scholarly journals Functional results of shoulders Neer’s prosthesis for four part fracture dislocation of shoulder

2021 ◽  
Vol 7 (3) ◽  
pp. 456
Author(s):  
Ansari Muqtadeer Abdul Aziz ◽  
Pratik Rathod ◽  
Altamash Patel
Keyword(s):  
External Rotation ◽  
Functional Results ◽  
Axillary Nerve ◽  
Fracture Dislocation ◽  
Superficial Infection ◽  
Shoulder Range Of Motion ◽  
Constant Murley Score ◽  
Satisfactory Outcome ◽  
The Mean ◽  
Hemi Arthroplasty

<p class="abstract"><strong>Background:</strong> Objective was to study the clinical and functional outcome of shoulder hemi-arthroplasty using Neer’s prosthesis in four part fracture dislocation of shoulder.</p><p class="abstract"><strong>Methods:</strong> The study was conducted on patients who underwent shoulder hemi-arthroplasty using Neer’s prosthesis for four part fracture dislocation of shoulder in Department of Orthopaedics, GMCH Aurangabad from January 2020 to January 2021. The patients were assessed clinically and functionally using Shoulder range of motion, Visual Analog Scale (VAS), American Society of shoulder and elbow (ASES) score and Constant-Murley score and radiological assessment at 3, 6 and 12 months.<strong></strong></p><p class="abstract"><strong>Results:</strong> At one year follow up of 30 patients, no loosening or dislocation of prosthesis was detected, and mean forward elevation of 129.33<sup>o</sup> (90<sup>o</sup> - 150<sup>o</sup>), mean external rotation of 26.7<sup>o</sup> (18<sup>o</sup> – 34<sup>o</sup>), mean internal rotation of 47.86<sup>o</sup> (33<sup>o</sup>-58<sup>o</sup>), the mean ASES score of 79.46 (range 68-88), the mean VAS score of 1.5 (range 1-3) and mean Constant-Murley score of 82.9 (range 72-94) were achieved. 1 patient developed axillary nerve injury which recovered 6 weeks after surgery and 1 diabetic patient developed superficial infection which healed with antibiotics.</p><p class="abstract"><strong>Conclusions:</strong> Hemiarthroplasty with Neer’s prosthesis can be utilized in four part fracture dislocations of humerus with poor bone stock risking avascular necrosis of head and screw cut out with satisfactory outcome.</p>

scholarly journals Range of motion of diabetic frozen shoulder recovers to the contralateral level

2016 ◽  
Vol 44 (6) ◽  
pp. 1191-1199 ◽  
Author(s):  
Heidi Vastamäki ◽  
Leena Ristolainen ◽  
Martti Vastamäki
Keyword(s):  
Range Of Motion ◽  
Frozen Shoulder ◽  
Functional Results ◽  
Shoulder Range Of Motion ◽  
Constant Murley Score ◽  
Patients With Diabetes ◽  
The Mean ◽  
Shoulder Range

Objective To determine whether frozen shoulder heals equally well in patients with and without diabetes and whether dependency on insulin affects the outcome. Methods We retrospectively examined 178 patients with idiopathic frozen shoulder; 27 patients had diabetes. We evaluated range of motion, pain, and functional results. The mean follow-up was 9.7 years (SD, 7.1 years). Results In the presence of frozen shoulder, range of motion did not differ between patients with and without diabetes. At follow-up, range of motion in all directions of both the affected and unaffected shoulders of patients with diabetes was inferior to that of patients without diabetes. Among patients with diabetes, range of motion of the once-frozen shoulder reached the level of the unaffected shoulder. Patients with and without diabetes experienced similar pain except during exertion. The Constant–Murley score was not significantly different between the two groups, and insulin dependency did not lead to worse outcomes. Conclusion Frozen shoulder heals well in patients with diabetes.

