The medial periosteal hinge plays a key role in fractures of the head of the humerus, offering mechanical support during and after reduction and maintaining perfusion of the head by the vessels in the posteromedial periosteum. We have investigated the biomechanical properties of the medial periosteum in
Abstract. Introduction. Intra-articular distal
Standard fixation for intra-articular distal
Objectives. To explore whether orthopaedic surgeons have adopted the Proximal
The function of the upper extremity is highly dependent on correlated motion of the shoulder. The shoulder can be affected by several diseases. The most common are: rotator cuff tear (RCT), shoulder instability, shoulder osteoarthritis and fractures. Rotator cuff disease is a common disorder. It has a high prevalence rate, causing high direct and indirect costs. The appropriate treatment for RCT is debated. The American Academy Orthopaedic Surgeons guidelines state that surgical repair is an option for patients with chronic, symptomatic full-thickness RCT, but the quality of evidence is unconvincing. Thus, the AAOS recommendations are inconclusive. We are performing a randomized controlled trial to compare surgical and conservative treatment of RCT, in term of functional outcomes, rotator cuff integrity, muscle atrophy and fatty degeneration. Shoulder instability occurs when the head of the upper arm bone is forced out of the shoulder socket. Shoulder instabilities have been classified according to the etiology, the direction of instability, or on combinations thereof. The Thomas and Matsen classification, which is currently the most commonly utilized classification, divides shoulder instability events into the traumatic, unidirectional, Bankart lesion, and surgery (TUBS) and the atraumatic, multidirectional, bilateral, rehabilitation, and capsular shift (AMBRI) categories. The acquired instability overstress surgery (AIOS) category was then added. Surgical procedures for shoulder instability includes arthroscopic capsuloplasty, remplissage, bone block procedure or Latarjet procedure. Reverse total shoulder arthroplasty (RTSA) represents a good solution for the management of patients with osteoarthritis or
Supracondylar
Advancements in treating distal
Capturing objective data of the postoperative changes in the mobility of patients is expected to generate a better understanding of the effect of postoperative treatment. Until recently, the collection of gait-related data was limited to controlled clinical environments. The emergence of accurate wearable accelerometers with sufficient runtime, however, enables the long-term measurement and extraction of mobility parameters, such as “real-world walking speed”. An interim analysis of 1967 hours of actibelt data (3D accelerometer, 100 Hz) from 5 patients (planned total 20) with a femur fracture and 5 patients (planned total 20) with a
Introduction. The standard treatment of proximal humerus fractures includes pre-contoured metal plates and up to nine cortical and trabecular screws. Frequent failures are reported, especially in case of poor bone quality. The scope of this study was to assess the strength of an innovative reconstruction technique (Cement-and-screws) based on a commercial plate, with a reduced number of screws compared to the standard, and with the injection of a beta-TCP additivated acrylic bone cement (Cal-Cemex, Tecres, Italy). The focus was on a four-fragment
This study compared the effect of a computer-assisted and a traditional surgical technique on the kinematics of the glenohumeral joint during passive abduction after hemiarthroplasty of the shoulder for the treatment of fractures. We used seven pairs of fresh-frozen cadaver shoulders to create simulated four-part
Introduction. Primary Total Elbow Replacement (TER) is gaining popularity as a primary treatment option for osteoporotic fractures of the elbow, particularly in patients with low demand. The aim of this study was to assess the clinical and functional efficacy of TER as a primary treatment for comminuted distal
The operative treatment of
This study evaluated the effect on movement under load of three different techniques for re-attachment of the tuberosities of the humerus using test sawbones. In the first, the tuberosities were attached both to the shaft and to each other, with one cerclage suture through the anterior hole in the prosthesis. The second technique was identical except for omission of the cerclage suture and in the third the tuberosities were attached to the prosthesis and to the shaft. An orthogonal photogrammetric system allowed all segments to be tracked in a 3D axis system. The humeri were incrementally-loaded in abduction, and the 3D linear and angular movements of all segments were calculated. Displacement between the tuberosities and the shaft was measured. The first and second techniques were the most stable constructs, with the third allowing greater separation of fragments and angular movement. Separation at the midpoint of the tuberosities was significantly greater using the latter technique (p <
0.05). The cerclage suture added no further stability to the fixation.