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At least 1,549 records · Page 86Linked to original sources
PubMed1992

Military static line parachute injuries.

A prospective study of 8886 military static line parachute descents causing 63 injuries including one fatality, is presented. The overall injury rate was 7.1 per 1000 descents. The injury rate was significantly greater when combat equipment was carried (13.7 per 1000), and greater still with tactical flying and simultaneous door exits (16.6 per 1000). These rates are both higher than those reported in other military studies, and higher than those in civilian studies. However, civilian parachutists sustain more fractures than military parachutists, most likely due to lower standards of fitness and training. The types of injuries which are now sustained have changed markedly from those first seen in the mass parachute deployments of World War Two. Fracture-dislocation of the shoulder has become the new 'paratroopers's fracture'. This injury occurs most commonly in descents with cross-winds of greater than 10 knots.

Aerospace Medicine↗
PubMedDate not supplied

Treatment of fractures of the humeral head by cemented and cementless hemiarthroplasty. Our experience.

Patients submitted to shoulder hemiarthroplasty for the treatment of fracture of the humeral head were analyzed. The study was conducted from 1991 to June 2001 using 2 different prosthetic models: the Neer cemented prosthesis and the Randelli cementless prosthesis. The authors were able to evaluate 93 cases out of 148 operated on. A review of data revealed the essential importance of reconstruction of the tuberosity and rehabilitation. It was also observed that the age of the patient and the severity of the fracture did not in any way influence results. X-ray examinations did not shed light on loosening phenomena in prosthetic implants. Erosion of the glenoid was observed only when two factors coexisted: incorrect position of the prosthesis and low mobility of the shoulder. The study allowed us to reveal numerous prognostic elements, both favorable and adverse, and to measure their importance and priority.

Aged↗
PubMed1995

Sonographic evaluation of lipohemarthrosis: clinical and in vitro study.

The purpose of this study is to evaluate the role of sonography in diagnosing lipohemarthrosis. Sonography was performed on seven patients with intra-articular fractures of the knee, shoulder, and hip. An in vitro mixture of fat and blood was examined as the gold standard. In the patients scanned a few minutes after immobilization, a two-band appearance of joint effusion was present, representing a fat-blood level. One patient scanned 3 hours after immobilization showed a three-band appearance of joint effusion, corresponding to the layers of fat, serum and red blood cells. Results of this study indicate a high reliability of ultrasonography in detecting lipohemarthrosis.

Adipose Tissue↗
PubMed1993

Radiological and histological improvement of oxalate osteopathy after combined liver-kidney transplantation in primary hyperoxaluria type 1.

A 15-year-old patient with severe bone disease (with bilateral fractures of hips and shoulders) due to primary hyperoxaluria type 1 (PH1) was treated with combined liver-kidney transplantation after a 4-year hemodialysis period. Normalization of excessive oxalate synthesis brought in by the liver graft combined with the slow excretion of skeletal oxalate stores by the renal graft led to progressive improvement of clinical, radiological, and histological evidence of oxalate osteopathy. This allowed bilateral hip replacement 3 years after transplantation, which led to complete physical rehabilitation of the crippled patient. Combined liver-kidney transplantation constitutes the treatment of choice for end-stage renal failure due to PH1, even in the face of severe oxalate bone disease.

Adolescent↗
PubMed2001

Infant shoulder sonography: technique, anatomy, and pathology.

BACKGROUND: In the infant, shoulder injury due to birth trauma and infection in joint and bone may be difficult to detect radiographically. Shoulder ultrasound provides a dynamic, noninvasive method of evaluation. OBJECTIVE: To develop a technique to evaluate the infant shoulder and to successfully demonstrate pathology. MATERIALS AND METHODS: Using a multiplanar, dynamic technique, 24 normal and 12 symptomatic infants (age range, 3 days to 9 months) were examined (49 shoulders). RESULTS: Sonographic findings were normal in 41 shoulders and abnormal in 8 shoulders. Abnormalities included subluxation, fracture, abnormal cartilage, soft-tissue mass, and inflammatory collections, including effusion. CONCLUSION: Ultrasound can be used successfully to evaluate the infant shoulder for instability, fracture, and infection.

Birth Injuries↗
PubMed2001

Early fatigue failures of cemented, forged, cobalt-chromium femoral stems at the neck-shoulder junction.

