• Title/Summary/Keyword: Shoulder fractures

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Hemiarthroplasty for Fractures or Fracture-Dislocations of the Proximal Humerus (상완골 근위부 골절 또는 골절 및 탈구에서의 상완골 두 치환술)

  • Kim Young Kyu;Eom Gi Serk
    • Clinics in Shoulder and Elbow
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    • v.3 no.1
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    • pp.20-25
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    • 2000
  • Purpose : To evaluate functional results and study factors influencing results after humeral hemiarthroplasty for comminuted fractures of the proximal humerus. Materials and Methods: We reviewed 12 patients with average follow-up period of 23 months(12 to 42). The proximal humeral fractures consisted of one anatomical neck fracture, five three-part and six four-part fractures or fracture-dislocations. Constant score and Compito et al' evaluation system were used for clinical assessment. Statistical analysis was done with the Wilcoxon test. Results: Six cases of anatomical neck, three-part fractures or fracture-dislocations showed 61 points on the average Constant score and three unsatisfactory results on the Compito et al' evaluation; Six of four-part fractures or fracture-dislocations showed 51 points and three unsatisfactory results. There were 59(two unsatisfactory) for five non-associated dislocation and 53(four unsatistactory) for seven associated dislocation; 66(one unsatisfactory) for three under 60 years and 41(five unsatisfactory) for nine over 60 years; 67(two unsatisfactory) for seven tuberosity union and 41(four unsatisfactory) for five tuberosity non-union or resorption; 58(four unsatisfactory) for ten early operation within two weeks and 43(all unsatisfactory) for two delayed operation; and 18(unsatisfactory) for one case of a accompanied rotator cuff tear. Conclusion: We concluded that tuberosity union was important factor influencing the results. Also, we thought that age, timing of operation and accompanied rotator cuff tear could be influenced to results.

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Internal Fixation with a Locking T-Plate for Proximal Humeral Fractures in Patients Aged 65 Years and Older

  • Yum, Jae-Kwang;Seong, Min-Kyu;Hong, Chi-Woon
    • Clinics in Shoulder and Elbow
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    • v.20 no.4
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    • pp.217-221
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    • 2017
  • Background: The purpose of this study was to evaluate the clinical and radiographic outcomes of internal fixation with locking T-plates for osteoporotic fractures of the proximal humerus in patients aged 65 years and older. Methods: From January 2007 through to December 2015, we recruited 47 patients aged 65 years and older with osteoporotic fractures of the proximal humerus. All fractures had been treated using open reduction and internal fixation with a locking T-plate. We classified the fractures in accordance to the Neer classification system; At the final follow-up, the indicators of clinical outcome-the range of motion of the shoulder (flexion, internal rotation, and external rotation) and the presence of postoperative complications-and the indicators of radiographic outcome-the time-to-union and the neck-shaft angle of the proximal humerus-were evaluated. The Paavolainen method was used to grade the level of radiological outcome in the patients. Results: The mean flexion was $155.0^{\circ}$ (range, $90^{\circ}-180^{\circ}$), the mean internal rotation was T8 (range, T6-L2), and the mean external rotation was $66.8^{\circ}$ (range, $30^{\circ}-80^{\circ}$). Postoperative complications, such as plate impingement, screw loosening, and varus malunion were observed in five patient. We found that all patients achieved bone union, and the mean time-to-union was 13.5 weeks of the treatment. The mean neck-shaft angle was $131.4^{\circ}$ at the 6-month follow-up. According to the Paavolainen method, "good" and "fair" radiographic results each accounted for 38 and 9 of the total patients, respectively. Conclusions: We concluded that locking T-plate fixation leads to satisfactory clinical and radiological outcomes in elderly patients with proximal humeral fractures by providing a larger surface area of contact with the fracture and a more rigid fixation.