FACTORS AFFECTING THE FUNCTIONAL RESULTS OF OPEN REDUCTION AND INTERNAL FIXATION FOR FRACTURE-DISLOCATIONS OF THE PROXIMAL INTERPHALANGEAL JOINT

Hand Surgery ◽  
2015 ◽  
Vol 20 (01) ◽  
pp. 107-114 ◽  
Author(s):  
Kentaro Watanabe ◽  
Yoshitake Kino ◽  
Hiroki Yajima
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Functional Results ◽  
Fracture Dislocation ◽  
Factors Affecting ◽  
Flexion Extension ◽  
Motion Exercise ◽  
Fracture Dislocations ◽  
Pip Joint ◽  
The Mean

To clarify the factors affecting functional results of fracture-dislocations of the proximal interphalangeal (PIP) joint treated by open reduction and internal fixation (ORIF), 60 patients, including 38 patients with a dorsal fracture-dislocation and 22 with a pilon fracture, were analysed. The mean ratio of articular surface involvement was 48.5% and a depressed central fragment existed in 75.3% of the cases. ORIF was performed in 47 patients through a lateral approach using Kirschner wires and in 13 through a palmar approach using a plate or screws. The mean flexion, extension and range of motion (ROM) of the PIP joint was 89.5°, 11.5° and 78.0°, respectively. Stepwise regression analysis revealed that a delayed start of active motion exercise after surgery, elderly age and ulnar ray digit were factors affecting functional outcomes. Although ORIF allows accurate restoration of the articular surfaces, an early start of motion exercise is essential for good results.

Prospective multicentre mid-term clinical and radiological outcomes of 159 reverse total shoulder replacements and assessment of the influence of post-operative complications

2020 ◽  
pp. 175857322097718
Author(s):  
Mohamed A Imam ◽  
Jörg Neumann ◽  
Werner Siebert ◽  
Sabine Mai ◽  
Olivier Verborgt ◽  
...  
Keyword(s):  
Total Shoulder Arthroplasty ◽  
Functional Results ◽  
Trabecular Metal ◽  
Prospective Multicentre Study ◽  
Post Surgery ◽  
Constant Murley Score ◽  
Significant Difference ◽  
The Mean ◽  
Reverse Shoulder Replacement ◽  
Reverse Total Shoulder

Background The aim of our prospective multicentre study is to evaluate the five-year follow-up outcomes of primary reverse shoulder replacement utilizing two different designs of glenoid baseplates. Methods There were 159 reverse shoulder replacements (91 cemented and 68 uncemented stems, 67 Trabecular Metal baseplates and 92 Anatomical Shoulder baseplates in 152 patients (99 women) with a mean age of 74.5 (58–90) years. The principal diagnosis was rotator cuff arthropathy in 108 shoulders. Results Clinical and functional results improved significantly overall; the adjusted Constant Murley score improved from 28.2 ± 13.3 pre-operatively to 75.5 ± 22.8 ( p < 0.0001) and the mean Subjective Shoulder Value improved from 27.5 ± 20 to 73.8 ± 21.3 points ( p < 0.0001). Radiologically, there was good bony stability in 88% and 86% of cemented and uncemented stems without significant impact on the Constant Murley score and Subjective Shoulder Value at one, two and five years post-surgery. There were no significant clinical differences between Trabecular Metal and Anatomical Shoulder baseplates at five years. There were four cases of intraoperative shaft fractures that were managed with cables. Although the Trabecular Metal baseplates showed better integration radiologically, there was no significant difference in the mean of Constant Murley, Subjective Shoulder Value and the range of motion depending on the grade of inferior scapular notching at one-, two- and five-year intervals. Conclusions Reverse total shoulder arthroplasty restores the function in shoulder with significant improvements in function and moderate complications with minor differences between both designs of baseplates that were not reflected clinically.

scholarly journals Fractures of the Distal End of Radius in Elderly Patients: A Comparative Study of Anatomical and Functional Results

2002 ◽  
Vol 10 (1) ◽  
pp. 9-15 ◽  
Author(s):  
Koji Fujii ◽  
Tatsuhiko Henmi ◽  
Yoshiji Kanematsu ◽  
Takuya Mishiro ◽  
Toshinori Sakai ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Elderly Patients ◽  
Subjective Evaluation ◽  
Functional Results ◽  
Radius Fractures ◽  
Radiographic Evidence ◽  
Satisfactory Outcome ◽  
The Mean ◽  
Grip Power

The functional and anatomical results of distal end of radius fractures with severe displacement in 22 elderly patients are reviewed in this retrospective study. The mean age of the patients was 69.4 years (range, 60–88 years) and the mean follow-up period was 24 months (range, 12–53 months). According to the sum of demerit points (Saito, 1983), the latest follow-up functional end results were ‘excellent’ in 64% of fractures and ‘good’ in 36%. As for the anatomical results at follow-up, the average radial tilt was 20.7°, ulnar variance was 4.0 mm, and palmar tilt was −2.7° respectively. Though most of the patients had satisfactory outcome and the functional results did not correlate with the radiographic evidence of minor deformities, the functional results of the patients with radial shortening of 6 mm or over were poor. Furthermore, the grip power was the most significant factor related to subjective evaluation and did not improve significantly in patients with the nondominant hand injured.

