The Neer type II distal clavicle fracture is notorious for its high nonunion rate, and surgical treatment is usually recommended. We reviewed articles from January 1990 to September 2009, and among them, 425 cases from 21 studies were included. According to the 425 cases in the literature, sixty patients were treated nonsurgically and 365 surgically. From 365 patients who were treated surgically, 105 were identified as receiving the coracoclavicular stabilization, 162 hook plate, 42 intramedullary fixation, 16 interfragmentary fixation, and 40 K-wire plus tension band wiring. The nonsurgical treatment resulted in 20 (33.3%) nonunions and 4 (6.7%) other complications. The surgical treatment resulted in 6 (1.6%) nonunions, 81 (22.2%) complications other than nonunion. The nonunion rate was significantly high with nonsurgical treatment (p < 0.001), and the complication rate was statistically high with surgery (p = 0.002). With surgical treatment, the nonunion rate was not significantly different among the modalities (p = 0.391). The complication rate was significantly higher in cases of the hook plate (40.7%) and the K-wire plus tension band wiring (20.0%) than those of the coracoclavicular stabilization (4.8%), the intramedullary (2.4%) and the interfragmentary fixation (6.3%). For the nonsurgical treatment, the functional outcomes were generally acceptable despite the high nonunion rate. The nonsurgical treatment could be considered as the first line treatment after sufficient counsel with the patient. The nonunion rate is high, however, the functional outcome is acceptable in most of the cases with nonunion. If the surgical treatment is considered, the intramedullary screw fixation, CC stabilization and interfragmentary fixation would be preferred because of their low complication rate.

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Registered with http://www.clinicaltrials.gov (NCT01877720).

Recovery from pseudoparalysis after rotator cuff repair was evident in a large portion of the study group, and postoperative function and cuff healing were not different according to the presence of pseudoparalysis. Considering possible complications and longevity of RTSA, rotator cuff repair should be the first-line treatment option for large-to-massive tears.

The presence of an atrial left-to-right shunt was associated with PH in preterm infants with moderate or severe BPD. Close follow up is needed for infants with interatrial shunts, and a more tailored prognostic evaluation and treatment are recommended.

BackgroundOwing to advances in the critical care of premature infants with bronchopulmonary dysplasia (BPD), BPD-associated pulmonary hypertension (PH) is becoming a growing concern. However, only few investigations were available on neurodevelopmental outcomes in preterm infants with PH. Therefore, this study aimed to identify the impact of PH on growth and neurodevelopment at 18–24 months of corrected age (CA).MethodsWe retrospectively analyzed the medical records of 394 infants (aged < 28 weeks of gestation) admitted to the neonatal intensive care unit between 2005 and 2014. Among the surviving infants, 123 returned for follow-up evaluations including the Bayley Scales of Infant and Toddler Development, third Edition (Bayley-III) screening tests and growth assessment at 18–24 months of CA. Among the 81 infants with moderate or severe BPD, 20 met the criteria for PH. Baseline characteristics and outcomes were compared in infants who developed BPD-associated PH (PH group, n = 20) and moderate or severe BPD infants who did not develop PH (non-PH group, n = 61).ResultsCompared to the non-PH group, the PH group showed significantly lower cognitive (85 vs. 95, p = 0.004), language (81 vs. 89, p = 0.040), and motor (88 vs. 94, p = 0.010) scores of the Bayley-III at 18–24 months of CA. Cognitive delay was found in 45.0% (9/20) of PH infants. In addition, z-scores of weight (− 1.4 ± 1.3 vs. -0.6 ± 1.1%, p = 0.011) and HC (− 1.2 ± 1.8 vs. 0.53 ± 1.0%, p = 0.035) were significantly lower in the BPD with PH group. With the subgroup analysis in infants with severe BPD only, the cognitive score was consistently lower and poorer and weight gain after discharge was identified in infants with PH and severe BPD.ConclusionPH was a worsening factor of non-optimal growth and poor neurodevelopmental outcome in preterm infants with BPD at 18–24 months of CA. Our findings suggest the importance of close developmental follow-up and recognition of that risk to help optimize the outcome of preterm infants with PH.

Arthroscopic rotator cuff repair significantly improved the patients' HRQOL both physically and mentally. Older age, female sex, diabetes, and low level of sports activity were related to low postoperative physical HRQOL, and female sex was also related to low postoperative mental HRQOL.

This study revealed distinct clinicopathological features of OSA patients over 40 years of age compared with younger patients, such as the high incidence of axial tumors, common osteolytic and mixed radiographic findings, the high frequency of unusual histologic subtypes, and poor prognosis. Contrary to Western elderly patients with OSA, there was no Paget's OSA in this study, which may result in a lower incidence of secondary OSA. Prognostic factor analyses demonstrated chemotherapy did not influence OS.