Objective To analyze if general factors such as age, gender, dominant side, fasting blood sugar level, BMI (body mass index), smoking, and drinking play a role in graft resorption after arthroscopic autologous scapular spine bone grafting. Methods From July 2016 to August 2018, patients who were diagnosed with anterior shoulder instability with subcritical bone loss (10%–15%) and underwent arthroscopic autologous scapular spine bone graft transplant were retrospectively reviewed and enrolled in this study. The age, gender, dominant side, fasting blood sugar level, BMI, smoking, and drinking conditions of the enrolled patients were recorded. The graft resorption rate at postoperative 1 year was also measured on three‐dimensional computed tomography (3D‐CT) scans. The Pearson test and the Spearman test were used to identify any significant correlation between the general factors and graft resorption rate. Results A total of 27 patients who underwent arthroscopic autologous scapular spine bone graft for recurrent shoulder instability qualified and were included in this study. There were 20 males and seven females, the mean age was 30.8 ± 9.4 years, the mean follow‐up time was 29.3 months (range, 25–39 months), during which no severe complications such as infection, neurovascular injury, or re‐dislocation were observed. The bone graft healed in all cases, the mean healing time was 2.6 ± 0.5 months (range, 2–3 months). At the last follow‐up, the mean Constant–Murley score was 89.74 ± 3.71, the mean Disabilities of Arm, Shoulder and Hand (DASH) score was 9.77 ± 5.31, and the mean visual analogue score (VAS) was 0.74 ± 0.64. The apprehension test was all negative at final follow‐up. The fasting blood sugar level was 4.78 ± 0.42 mmol/L, BMI was 23.70 ± 4.70. Five patients were “smoking” and 22 “non‐smoking”, four patients were “drinking” and 23 were “non‐drinking.” The graft resorption rate at postoperative 1 year was 19.4% ± 7.5%. The Pearson test and the Spearman test showed no significant correlation between age, gender, dominant side, fasting blood sugar level, BMI, smoking, drinking, and graft resorption rate. Conclusion Age, gender, dominant side, fasting blood sugar level, BMI, smoking, and drinking were not significantly correlated with graft resorption after the arthroscopic autologous scapular spine bone graft for recurrent shoulder instability.
Based on the morphological characteristics of glenoid and greater tuberosity (GT) fractures and the relationship between them, we explored the injury mechanism of acute anterior shoulder dislocation associated with glenoid and GT fractures. Methods: From December 2013 to December 2019, we retrospectively reviewed the clinical data of patients who were diagnosed with acute anterior shoulder dislocation associated with glenoid and GT fractures in our hospital. According to the fracture site, a glenoid fracture group and a greater tuberosity fracture (GT) group were established, and the morphological characteristics of both glenoid and GT fractures were measured and statistically analyzed. Results: A total of 41 patients (43 shoulders) met the inclusion criteria (39 unilateral shoulders and 2 bilateral shoulders). The mean age was 50.21 years (range, 22-71 years). A total of 27 shoulder injuries (62.8%) were split GT fractures and 33 shoulder injuries (76.7%) were combined with rotator cuff tears. The mean size of glenoid fragments was 30.16% and the mean displacement was 8.85 mm. The mean size of GT fragments was 28.43 mm. The mean superoinferior and anteroposterior displacements of the GT fragment were 6.77 mm and 4.96 mm, respectively. There was a negative correlation between the size of glenoid and GT fracture fragments (r = −0.64, P < 0.05). The glenoid fragments in the Ideberg type Ia glenoid fracture group were smaller than those in the Ideberg type II glenoid fracture group (28.41% and 40.95%, respectively), while the size of GT fragments in the type Ia group were larger than those in the type II group (29.77 mm and 20.21 mm, respectively) (P < 0.05). The GT fragments in the split GT fracture group were larger than those in the avulsion or depression GT fracture group (33.69 mm, 19.07 mm and 21.12 mm, respectively), while the size of glenoid fragments in the split GT fracture group were smaller than those in the avulsion or depression GT fracture group (23.57%, 41.37%, and 43.42%, respectively) (P < 0.05). As for the displacement direction of GT fragments, depression fractures were mainly inferior displacements, avulsion fractures were mainly anterosuperior displacements, while split fractures were mainly posteroinferior displacements (P < 0.05). Multiple regression analysis suggested that the type and the fragment size of GT fractures have a significant influence on the size of glenoid fragments. Conclusion: Acute anterior shoulder dislocations associated with glenoid and GT fractures are often combined with rotator cuff tears. There is a negative correlation between the size of glenoid and GT fragments, and split GT fractures are most common. Such injuries are highly correlated to the relative spatial location between the GT and the glenoid when the shoulder dislocates.
