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At least 163 records · Page 9Linked to original sources
PubMed1985

Sixteen fractures of the shoulder region in the horse.

The clinical and radiological features of fractures of the shoulder region in 16 horses are described. High quality radiographic views were essential for an accurate diagnosis. This sometimes necessitated general anaesthesia. The limitations of radiography are discussed. Nine horses had articular fractures of the supraglenoid tuberosity and eight of these were destroyed because of persistent lameness. The possibility of surgical removal of the fracture fragment(s) is discussed and the importance of early diagnosis emphasised. Seven other fractures of the shoulder region are described. The clinical outcome depended upon the location and nature of the fracture.

Animals↗
PubMed2006

[Total knee arthroplasty for recent severe fracture of the proximal tibial epiphysis in the elderly subject].

PURPOSE OF THE STUDY: Bone comminution, serious cartilage damage, and the poor mechanical quality of osteoporotic bone create a difficult challenge for osteosynthesis of joint fractures in the elderly subject. Poor results with certain hip, elbow and shoulder fractures have lead certain authors to propose emergency arthroplasty in selected cases. We report our experience with four knee arthroplasties implanted for recent severe fracture of the proximal tibial epiphysis in elderly subjects. MATERIAL AND METHODS: Four independent patients aged over 75 years presented a severe comminutive fracture of the proximal epiphysis of the tibia (Three Schatzker 5, one Schatzker 4). After obtaining the patients' informed consent, early knee arthroplasty was performed. A long-stem cemented tibial piece was used on which the epiphysis was reconstructed. Implants providing support for ligament deficits were used in all cases. Immediate weight-bearing was authorized. RESULTS: Follow-up ranged from two to seven years. The IKS function score (15, 60, 100, 100) depended on the patient's general status. The IKS knee score was excellent for three knees (90, 95, 95), and fair in one (45). Re-operations were not needed in any of the patients. All x-rays showed bone healing with correctly aligned limbs (less than 2 degrees deformation). There were no lucent lines at last follow-up. DISCUSSION: Early arthroplasty for complex fractures of the proximal epiphysis of the tibia is a realistic option. Using a cemented long-stem tibial piece ensures primary stability sufficient for early weight-bearing before bone healing. Use of a constrained prosthesis, or better a hinged prosthesis, can be questioned but avoids the difficulty of ligament balance on an osteoporotic knee with a destroyed joint surface. None of the patients required reoperation and the results in terms of pain were excellent. The overall outcome depends on the general status of the patient.

Aged↗
PubMed1991

[Accident causes and prevention of injuries in Enduro-motorbike sport].

365 participants of the 64. Enduro-World Championship in 1989 reported 232 injuries within a 10-years-period of motorbike driving. The knee was most frequent (21.5 pc., mainly ligament ruptures) injured, followed by fracture of the clavicle (18.5 pc.), hand (15.5 pc.) and damages of the shoulder. Fractures are very common (55.5 pc.) in motorbike sports. Injuries often were produced by collisions with other motorbikes or trees. Driving mistakes, jumps, slipping wheels and overturn were other causes for an accident. During the championship 13 accidents were registered. In a clinical examination defects or alterations of the joints and bones were observed at 91 drivers. Important is the incidence of two malign tumours of the testicles. Preventive measures against accidents are discussed.

Adolescent↗
PubMed1988

[Isolated fractures of the shoulder blade in childhood and adolescence].

Fractures of the scapula in childhood and youth are very rare injuries. Despite the few number of cases one can clearly distinguish, with regard to the cause of the accident, the sort of forces involved and the type of fracture, between those injuries received by adults and those of children. In the case of children and youths isolated scapular injuries and a larger number of isolated fractures of the acromial and the coracoid processes can be found. For an accurate diagnosis a thorough radiological examination must be undertaken, and if necessary further special x-ray projections or on-target x-ray spot exposures.

Adolescent↗
PubMed1999

[Prognostic factors during rehabilitation after shoulder prostheses for fracture].

