33 months (range, 18-47 months). On the basis of the Rowe system,9 patients had excellent results and 1 had a poor result at final follow-up. The mean score improved from 37.5 to 94 points on the Rowe scale, from 73 to 90.4 points on the Constant scale, and from 1.6 to 7.7 points on a numeric satisfaction scale (P <.001 for all). The one poor result was in the only patient who underwent multiple attempts at open stabilization prior to laser-assisted capsular shrinkage. There were no complications. We conclude that the results of an inferior capsular shift for multidirectional instability are not necessarily adversely affected by a previous failed laser-assisted capsular shrinkage procedure.
Adult↗
The role of arthroscopy for the problem shoulder arthroplasty.
Between 1995 and 2000, 29 patients who had excessive pain or limitation of motion after a shoulder arthroplasty underwent arthroscopy. Preoperative diagnoses of impingement syndrome in 10 patients (treated by arthroscopic subacromial decompression), large rotator cuff tear in 1, loose bodies in 1, unstable cuff arthropathy in 1, and septic arthritis in another were confirmed at arthroscopy. Of the 15 patients without a preoperative diagnosis, 7 had postarthroplasty capsular fibrosis, with 6 undergoing arthroscopic capsular release. A malpositioned glenoid component was found in 1 patient. Loose or worn components were found in 4 of the shoulders, impingement with a small partial-thickness cuff tear was identified in 1, a florid synovitis was present in another, and in 1 no abnormality could be found. The procedures were often hindered by limited access and reflection from the prosthesis. Arthroscopy after shoulder arthroplasty is useful for the diagnosis and treatment of pain and loss of motion in selected patients but can be technically challenging.
Adult↗
The vertical-apical suture Bankart lesion repair for anteroinferior glenohumeral instability.
We report the results of the vertical-apical suture Bankart lesion repair in 59 patients with traumatic anteroinferior glenohumeral instability. According to the system of Rowe et al, at a mean follow-up of 42 months (minimum, 2 years), 94.9% (56 patients) had a rating of good or excellent. Three patients had a recurrent dislocation due to further trauma. The mean Rowe score was 94.6, the mean Walch-Duplay score was 94.3, the mean Constant score was 90.4, and the mean rating on a numerical satisfaction scale was 8.7. The mean loss of external rotation with the arm at the side was 2.4 degrees, and in 90 degrees abduction it was 2.2 degrees. Of 44 patients, 35 (79.5%) returned to the same sport at the same level of activity, 7 returned to the same sport at a reduced level of activity, and 2 stopped all sporting activities. There were no complications. We recommend the vertical-apical suture as a technique for Bankart repair that uses absorbable sutures and no suture anchors or tacks.
Adolescent↗
Operative management of the frozen shoulder in patients with diabetes.
Forty-three patients with diabetes (47 shoulders) who had a manipulation under anesthesia only (24 shoulders), a manipulation under anesthesia followed by an arthroscopy (12 shoulders), or an arthroscopic release (11 shoulders) for a frozen shoulder were followed-up for a mean period of 35 months. The mean Constant score improved from 20.3 to 63.7 points (P <.001). The mean improvement in forward flexion was 71.7 degrees, in abduction 78.5 degrees, in external rotation with the arm at the side 36.3 degrees, and in internal rotation from the buttock to the first lumbar vertebra (P <.001 for all). When gentle manipulation with the patient under anesthesia was possible, the outcome was satisfactory in 13 of 15 shoulders (86.7%) in patients with non-insulin-dependent diabetes and in 17 of 21 shoulders (81%) in patients with insulin-dependent diabetes (P >.5). Insulin-dependent patients with diabetes were more likely to require an arthroscopic release than patients with non-insulin-dependent diabetes (P <.05). Most of our patients obtained their maximum relief of pain and functional recovery within 3 months of surgery. We recommend manipulation under anesthesia for the resistant frozen shoulder in patients with diabetes. Arthroscopic release is required when mobilization under anesthesia is not possible.
Adult↗
Simple, minimally invasive surgical technique for treatment of type 2 fractures of the distal clavicle.
Neer type 2 fractures of the distal clavicle have a high rate of nonunion and delayed union. A simple, minimally invasive surgical technique using suture fixation is introduced. In this series 12 patients were treated with suture fixation of this fracture with absorbable suture material, resulting in union of all fractures. There was a rapid return to function and no complications. This technique allows simple, minimally invasive fixation with good fracture healing and early return to work and sports.
Adolescent↗