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At least 325 records · Page 18Linked to original sources
PubMed1995

Internal fixation of proximal humeral fractures.

Fractures of the proximal humerus are common, especially in elderly individuals, and are usually classified according to Neer into fractures having one, two, three, or four parts with or without an associated dislocation or an injury splitting the humeral head. This article is intended to assist the surgeon in selecting and using techniques for internal fixation of these fractures. The use of open reduction and internal fixation using plates and screws has become less popular because of the extensive dissection required and the tendency for the plate to impinge. Use of multiple percutaneous pins to fix the humeral head to the shaft (surgical neck) and heavy sutures or wires to reattach the tuberosities is often preferable.

Aged↗
PubMed1994

[Early experience with total shoulder arthroplasty].

The author gives a report on the indication, on the surgical technique and on the results of shoulder arthroplasty, following 30 porous coated, unconstrained, BIO-MODULAR total endoprothesis were implanted. The pain, which was uncurable with any other methods, was relieved by implanting the total shoulder prosthesis. The functional result is determined by the condition of rotator cuff and by the way of reconstruction, rehabilitation and cooperation of the patients. The experience in soft tissue surgery is absolute necessary to be successful.

Adult↗
PubMed1995

Gunshot wounds to the shoulder.

The proximity of vascular, neural, osseous, and muscular structures make gunshot wounds to the shoulder area particularly challenging. This review focuses on the epidemiology, pathophysiology, diagnosis, and treatment of these injuries. Special attention is given to the usefulness of vascular and electrodiagnostic studies.

Algorithms↗
PubMed1994

Displaced Salter-Harris type I injury in a gymnast. A slipped capital humeral epiphysis?

The case of an adolescent Olympic-level gymnast with insidious onset shoulder pain is presented. Radiographic evaluation revealed bilateral physeal irregularities of the proximal humerus similar to those seen in Little Leaguer's shoulder. Roentgenograms of the involved shoulder also demonstrated Salter-Harris type I displacement at this physis and a slipped capital humeral epiphysis was diagnosed. A discussion reviewing proximal humeral physeal injury follows the case presentation.

Adolescent↗
PubMed1996

Bipolar salvage shoulder arthroplasty. Follow-up in 14 patients.

A bipolar spacer was inserted for severe arthritic destruction of the shoulder in 14 patients, and followed up for a mean of 5.9 years. In one patient the operation failed because of infection. Two others required revision for loss of low-friction properties which caused loosening of the humeral component. At the end of the follow-up all the patients showed improvement. The Hospital for Special Surgery pain score had increased from 5.3 to 18.9 and the movement score from 7.5 to 20.1.

Aged↗
PubMed1983

Anterior glenohumeral instability.

Anterior glenohumeral instability is an important cause of shoulder disability in athletes. Recurrent glenohumeral instability can seriously impair the athlete's performance. Since the surgical repair of recurrent instability may result in a loss of flexibility, particularly in the thrower and gymnast, the physician must optimize both joint stability and joint flexibility.

Athletic Injuries↗
PubMed1997

[Useful imaging data before intervention for an unstable shoulder].

Recurrent instability of the shoulder may sometimes be a difficult diagnostic challenge. Bernageau's standard X-rays set, which includes 3 antero-posterior X-rays with medial rotation and 2 glenoid views, is able to confirm the existence of anterior instability events. However, it gives no information on the glenoid labrum and the glenohumeral ligaments. As surgical techniques are more sophisticated, more precise imaging techniques are needed in order to adapt the surgical technique to the anatomical lesions. Although CT arthrography is today the best imaging technique to choose a surgical technique, it will probably be replaced by MR arthrography in the near future. Pros and cons of each imaging techniques are described, together with their implications for the choice of treatment.

Arthrography↗
PubMed2004

Bilateral posterior fracture dislocation of the shoulders following seizure.

Bilateral posterior fracture dislocation is a rare injury known to be associated with seizures. Convulsion was found to be the cause of fracture dislocation in 78% of the cases reported. The mechanism of injury was described by Shaw in 1971. The management depends largely on the severity of the injury. In many cases reported, the fracture was a large compression defect in the anteromedial aspect of the articular surface of the humeral head. It has been suggested that for defects that involve less than 20% of the articular surface closed reduction can be attempted. Rush nail or percutaneous K wires can be used to maintain reduction. Open reduction is necessary for defects that are involving 20-40% of the surface. The aim in these cases is to reconstruct the proximal humerus if possible by the use of internal fixation. If reconstruction is not feasible, a modified McLaughlin procedure can be used to prevent chronic instability of the shoulder. This procedure involves re-implanting the subscapularis tendon into the defect. Reconstructing fractures that involve more than 40% of the articular surface or 4-part fracture is not usually successful. These fractures are associated with a high the risk of avascular necrosis. Hemi-arthroplasty or total shoulder replacement is generally regarded as better option as they offer rapid recovery and eliminate the possibility of multiple procedures if fixation fails.

Diagnosis, Differential↗
PubMedDate not supplied

[X-ray morphometric evaluation of the location of an intercalated fragment in double fractures of the shoulder].

The Academician G.A. Ilizarov Russian Research Center "Reconstructive Traumatology and Orthopedics" treated 40 patients with double humeral fractures. On examining their X-ray films, the patients were divided into groups according to the location of an intercalated fragment. The Eletto procedure was used to estimate the levels of fractures. Comparison of the X-ray morphometric studies, the diagram of the humeral architectonics, and clinical observations revealed a relationship between the time of consolidation and the location of an intercalated fragment, which is explained by the degree of preservation of the latter's intramedullary blood flow. While treating patients with double fragments of the shoulder, it is expedient to use the Eletto index to determine the levels of the fragments.

Female↗