Shoulder Arthrodesis for Traumatic Brachial Plexus Injuries: Functional Outcomes and Complications

Hand ◽  
2021 ◽  
pp. 155894472199800
Author(s):  
Alvaro Baik Cho ◽  
Helio Jiseok Choi ◽  
Carlos Henrique Vieira Ferreira ◽  
Leandro Yoshinobu Kiyohara ◽  
Gustavo Bersani Silva ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
External Rotation ◽  
Therapeutic Option ◽  
Functional Results ◽  
Shoulder Abduction ◽  
Subacromial Space ◽  
Nerve Reconstruction ◽  
The Mean ◽  
Shoulder Arthrodesis

Background The external rotation and abduction of shoulder are considered one of the priorities of reconstruction in brachial plexus injury. The aim of this study was to evaluate the functional results and complications of shoulder arthrodesis in patients with brachial plexus injury to better comprehend the benefits of this procedure. Methods Between 2015 and 2019, 15 shoulder arthrodesis were performed in patients with long-standing brachial plexus injury. The main indication for arthrodesis was absent or poor recovery of shoulder abduction and external rotation. Patients presented different levels of injury. Shoulder measurements of active abduction and external rotation were made based on image records of the patients. A long 4.5-mm reconstruction plate was fit along the scapular spine, acromion, and lateral proximal third of the humerus. Structured bone graft was fit into the subacromial space. Results The mean preoperative abduction was 16°, and the mean postoperative abduction was 42°. The mean preoperative external rotation was −59°, and the mean postoperative external rotation was −13°. The mean increase in abduction and external rotation was 25° and 45°, respectively. Bone union was achieved in all cases at an average time of 5.23 months. We experienced humeral fractures in 26.66% of the cases, which were all successfully treated nonoperatively. Conclusions Shoulder arthrodesis is a rewarding procedure for patients with brachial plexus injuries. A marked improvement in the upper limb positioning was observed in all patients. It should be considered as the main therapeutic option in cases where nerve reconstruction is no longer possible.

A novel plating technique for Ideberg type 1 A glenoid fractures: a report of five patients

2021 ◽  
pp. 175857322110018
Author(s):  
Sinan Oguzkaya ◽  
Jacobien van der Wijk ◽  
Alexander van Tongel ◽  
Joris Beckers ◽  
Tom van Isacker ◽  
...  
Keyword(s):  
Open Reduction ◽  
External Rotation ◽  
Plate Fixation ◽  
Fixation Method ◽  
Complication Rates ◽  
Constant Murley Score ◽  
Uninjured Side ◽  
The Mean

Background Glenoid rim fractures are uncommon and generally associated with high complication rates. The most common treatment techniques include screw or anchor fixation. Here, we introduce a new fixation method to treat Ideberg type 1 A fractures. Methods A retrospective analysis was performed on patients treated with open reduction and plate fixation for Ideberg type 1 A fractures. The active range of motion capacity of both shoulders was recorded postoperatively. Constant-Murley score and Oxford disability index scores were used as outcome tools. Results Five patients (three men and two women) were evaluated; their mean age was 56 years (standard deviation (SD), 10 years). The mean follow-up period was 25 months (range, 6–69 months); all fractures healed radiologically during the follow-up period. The mean Constant-Murley score was 80.36 (SD 11.01); the mean Oxford disability index was 37 (SD 9). The subsequent flexion and external rotation of the injured shoulders were similar to those of the uninjured side (injured vs. uninjured side: flexion, 176 ± 5.4 vs. 178 ± 4.4; external rotation, 48 ± 10.9 vs. 60 ± 0). No patient showed signs of osteoarthritis, stiffness, instability, or chronic pain at the last follow-up. Discussion Open reduction and internal fixation with a plate is suitable for Ideberg type 1A glenoid fractures.

scholarly journals Change in the Distance From the Axillary Nerve to the Glenohumeral Joint With Shoulder External Rotation or Abduction Position

Hand ◽  
2016 ◽  
Vol 12 (4) ◽  
pp. 395-400 ◽  
Author(s):  
Juan Pablo Simone ◽  
Philipp N. Streubel ◽  
Joaquin Sanchez-Sotelo ◽  
Scott P. Steinmann ◽  
Julie E. Adams
Keyword(s):  
Humeral Head ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Axillary Nerve ◽  
Shoulder Abduction ◽  
Continuous Variables ◽  
Inferior Aspect ◽  
Fresh Frozen ◽  
The Mean ◽  
Inferior Border