Femoral component fracture is a rare but well-documented complication after total hip arthroplasty. Historically, most stem fractures have occurred at the middle third of the implant, where proximal stem loosening and solid distal stem fixation result in cantilever bending and eventual fatigue failure. In contrast, we report 2 early fatigue failures of well-positioned, well-fixed, cemented, forged, cobalt-chromium femoral components at the neck-shoulder junction. A contributing factor to the implant failures was heavy laser etching in a region of the implant subjected to high stresses, leading to decreased fatigue resistance and subsequent fracture.

Aged↗
PubMed1997

Traumatic first rib fracture: is angiography necessary? A review of 730 cases.

The two most common sites of first rib fracture were at the subclavian sulcus and in the neck of the first rib, posteriorly. Five distinct mechanisms for rib fracture were identified and included: (i) posteriorly directed trauma to the upper thorax or shoulder girdle; (ii) a direct blow to the sternum and anterior chest wall; (iii) a blow fracturing the clavicle; (iv) a strong sudden contraction of the scalenus anticus muscle; and (v) radiographic findings of a first rib fracture without history of trauma. Isolated first rib fracture regardless of mechanism of injury, results in a low incidence of major vascular injury (mean 3%), although with fracture displacement, the incidence is higher. First rib fracture associated with concomitant head, thoracic, abdominal, or long bone trauma was associated with vascular injury in 24% of cases. According to this review, specific indications for subclavian artery and aortic arch arteriography in patients with traumatic first rib fracture include widened mediastinum on chest radiography, upper-extremity pulse deficit, posteriorly displaced first rib fracture, subclavian groove fracture anteriorly, brachial plexus injury and expanding hematoma.

Angiography↗
PubMed1987

[Fractures of the glenoid surface of the scapula].

The communications of literature regarding osteosynthesis in glenoid fractures of the scapula are reviewed, and six own cases are presented. The results are better than expected even in case of comminuted fractures. The indication for surgical reconstruction should therefore be adopted in dislocated fractures of the shoulder joint surface. Although the adequate operation technique is still under discussion, there seems to be a trend towards screwing and a narrow DC plate.

Follow-Up Studies↗
PubMed2002

Optimal age for preventing osteoporosis after menopause depends on effects of stopping treatment.

The aim of this study was to model the effect of short (3 year) treatments for osteoporosis at different times after menopause on the risk of osteoporotic fracture and to assess the impact of strategies to target high-risk individuals. Treatment efficacy for hip, proximal forearm, shoulder, and spine fracture were computed from the relationship between bone mineral density (BMD) and fracture in women from Sweden. Treatment that increased hip bone mineral density by 6% over untreated women saved 126 vertebral, hip, proximal humerus, and forearm fractures per 1000 women at the age of 50 years, provided that the effects of treatment persisted. Targeting women with osteoporosis at this age would save an additional 50% of fractures. With age, the number of fractures saved decreased moderately. At the age of 70 years, 133 fractures would be saved in women with osteoporosis compared to 198 in women with osteoporosis at the age of 50 years. Where the effect of treatment was assumed to wear off over 20 years after stopping treatment, the efficacy of treatment was reduced at all ages, but most markedly at the age of 50 years. Where all women aged 50 years were treated, the number of fractures saved per 1000 women decreased from 127 to 15 and, in the case of targeting women with osteoporosis, decreased from 198 to 27 per 1000 women. By contrast, with a persisting effect of treatment, the number of fractures saved increased markedly with advancing age. If all women were targeted at the age of 50 years, 15 fractures would be saved, whereas this increased to 55 per 1000 women at the age of 70 years. When treatment effects wore off more rapidly with an offset half-time of 2.5 years only 5 fractures were saved per 1000 women at the age of 50 years. This figure rose to 23 per 1000 at the age of 70 years. We conclude that, although uncertainty exists concerning the offset of effect of treatments, treatments should be optimally given to women without prior fractures in later life.

Age Factors↗
PubMed2006

Chronic posterior dislocation of the glenohumeral joint complicated by a fractured proximal humerus: a case report.