Acromion Fracture after Hook Plate Fixation for Distal Clavicle Injury: A Report of 2 Cases

  • Kang, Suk;Lee, Ho Min;Back, In Hwa
    • Clinics in Shoulder and Elbow
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    • v.19 no.3
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    • pp.168-171
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    • 2016
  • Fractures at the lateral end of the clavicle inevitably require surgical treatment as there is high potential for delayed union or nonunion. Acromioclavicular dislocation also requires stable and solid fixation for healing, and surgical treatment is recommended for the maintenance of joint function. The hook plate maintains the biomechanics of the acromioclavicular joint, enabling early range of motion. Therefore, for the past 10 years, the hook plate has been widely used in distal clavicle fractures and acromioclavicular joint injuries. However, the hook plate is associated with several complications, such as proximal clavicle fractures, widening of the hook hole, rotator cuff tear, subacromial impingement, and often acromial fractures. We report on two unusual cases of acromion fracture after hook plate fixation in patients with distal clavicle fracture and acromioclavicular dislocation alongside a literature review.

An Anterosuperior Deltoid Splitting Approach for Plate Fixation of Proximal Humeral Fractures

  • Shin, Dong-Ju;Byun, Young-Soo;Cho, Young-Ho;Park, Ki-Hong;Yoo, Hyun-Seong
    • Clinics in Shoulder and Elbow
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    • v.18 no.1
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    • pp.2-7
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    • 2015
  • Background: The purpose of this study was to evaluate the usefulness and safety of the anterosuperior deltoid splitting approach for fixation of displaced proximal humeral fractures by analyzing the surgical outcomes. Methods: Twenty-three patients who could be followed-up for at least 8 months after the treatment of displaced proximal humeral fractures through the anterosuperior deltoid splitting approach were enrolled. We evaluated the reduction of the fractures and surgery-related complications at the last follow-up using X-ray results and clinical outcomes comprising the University of California at Los Angeles (UCLA) scoring system and the Korean Shoulder Society (KSS) score. Results: At the last follow-up of patients treated using the anterosuperior deltoid splitting approach for internal fixation of proximal humeral fractures, we found 22 cases (95.6%) of bone union, a mean UCLA score of 28.3 (range, 15 to 34) and a mean KSS score of 82.1 (range, 67 to 95). Various surgery-related complications were noted; a case of varus malunion after fracture displacement, a case of nonunion, a case of delayed union, two cases of impingement, and a case of partial axillary nerve injury, which recovered completely through the follow-up. Conclusions: Plate fixation using the anterosuperior deltoid splitting approach could be another reliable option for treating displaced proximal humeral fractures.

Midterm outcomes of suture anchor fixation for displaced olecranon fractures

  • Michael J. Gutman;Jacob M. Kirsch;Jonathan Koa;Mohamad Y. Fares;Joseph A. Abboud
    • Clinics in Shoulder and Elbow
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    • v.27 no.1
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    • pp.39-44
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    • 2024
  • Background: Displaced olecranon fractures constitute a challenging problem for elbow surgeons. The purpose of this study is to evaluate the role of suture anchor fixation for treating patients with displaced olecranon fractures. Methods: A retrospective review was performed for all consecutive patients with displaced olecranon fractures treated with suture anchor fixation with at least 2 years of clinical follow-up. Surgical repair was performed acutely in all cases with nonmetallic suture anchors in a double-row configuration utilizing suture augmentation via the triceps tendon. Osseous union and perioperative complications were uniformly assessed. Results: Suture anchor fixation was performed on 17 patients with displaced olecranon fractures. Functional outcome scores were collected from 12 patients (70.6%). The mean age at the time of surgery was 65.6 years, and the mean follow-up was 5.6 years. Sixteen of 17 patients (94%) achieved osseous union in an acceptable position. No hardware-related complications or fixation failure occurred. Mean postoperative shortened disabilities of the arm, shoulder, and hand (QuickDASH) score was 3.8±6.9, and mean Oxford Elbow Score was 47.5±1.0, with nine patients (75%) achieving a perfect score. Conclusions: Suture anchor fixation of displaced olecranon fractures resulted in excellent midterm functional outcomes. Additionally, this technique resulted in high rates of osseous union without any hardware-related complications or fixation failures.