Background: This study investigated whether axillary nerve (AN) distance to the inferior border of the humeral head and inferior glenoid would change while placing the glenohumeral joint in different degrees of external rotation and abduction. Methods: A standard deltopectoral approach was performed on 10 fresh-frozen cadaveric specimens. The distance between AN and the inferior border of the humeral head and inferior glenoid while placing the shoulder in 0°, 45°, and 90° of external rotation or abduction was measured. Continuous variables for changes in AN position were compared with paired 2-tailed Student t test. Results: The mean distance between the AN and the humeral head with the shoulder in 0°, 45°, and 90° of external rotation and 0° of abduction was 13.77 mm (SD 4.31), 13.99 mm (SD 4.12), and 16.28 mm (SD 5.40), respectively. The mean distance between the AN and glenoid with the shoulder in 0°, 45°, and 90° of external rotation was 16.33 mm (SD 3.60), 15.60 mm (SD 4.19), and 16.43 (SD 5.35), respectively. The mean distance between the AN and the humeral head with the shoulder in 0°, 45°, and 90° of abduction and 0° of external rotation was 13.76 mm (SD 4.31), 10.68 mm (SD 4.19), and 3.81 mm (SD 3.08), respectively. The mean distance between the AN and glenoid with the shoulder in 0°, 45°, and 90° of abduction was 16.33 mm (SD 3.60), 17.66 mm (SD 5.80), and 12.44 mm (SD 5.57), respectively. Conclusions: The AN position relative to the inferior aspect of the glenohumeral joint does not significantly change despite position of external rotation. Increasing shoulder abduction over 45° decreases the distance from the glenohumeral joint to the AN and should be avoided.

scholarly journals Treatment of fractures of the femoral shaft by locked intramedullary nailing in adults at the University Clinics of Bukavu

2020 ◽  
Vol 6 (5) ◽  
pp. 262-267
Author(s):  
Mupenda Mwenibamba Rodrigue ◽  
◽  
Augustin Kibonge Mukakala ◽  
Mbaluku Colombe Moise ◽  
Mugangu Cishibanzi Emmanuel ◽  
...  
Keyword(s):  
Intramedullary Nailing ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Femoral Shaft ◽  
Functional Results ◽  
Clinical Aspects ◽  
Postoperative Rehabilitation ◽  
Superficial Infection ◽  
The Mean ◽  
The University

Introduction: The objective was to report the experience of the University Clinics of Bukavu on the treatment of fractures of the femoral shaft by locked intramedullary nailing in adults. Patients and method: This is a descriptive prospective study of a series of 31 cases collected in two centers: the University Clinics of Bukavu and the Skyborne Hospital from January 1, 2018 to December 31, 2019. The data collected includes epidemiological, clinical aspects and treatment of patients and had been analyzed by the software Epi Info version 7.2. Results: The mean age of our patients was 34.6 ± 13.2 years (range: 16-68 years) with a sex ratio of 1.2. Spinal anesthesia was used in 29 (93.55%) patients and 29 patients were installed in a supine position contralateral to the lesion. Open reduction predominated (83.87%). SIGN and TIBA type nails were used, and their dimensions varied depending on the size of the patient's femur. Static locking was performed in 29 (93.55%) patients. The mean operating time was 88.2 ± 18.2 minutes (range: 60-120 minutes). The mean length of hospital stay was 11.3 ± 3.16 days (range: 7-21 days). The average number of postoperative rehabilitation sessions was 26.8 ± 3.86 (range: 20-35 sessions). The mean follow-up was 14.87 ± 3.93 months (range: 9-20 months). The mean time to union was 3.33 ± 0.55 months (range: 3-5 months) and, 8 patients presented complications, i.e. 3 cases of hemorrhagic shock on admission, 3 cases of shortening of 1cm, one superficial infection and one case of delayed union and 30 (96.78%) patients were satisfied with their functional results. Socioprofessional or school reintegration was observed in 28 (90.32%) patients. Conclusion: Locked intramedullary nailing has proven to be an effective osteosynthesis technique in the surgical treatment of fractures of the femoral shaft at the University Clinics of Bukavu and at Skyborne Hospital.

