JSES open access最新文献

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Elbow contracture following operative fixation of fractures about the elbow 肘关节周围骨折手术固定后肘关节挛缩。

JSES open access

Pub Date : 2019-12-01 DOI: 10.1016/j.jses.2019.09.004

Lauren E. Wessel MD, Alex Gu BSc, Shawn S. Richardson MD, Duretti T. Fufa MD, Daniel A. Osei MD

Background

The rates of elbow contracture and contracture release after surgically treated elbow trauma are poorly defined. The purpose of this study was to define the incidence of elbow contracture diagnosis and release after surgical treatment for elbow trauma.

Methods

The Humana insurance database was queried using the PearlDiver Patient Records Database between 2007 and 2017. Subjects were identified using International Classification of Diseases (ICD) codes in combination with Current Procedural Terminology codes and were included if they had a minimum of 1-year follow-up. Qualifying operative elbow trauma patients were queried for development of postoperative elbow contracture. Patient demographic characteristics, risk factors for elbow stiffness, and use of postoperative anticoagulation were recorded. Fracture severity was classified based on ICD-9 and ICD-10 codes. Logistic multivariate analysis was performed to determine independent risk factors for postoperative elbow contracture.

Results

The study population included 10,672 patients who were surgically treated for elbow trauma. In total, 902 patients (8.4%) were diagnosed with a contracture following fracture. Of patients with a diagnosis of elbow contracture, 65 patients (7.2%) underwent contracture release. On average, time to contracture diagnosis was 3.6 months (SD 7 months) and time to contracture release was 8.4 months (SD 3.6 months). The use of postoperative anticoagulation, burn or head injury at the time of fracture, male sex, obesity, opioid use, and moderate or severe fracture severity were significantly associated with progression to elbow contracture.

Conclusion

The development of elbow contracture after surgical treatment of elbow trauma has a relatively high incidence of 8.4%.

背景:手术治疗肘关节创伤后肘关节挛缩和挛缩解除的发生率尚不明确。本研究的目的是确定肘关节挛缩的诊断和肘关节创伤手术治疗后的释放发生率。方法:使用PearlDiver病历数据库查询2007 - 2017年Humana保险数据库。使用国际疾病分类(ICD)代码结合现行程序术语代码确定受试者，如果他们至少有1年的随访，则纳入受试者。合格的手术肘关节创伤患者被询问术后肘关节挛缩的发展情况。记录患者的人口统计学特征、肘部僵硬的危险因素以及术后抗凝的使用情况。根据ICD-9和ICD-10编码对骨折严重程度进行分类。进行Logistic多因素分析以确定术后肘关节挛缩的独立危险因素。结果:研究人群包括10,672例手术治疗肘部创伤的患者。共有902例(8.4%)患者被诊断为骨折后挛缩。诊断为肘部挛缩的患者中，65例(7.2%)接受了挛缩松解术。平均到挛缩诊断时间3.6个月(SD 7个月)，到挛缩解除时间8.4个月(SD 3.6个月)。术后抗凝、骨折时烧伤或头部损伤、男性、肥胖、阿片类药物使用以及中度或重度骨折严重程度与肘关节挛缩进展显著相关。结论:肘关节外伤术后发生肘关节挛缩的发生率较高，为8.4%。

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引用次数: 8

Medium Term Outcomes of Stemless, Ceramic Head, Anatomic Shoulder Replacement in Patients With Type B and C Glenoids. Results Better Than Expected 无柄、陶瓷头、解剖肩关节置换术治疗B型和C型肩关节囊肿的中期疗效结果好于预期

JSES open access

Pub Date : 2019-12-01 DOI: 10.1016/j.jses.2019.10.093

Simon Bell, Jennifer Coghlan, Gray Edwards

引用次数: 0

Determination of Carrying Angle of Elbow Among Adult Pakistani Population 巴基斯坦成年人群肘部负重角的测定

JSES open access

Pub Date : 2019-12-01 DOI: 10.1016/j.jses.2019.10.078

Syed Kamran Ahmed, Javed Ali Markhand, Sundus Iftikhar

引用次数: 0

Low Survival Rates of Stemmed Hemiarthroplasty and Reverse Arthroplasty After Treatment for Proximal Humerus Fracture Sequelae. A Register-Based Study from the Nordic Arthroplasty Register Association 肱骨近端骨折后遗症治疗后半关节置换术和反向关节置换术的低生存率。北欧关节成形术登记协会的一项基于登记的研究

JSES open access

Pub Date : 2019-12-01 DOI: 10.1016/j.jses.2019.10.035

Ditte Unbehaun , Sigrid Rasmussen , Randi Hole , Anne Marie Fenstad , Björn Salomonsson , Yilmaz Demir , Steen Lund Jensen , Stig Brorson , Ville Äärimaa , Inger Mechlenburg , Jeppe Vejlgaard Rasmussen

引用次数: 0

Arthroscopic vs Open Plate Removal in Sequelae of Proximal Humerus Fracture: Does it Better Outcomes? 肱骨近端骨折后遗症的关节镜与开放钢板取出:效果更好吗?