ObjectivesRotator cuff injury caused by subacromial impingement presents different morphologies. This study aims to investigate the correlation between various shoulder anatomical indexes on X‐ray with subacromial impingement and morphology of rotator cuff tears to facilitate surgical management.MethodThis retrospective study was carried out between January 2020 and May 2022. Patients who were diagnosed as sub‐acromial impingement associated with rotator cuff tears (without tendon retraction) and received arthroscopic surgery were enrolled in this study. The radiographic indexes of acromial slope (AS), acromial tilt (AT), lateral acromial angle (LAA), acromial Index (AI), and sub‐acromial distance (SAD) were measured on preoperative true AP view and outlet view. The location of rotator cuff tear (anterior, middle, posterior, medial, and lateral) and morphology of tear (horizontal, longitudinal, L‐shaped, and irregular shaped) were evaluated by arthroscopy. Groups were set up due to different tear location and tear morphologies, by comparing the various radiographic indices between each group (one‐way analysis of variance and t‐test), the correlation between radiographic indices and tear characteristics was investigated.ResultsWe analyzed 92 shoulders from 92 patients with a mean age of 57.23 ± 8.45 years. The AS in anterior tear group (29.32 ± 6.91°) was significantly larger than that in middle tear group (18.41 ± 6.13°) (p = 0.000) and posterior tear group (24.01 ± 7.69°) (p = 0.041). The AS in posterior tear group (24.01 ± 7.69°) was significantly larger than that in middle tear group (18.41 ± 6.13°) (p = 0.029). The LAA in middle tear group (67.41 ± 6.54°) was significantly smaller than that in posterior group (72.74 ± 8.78°) (p = 0.046). The AS in longitudinal tear group (26.86 ± 8.41°) was significantly larger than that in horizontal tear group (22.05 ± 9.47°) (p = 0.035) and L‐shaped group (21.56 ± 6.62°) (p = 0.032). The LAA in horizontal group (70.60 ± 6.50°) was significantly larger than that in L‐shaped group (66.39 ± 7.31°) (p = 0.033). The AI in L‐shaped tear group (0.832 ± 0.074) was significantly larger than that in horizontal tear group (0.780 ± 0.084) (p = 0.019) and irregular tear group (0.781 ± 0.068) (p = 0.047).ConclusionAcromion with a larger AS and a smaller LAA tend to cause anterior or posterior rotator cuff tears rather than middle tears in sub‐acromial impingement. Meanwhile acromion with a larger AS tends to cause a longitudinal tear, a larger LAA tends to cause horizontal tears and a larger AI tends to cause L‐shaped tears.
ObjectiveComplications related to triceps after total elbow arthroplasty (TEA) have become a major surgical concern. The triceps‐preserving approach has the advantage of not disturbing the insertion of triceps but is disadvantaged by the reduced exposure of the elbow joint. The aim of this study was to investigate the clinical and radiological outcomes of TEA with a triceps‐preserving approach and to compare the outcomes of TEA to treat arthropathy with that of TEA to treat acute distal humerus fracture.MethodsFrom January 2010 to December 2018, 23 patients undergoing primary TEAs were retrospectively reviewed with a mean follow‐up time of 92.6 months (range, 52–136 months). Each TEA was performed using the triceps‐preserving approach with a semi‐constrained Coonrad–Morrey prosthesis. Patient demographics, range of motion (ROM), pain visual analogue scale (VAS), and triceps strength (Medical Research Council [MRC] scale) were compared before and after surgery. The Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, radiographic outcome, and complications were evaluated at follow‐up.ResultsIn total, seven males and 16 females were included in this study, with a mean age of 66.1 years (range:46–85 years). By the last follow‐up, pain had been significantly relieved in all patients. The average MEPS in the arthropathy group and fracture group were 90.8 ± 10.3 points (range: 68–98 points) and 91.7 ± 0.4 (range: 76–100 points), respectively. The average DASH of the arthropathy group and fracture group was 37.3 ± 18.8 points (range: 18–52 points) and 38.4 ± 20.1 (range: 16–60 points). At the last follow‐up after surgery, the mean flexion arcs in the arthropathy group and fracture group were 100.4° ± 24.1° and 97.8° ± 28.1°, respectively. The mean pro‐supination arcs in the arthropathy group and fracture group were 142.4° ± 15.2° and 139.2° ± 17.5°, respectively. There were no significant differences in clinical outcomes between the two groups (P ≥ 0.05). Triceps strength was normal (MRC grade V) in 15 elbows and good in eight elbows. None of the cases experienced weakness of the triceps strength, infection, periprosthetic fractures, or prosthesis breakage.ConclusionsThe clinical and radiographical outcomes of TEA with the triceps‐preserving approach were satisfactory in patients with distal humerus fracture, osteoarthritis and rheumatoid arthritis.
ObjectiveThere is currently no consensus on proximal humerus fractures with an initial deformity in the coronal plane who are better off with plates or nails, so we designed this study. To compare the effect of the initial deformity in the coronal plane of proximal humerus fractures on postoperative outcomes, we compare the maintenance of reduction in procedures utilizing plates and nails, and analyzed the subsequent occurrence of complications to explore whether the initial deformity should dictate the fixation approach.MethodsThe clinical data of patients with proximal humerus fractures who were hospitalized and underwent surgical treatment in our hospital from January 2016 to December 2020 were reviewed. Postoperative functional scores (American Shoulder and Elbow Surgeons, ASES; Constant‐Murley Score, CMS), Neck‐shaft angle (NSA), Quality of fracture reduction, Deltoid Tuberosity Index (DTI), and complications were compared among cases with initial varus, normal, or valgus deformities.ResultsWe included 131 patients, 56 males and 75 females, with a mean age of 60.89 ± 5.53 years (range 50–76) and a mean follow‐up duration of 16.63 ± 6.78 months (range 12–48). Of these, 29 cases had initial varus displacement, 71 had a normal NSA, and 31 had initial valgus displacement. Seventy‐five were treated with a locking plate and 56 with a nail. After open reduction and internal fixation, the NSA was restored to normal (−135°) in all patients in all groups (P > 0.05). There was a significant difference in NSA changes at the last follow‐up; 2.93° ± 2.12° in the varus group, 1.77° ± 1.18° in the normal group, and 2.32° ± 1.64° in the valgus group, with the highest change occurring in the varus group. There was no significant difference in the range of motion or functional scores including ASES and CMS among the three groups (P > 0.05). The complication rate of 20.7% in the varus group was significantly higher than the complication rates of 12.7% in the normal and 12.9% in the valgus groups (P < 0.05).ConclusionsWhile proximal humerus fractures with initial coronal displacement (varus, normal, and valgus) show similar postoperative functional outcomes, varus fractures have a higher rate of complications. The nail provides better maintenance of reduction than the locking plate, especially in varus fractures.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.