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S R Jacobson

Publications and source records attributed to S R Jacobson.

8 recordsLinked to original sources
PubMed1997

Comparison of distal humerus fracture fixation: a biomechanical study.

Few biomechanical studies have been done evaluating the rigidity of internal fixation constructs for distal humerus fractures. We assessed the bending and torsional stiffness of five commonly used multiple plate constructs. Plates were applied in three positions: medially, along the medial supracondylar column; laterally, along the lateral supracondylar column; or posterolaterally, extending distally to the capitellum. Each specimen was randomly assigned to one of five construct groups. All plated specimens were stiffer in the frontal plane as compared with the sagittal plane and, when compared with intact specimens, showed a disproportionate decrease in sagittal plane stiffness. Constructs 1 and 5 had significantly greater relative bending stiffness in the sagittal plane than constructs 3 and 4. Construct 4 had the lowest relative bending stiffness in the frontal plane. This reached statistical significance when compared with constructs 2 and 5. There was no significant difference in the torsional stiffness of the five constructs. We conclude that the multiple plate constructs offered significantly less bending stiffness than the intact specimens, with a particular deficiency in the sagittal plane. The triple-plated construct (construct 5) did not confer greater stiffness and was technically difficult to implant. The medial pelvic reconstruction plate combined with the posterolateral DCP (construct 1) provided the greatest sagittal plane stiffness, in addition to comparable frontal plane and torsional stiffness. We recommend its use in the treatment of fractures of the distal humerus.

Adolescent↗
PubMed1995

Fracture of a supracondylar humeral myositis ossificans.

Although myositis ossificans is a well-known sequela of elbow trauma, reinjury to the affected region can also occur, resulting in acute symptoms from a fracture of the myositis ossificans. An 18-year-old man presented with localized pain, soft-tissue swelling, and a bony mass along the anterolateral distal humerus with restricted elbow range of motion after injury to his elbow during football. One year earlier he had sustained a similar crush injury to his elbow that resulted in a limited, although painless, arc of motion. Radiographs and tomograms established the diagnosis of a fractured supracondylar humeral myositis ossificans. Surgical excision of the large mature ossified fragment confirmed the diagnosis and restored a full range of motion of the elbow.

Adolescent↗
PubMed1994

Fractures of the supracondylar process of the humerus.

The supracondylar process of the humerus is a relatively rare but well-known anatomic variant that can be associated with other anomalies. While it usually remains clinically silent, the spur can be responsible for a wide spectrum of symptoms. We present 3 patients with fractures of the supracondylar process and review 12 other cases in the literature. The supracondylar process has potential for fracture and important neurovascular sequelae.

Adolescent↗
PubMedDate not supplied

Reliability of radiographic assessment of acromial morphology.

The most widely used radiographic classification system for acromial morphology identifies three distinct acromial shapes: type I (flat), type II (curved), and type III (hooked). The purpose of this study was to measure the interobserver and intraobserver reliability of determinations of acromial morphology as defined by this system. Between 1990 and 1992, one hundred twenty-six supraspinatus outlet radiographs were obtained from 126 patients by technicians from Triangle Orthopaedic Associates in Durham, N.C. Six fellowship-trained shoulder surgeons independently reviewed each radiograph and classified it as type I, II, or III on the basis of established guidelines. Two surgeons classified each film a second time in random order. Analysis of variance was performed to obtain coefficients for interobserver and intraobserver reliability. Consensus ratings were then used to classify the 126 radiographs into consensus type I, consensus type II, or consensus type III groups. Percentages of type I, II, and III individual ratings within each consensus group were determined. The intraobserver reliability coefficient was 0.888, interpreted as good to excellent reliability. The interobserver reliability coefficient was 0.516, interpreted as poor to fair reliability. Of the 126 radiographs, 26 (20.6%) were rated as consensus type I, 76 (60.3%) were rated as consensus type II, and 24 (19.1%) were rated as consensus type III. The reliability of observer ratings was lowest when delineation between acromial types II and III was required. The low interobserver reliability makes comparisons of studies by different authors difficult to interpret and obscures the true incidence of acromial morphologic types. It also questions reported correlations between acromial type and shoulder pathologic conditions. It is concluded that a system that incorporates more objective classification criteria and acknowledges the continuous nature of acromial morphologic types may improve interobserver reliability and validate the system's use in making clinical and surgical judgments.

Acromion↗