PURPOSE: To evaluate the role, the difficulties of rehabilitation and to diagnose the eventual surgical complications after shoulder prosthesis for 4-part fractures. MATERIAL AND METHODS: Forty three patients (46 shoulders) who underwent shoulder arthroplasty after fracture of the proximal humerus underwent rehabilitation and follow-up at a special reeducation center for an average of 3 months (1 to 6). There were 42 four-part fractures (with 22 fracture-dislocation) and 4 three-part fractures. The patients were send by five different hospitals and have all been operated by senior surgeons. Three types of implants were used: the Modular Shoulder prosthesis (27 cases), the Global prosthesis (2 cases), and the Aequalis prosthesis (17 cases). The rehabilitation followed the protocol recommended by Neer (recovery of passive joint movements, muscular strengthening and stretching) to which were added hydrotherapy, physiotherapy and occupational therapy. Forty patients (43 épaules) were reviewed and radiographed with an average follow-up of 29 months (18 to 72 months). RESULTS: The functional results were disappointing with a normalised Constant score of only 60.2 per cent and an average active elevation of only 96 degrees. There appeared to be two factors which explained these poor results. Firstly, the advanced age of the population (52 per cent older than 70) who was often poorly or non-motivated (22 per cent) and debilitated (21 per cent chronic alcoholics) and who had significant medical and neuro-psychiatric histories. Secondly, incompletely resolved anatomical and surgical problems: damage to the circumflex nerve (6.5 per cent), early migration of the greater tuberosity (6.5 per cent), secondary migration with malunion (15 per cent) and/or nonunion (11 per cent) of the greater tuberosity. Migration of the greater tuberosity should be suspected clinically in three circumstances: 1) in patients who have an abnormally painful shoulder in the immediate post-operative period (16 cases in our series); 2) when there is no progression (24 per cent) or regression (9 per cent) of active shoulder mobility after three months of correct supervised rehabilitation; 3) later, if there is a dissociation between active anterior elevation (deficient) and passive anterior elevation (preserved). DISCUSSION AND CONCLUSION: The age and poor general condition of the patients as well as the difficulty of the surgical technique more than the rehabilitation, explain the disappointing results observed after shoulder prosthesis for four-part fractures. The discrepancy between active and passive elevation suggests that limited motion is not caused by a stiff shoulder because of glenohumeral scarring but instead by weakness of the deltoid (because of axillary lesion) and/or of the external rotators (because of greater tuberosity migration). There is some discordance between the necessity to early mobilise the shoulder and the high rate of tuberosity migration.

Adult↗
PubMedDate not supplied

Clinical outcome of the treatment of floating shoulder by osteosynthesis for clavicular fracture alone.

Floating shoulder is an unstable combination of fractures that involve the scapular neck and the ipsilateral midclavicle and require surgical treatment. The clinical outcome of the surgical treatment of floating shoulder for the clavicular fracture alone is reported. In 5 male patients (mean age, 38.6 years), fixation of the clavicular fracture was achieved with the use of a bone plate in 1 patient and with Kirschner wires in 4 patients. In all patients, union of the fractures of both the clavicle and the scapular neck was achieved, and the mean time for fracture healing was 17 weeks. According to the UCLA score, the mean score was 34.2 points during a mean follow-up period of 57.4 months. In patients with a floating shoulder, it is important to evaluate the severity of fracture displacement and coracoclavicular ligament rupture accurately, and on the basis of this evaluation, an appropriate treatment for both fractures that may lead to a satisfactory clinical outcome can be determined.

Accidents, Traffic↗
PubMed1996

Concomitant fracture of the coracoid and acromion after direct shoulder trauma.

Fractures of the acromial process or coracoid process of the scapula are rare. We present a combined fracture of the coracoid and acromion after direct trauma to the shoulder. An anteroposterior radiography with the central x-ray beam angled 25 degrees cephalad or an axillary lateral radiograph may be needed to detect these fractures.

Acromion↗
PubMed1994

[Anterior instability of the shoulder associated with fracture of the coracoid process. Apropos of 3 cases].

PURPOSE OF THE STUDY: The aim of this paper is to present an unusual lesion associating anterior instability of the shoulder with a fracture of the horizontal part of the coracoid process. It emphasizes surgical treatment using the Latarjet procedure. MATERIAL AND METHODS: Three cases are presented: One case was a recurrent anterior dislocation of the shoulder associated with a fracture of the horizontal part of the coracoid process; an other case was a painful shoulder associated with pseudarthrosis of the coracoid process and a fracture of the anterior and inferior edge of the glenoid. In the last case there was a recurrent dislocation of the shoulder associated with a pseudarthrosis of the coracoid process detected intra-operatively. All the patients were operated on using the Latarjet's procedure using the fractured coracoid process. RESULTS: The three cases had a good result. DISCUSSION: The association of an anterior dislocation of the shoulder and a fracture of the coracoid process is very unusual. It is often unrecognized because of poor knowledge of this lesion or a poor quality of the radiograms performed in the emergency room. The most likely mechanism is a direct impact of the humeral head against the coracoid process during the dislocation. The fracture is located (as in our 3 cases) at the horizontal part of the coracoid process near its elbow and they are often associated lesions at the anterior and inferior edge of the glenoid. The diagnosis requires good quality radiograms and a Garth's view systematically performed after reducing the dislocation. When the shoulder is painful or unstable, surgical treatment is performed and the Latarjet's procedure takes care of the pseudarthrosis and the instability of the shoulder. CONCLUSION: Isolated fractures of the coracoid process are probably uncommon. When there is a fracture of the horizontal part of the coracoid process anterior instability of the shoulder should be suspected. This is the case when the shoulder has never been dislocated and when the standard radiograms are "normal" without "crossing lesions" at the anterior and inferior edge of the glenoid or at the humeral head (Hill-Sach lesion).

Adolescent↗