scholarly journals InSafeLOCK® humeral nailing for humeral nonunions: Clinical and radiological results

2021 ◽  
Vol 32 (2) ◽  
pp. 446-453
Author(s):  
Oktay Polat ◽  
Serdar Toy ◽  
Birkan Kibar
Keyword(s):  
External Rotation ◽  
Operation Time ◽  
Functional Results ◽  
Dash Score ◽  
Radiological Results ◽  
Iliac Bone Graft ◽  
Loss Of Reduction ◽  
The Mean ◽  
Clinical And Radiological Results

Objectives: This study aims to evaluate the clinical and functional results of patients treated with InSafeLOCK® humeral nail and iliac crest autograft for humeral nonunion. Patients and methods: A total of 15 patients (11 males, 4 females; mean age: 52.1±15.3 years; range, 31 to 78 years) who were followed conservatively for humeral fractures and operated with the InSafeLOCK® humeral nail and iliac bone graft in our center between June 2018 and January 2020 were retrospectively analyzed. Data including demographic and clinical characteristics of the patients, operative data, and pre- and postoperative Visual Analog Scale (VAS), Disabilities of the Arm, Shoulder, and Hand (DASH), and Constant-Murley Scores (CMS) were recorded. Results: The mean time from injury to nonunion treatment was 10.9±1.6 months. Five patients had atrophic, eight patients had oligotrophic, and two patients had hypertrophic nonunion. Preoperatively, the mean DASH was 37.7±9.1, the mean CMS was 69.7±6.3, and the mean VAS was 3.8±0.7. In all patients, union was achieved. The mean operation time was 59.0±16.2 min. The mean postoperative DASH score was 16.1±8.7, CMS 87.4±3.4, and VAS score 0.8±0.7. Regarding the shoulder joint, the mean abduction was 164.7±11.3 degrees, the mean internal rotation was 82.0±6.8 degrees, the mean external rotation was 81.3±8.3 degrees, and the mean flexion was 162.0±12.1 degrees. During follow-up, complications such as vascular-nerve injury, reflex sympathetic dystrophy, screw migration or loosening, implant failure, and loss of reduction did not occur in any of our patients. Conclusion: Considering the satisfactory functional and radiological results, the InSafeLOCK® humeral nail can be used safely in humeral nonunions.

scholarly journals CONSTANT MURLEY SCORE ON PATIENTS POST SUPRASPINATUS RECONSTRUCTION WITH MEMBRANE AMNION COMPOSITE AND FAT TISSUE ALLOGENIC MESENCHYMAL STEM CELL AUGMENTATION

2019 ◽  
Vol 8 (2) ◽  
pp. 77
Author(s):  
Heri Suroto ◽  
Bayu Antara Hadi ◽  
Goklas Ridwan Ricardo Gultom
Keyword(s):  
Stem Cell ◽  
Rotator Cuff ◽  
Mesenchymal Stem Cell ◽  
Pain Score ◽  
Internal Rotation ◽  
External Rotation ◽  
Functional Results ◽  
Rotator Cuff Tears ◽  
Constant Murley Score ◽  
Hospital Patients

Background: Rotator cuff tears are the most common cases in nontrauma upper extremities in group patient more than 50 years old. Incidence on rotator cuff can’t show the real population. New Approaches healing rotator cuff syndrome is tendon regeneration like mesenchymal stem cell injection and growth factor or tissue engineering that has been developed.Methods: Retrospective comparation study of 15 postsupraspinatus reparation patients who has been treated for more than 4 months at the Dr. Soetomo general hospital. Patients is divided into group undergone supraspinatus reparation and patient supraspinatus reparation with augmented by membrane amnion composite and mesenchymal stem cell. Its’ functional results were evaluated using constant murley score.Results: Pain score average on supraspinatus reparation patients which augmented by membrane amnion and mesenchymal stem cell and those without augmentation is 15 and 13.7 (p=0.036). Daily activity score average on patients with and without augmentation are 20 and 17 (p=0.037). Flexion score average on patients with and without augmentation are 10 and 8.6 (p=0.114). External rotation score average on patients with and without augmentation are 9.6 and 7.2 (p=0.004). Internal rotation score average on patients with and without augmentation are 9.2 and 7.2 (p=0.012).Conclusion: The constant murley score pain score, ADL score, external rotation score, and internal rotation score in the group with the addition of amniotic membrane and mesenchymal stem cells were significantly better than the group with supraspinatus repair only, but not significantly on the flexion score and lateral elevation score components.

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