A 41-year-old right-handed woman was involved in a traffic accident and landed on the right arm while the right shoulder was in flexion. She experienced pain and severe impairment of right shoulder motion immediately following the accident. She was misdiagnosed with a fractured proximal humerus with no displacement and was treated conservatively by immobilisation. There was inadequate recovery in range of motion and gradual development of severe pain. Two years and 4 months after the injury, the patient presented to our hospital where a diagnosis of chronic posterior fracture dislocation of the shoulder with split articular surface of the humeral head was made. A humeral head replacement without resection of the greater tuberosity or the coracoid process was performed. Postoperative recovery was uneventful. The patient returned to work as a cook one year later. At 20-month follow-up, the patient had no pain, and her shoulder range of motion was forward flexion 160 degrees, abduction 140 degrees, external rotation 40 degrees, and internal rotation L3.

Adult↗
PubMed2005

The floating shoulder.

Ipsilateral scapular neck and clavicular shaft fractures comprise the so-called "floating shoulder". This rare injury, which is, in general, caused by a high-energy trauma, is perceived to be an unstable injury with the considerable risk of significant displacement of scapular neck and/or the clavicular fracture. An understanding of the patho-anatomy is important in identifying a floating shoulder and to offer rational treatment for this injury. The current status of the anatomical, biomechanical and clinical aspects of a floating shoulder is reviewed in this article. Recommendations for treatment of particularly displaced ipsilateral fractures of the scapular neck and clavicular shaft cannot be derived from the reported clinical studies. The possible correlation between functional outcome and malunion of the scapular neck is called into doubt.

Clavicle↗
PubMed1985

Cubitus varus deformity following supracondylar fracture of the humerus. A method for measuring rotational deformity.

Cubitus varus following supracondylar fracture of the humerus in children consists of varus, hyperextension, and internal rotation deformities of the distal bone fragment of the humerus. There has been no simple clinical method of measuring internal rotation deformity. The authors report here on a method of accurately measuring the internal rotation of the shoulder in a position with the elbow at 90 degrees flexion on the back and the shoulder held at the maximum extension. When a patient with developing cubitus varus attempts to rotate his shoulder internally, there is an apparent increase in the degree of internal rotation at the shoulder of the fractured side. The mean value of the angle formed between the horizontal plane of the back and the mid-line of the forearm was approximately 0 degrees in 217 normal children, whereas an increase of 35 degrees was seen in seven children with cubitus varus. When this angle was corrected successfully, the angle after surgical correction became approximately 0 degrees. In the treatment of cubitus varus deformity, it is necessary to simultaneously correct three-dimensional deformities.

Child↗
PubMedDate not supplied

[Comparative study of surgically treated shoulder injuries with or without metal implants].

In 36 patients with acromioclavicular fracture type III, IV and V following the Rockwood classification, different surgical procedures without using metal implants were compared. Augmentation of both, the coracoclavicular and acromioclavicular ligaments was done by Vicryl-threads (5 mm) in 26 cases (group I). Solitary augmentation of coracoclavicular ligaments were done in 6 cases (group II), of acromioclavicular ligaments in 4 cases (group III). Twenty-four patients underwent follow-up regarding clinical, ultrasonic and radiological results after 30 month in average. Dislocations of more than 10 mm we found once in group I and II, three times in group III. Using the Taft score, regarding clinical, ultrasonic and radiological findings, five patients had an excellent, 15 a good five patients a satisfying result and the remaining patient had a poor reconstruction of the acromioclavicular joint. Comparing these results with previous 75 patients who underwent surgical reconstruction of acromioclavicular joint, using metal implants between 1980 and 1985, the results were nearly equal. Although severe complications like migration or fracture of the implant and the necessity for another surgical intervention for explantation were not given in patients who were treated without using metal implants. Solitary augmentation of acromioclavicular ligament showed insufficient results, therefore this therapy should not be recommended anymore.

Acromioclavicular Joint↗
PubMed2006

The floating shoulder.

The floating shoulder is defined as ipsilateral fractures of the midshaft of the clavicle and the neck of the glenoid. This rare injury can be difficult to manage without a thorough understanding of the complex anatomy of the shoulder girdle. Surgical intervention needs to be considered for all of these injuries. While acceptable results can be expected with non-operative management of minimally-displaced fractures, displacement at one or both sites is best managed with surgical reduction and fixation.

Biomechanical Phenomena↗
PubMed1993

Luxatio erecta: persistent displacement of the greater tuberosity after reduction.

The case of a 36-year-old man who sustained a luxatio erecta dislocation of his shoulder is reported. He had persistent displacement of a fracture of the greater tuberosity after closed reduction of the shoulder. The two-part fracture required operative treatment. This is the first occurrence of this complication reported in the literature.

Adult↗