JSES open access

Pub Date : 2019-12-01 DOI: 10.1016/j.jses.2019.10.057

Paolo Paladini , Giovanni Merolla , Carlo Alberto Augusti , Giuseppe Porcellini , Antonio Padolino

引用次数: 0

Clinical and Radiographic Outcomes of Salvage Radial Head Arthroplasty 补救性桡骨头置换术的临床和影像学结果

JSES open access

Pub Date : 2019-12-01 DOI: 10.1016/j.jses.2019.10.025

J. Singh, Z. Hammoudi, Adam C. Watts

引用次数: 0

Manipulation Under Anaesthetic for Frozen Shoulder Using Codman’s Paradox - Safe and Early Return of Function 应用Codman悖论麻醉下手法治疗肩周炎——安全、早期恢复功能

JSES open access

Pub Date : 2019-12-01 DOI: 10.1016/j.jses.2019.10.068

Paolo Consigliere, Oren Tsvieli, Ioannis Polyzois, Ehud Atoun, Giuseppe Sforza, Juan Bruguera, Ofer Levy

引用次数: 0

The over-the-top subscapularis repair in reverse shoulder arthroplasty: biomechanical evaluation of a novel technique 肩胛下肌过顶修复术:一种新技术的生物力学评价

JSES open access

Pub Date : 2019-12-01 DOI: 10.1016/j.jses.2019.09.005

Joseph J. King MD , Alexander T. Greene BS , Matthew A. Hamilton PhD , Phong T. Diep BS , Jorge Gil MD , Thomas W. Wright MD , Bradley S. Schoch MD

Background

We evaluate the effect of repairing the upper subscapularis tendon at an alternative location on the anterior greater tuberosity above the center of rotation using a reverse shoulder arthroplasty (RSA) muscle model.

Methods

We compared an innovative subscapularis repair on the anterior aspect of the greater tuberosity with the standard repair on the lesser tuberosity in a previously validated digital linear RSA muscle model. Standard repair vs. a new repair datasets were compared for 3 RSA designs. Each model was run through humeral abduction from 0° to 140° in 2.5° increments; the resulting moment arm measurements (model of tendon efficiency) were recorded in millimeters for 3 sections (superior, middle, inferior). An isolated upper two-thirds subscapularis repair to the anterior greater tuberosity was also evaluated (the over-the-top repair).

Results

The new over-the-top subscapularis repair significantly increased the abduction moment arm lengths in the superior, middle, and inferior subscapularis components compared with the standard repair to the lesser tuberosity at all levels of glenohumeral abduction and for all 3 RSA designs. Repair of the upper two-thirds of the subscapularis to the new location was an abductor at a much lower level of abduction compared with the native subscapularis repair.

Conclusion

By repairing the upper subscapularis tendon above the center of rotation (over-the-top repair) in an RSA muscle model, the subscapularis has an improved movement arm and functions as an abductor through a greater range of motion that may result in clinically increased muscle efficiency and improved strength.

背景:我们使用反向肩关节置换术(RSA)肌肉模型评估在旋转中心以上的前大结节的另一位置修复肩胛下肌腱的效果。方法:在先前验证的数字线性RSA肌肉模型中，我们比较了大结节前部的创新肩胛下肌修复与小结节的标准修复。对3种RSA设计的标准修复与新修复数据集进行了比较。每个模型以2.5°为单位进行肱骨外展，从0°到140°;所得的力臂测量(肌腱效率模型)以毫米为单位记录3个断面(上、中、下)。我们还评估了对前大结节的肩胛下肌上三分之二的孤立修复(过顶修复)。结果与标准的肱骨外展小结节修复和所有3种RSA设计相比，新型肩胛下过顶修复明显增加了肩胛下上、中、下构件的外展力矩臂长度。肩胛下肌上三分之二到新位置的修复是一个外展肌，与原来的肩胛下肌修复相比，外展水平低得多。结论在RSA肌肉模型中，通过修复旋转中心以上的肩胛下肌上肌腱(过顶修复)，肩胛下肌具有改进的运动臂和外展肌功能，其运动范围更大，可能导致临床肌肉效率和力量的提高。

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引用次数: 6

The Treatment of Lateral Epicondylitis: The Effect of Platelet Rich Plasma on Healing — A Randomized Controlled Double-Blinded Trial 治疗外上髁炎:富血小板血浆对愈合的影响-一项随机对照双盲试验

JSES open access

Pub Date : 2019-12-01 DOI: 10.1016/j.jses.2019.10.022

Janne Tapani Lehtinen , Olli Leppänen , Lasse Linnamäki

引用次数: 1

Outcome of a Metaphyseal Stemless Reverse Total Shoulder Replacement in Rheumatoid Arthritis 类风湿性关节炎干骺端无茎反向全肩关节置换术的疗效

JSES open access

Pub Date : 2019-12-01 DOI: 10.1016/j.jses.2019.10.012

Paolo Consigliere, Caroline Witney-Lagen, Laura Mariani, Luis Natera, Ehud Atoun, Juan Bruguera, Giuseppe Sforza, Ofer Levy

引用次数: 1

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