This study aims to describe a new method that may be used as a supplement to evaluate humeral rotational alignment during intramedullary nail (IMN) insertion using the profile of the perpendicular peak of the greater tuberosity and its relation to the transepicondylar axis. We called this angle the greater tuberosity version angle (GTVA). This study analyzed 506 cadaveric humeri of adult patients. All humeri were CT scanned using 0.625 × 0.625 × 0.625 mm cubic voxels. The images acquired were used to generate 3D surface models of the humerus. Next, 3D landmarks were automatically calculated on each 3D bone using custom-written C++ software. The anatomical landmarks analyzed were the transepicondylar axis, the humerus anatomical axis, and the peak of the perpendicular axis of the greater tuberosity. Lastly, the angle between the transepicondylar axis and the greater tuberosity axis was calculated and defined as the GTVA.Aims
Methods
The aim of this study is to provide a detailed description of cases combining bridging patch repair with artificial ligament “internal brace” reinforcement to treat irreparable massive rotator cuff tears, and report the preliminary results. This is a retrospective review of patients with irreparable massive rotator cuff tears undergoing fascia lata autograft bridging repair with artificial ligament “internal brace” reinforcement technique between January 2017 and May 2018. Inclusion criteria were: patients treated arthroscopically for an incompletely reparable massive rotator cuff tear (dimension > 5 cm or two tendons fully torn), stage 0 to 4 supraspinatus fatty degeneration on MRI according to the Goutallier grading system, and an intact or reparable infraspinatus and/or subscapularis tendon of radiological classification Hamada 0 to 4. The surgical technique comprised two components: first, superior capsular reconstruction using an artificial ligament as an “internal brace” protective device for a fascia lata patch. The second was fascia lata autograft bridging repair for the torn supraspinatus. In all, 26 patients with a mean age 63.4 years (SD 6.2) were included.Aims
Methods
The purpose of this study was to assess the prevalence of depression and anxiety symptoms in patients undergoing shoulder surgery using the National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System (PROMIS) Depression and Anxiety computer adaptive tests, and to determine the factors associated with more severe symptoms. Additionally, we sought to determine whether PROMIS Depression and Anxiety were associated with functional outcomes after shoulder surgery. This was a retrospective analysis of 293 patients from an urban population who underwent elective shoulder surgery from 2015 to 2018. Survey questionnaires included preoperative and two-year postoperative data. Bivariate analysis was used to identify associations and multivariable analysis was used to control for confounding variables.Aims
Methods
Failure of healing is a well-known problem after repair of the rotator cuff. This study aimed to investigate if early repair of trauma-related full-thickness rotator cuff tears (FTRCTs) could prevent this failure. In this prospective trial, 62 consecutive patients (14 women (23%), 48 men (77%); median age 61 years (interquartile range (IQR) 54 to 65)) with trauma-related FTRCT underwent arthroscopic single-row repair within six weeks of trauma. Tendon integrity was assessed one year after surgery using the Sugaya score on MR images. Patients were followed up with Western Ontario Rotator Cuff (WORC) index, EuroQol visual analogue scale (EQ VAS), and the Constant–Murley score (CS) two years after repair.Aims
Patients and Methods
The natural history of primary anterior dislocation
of the glenohumeral joint in adolescent patients remains unclear and
there is no consensus for management of these patients. The objectives of this study were to report the natural history
of primary anterior dislocation of the glenohumeral joint in adolescent
patients and to identify the risk factors for recurrent dislocation. We reviewed prospectively-collected clinical and radiological
data on 133 adolescent patients diagnosed with a primary anterior
dislocation of the glenohumeral joint who had been managed non-operatively
at our hospital between 1996 and 2008. There were 115 male (86.5%)
and 18 female patients (13.5%) with a mean age of 16.3 years (13
to 18) and a mean follow-up of 95.2 months (1 to 215). During follow-up, 102 (absolute incidence of 76.7%) patients
had a recurrent dislocation. The median interval between primary
and recurrent dislocation was ten months (95% CI 7.4 to 12.6). Applying
survival analysis the likelihood of having a stable shoulder one
year after the initial injury was 59% (95% CI 51.2 to 66.8), 38%
(95% CI 30.2 to 45.8%) after two years, 21% (95% CI 13.2 to 28.8)
after five years, and 7% (95% CI 1.1 to 12.9) after ten years. Neither
age nor gender significantly predicted recurrent dislocation during
follow-up. We conclude that adolescent patients with a primary anterior
dislocation of the glenohumeral joint have a high rate of recurrent
dislocation, which usually occurs within two years of their initial
injury: these patients should be considered for early operative
stabilisation. Cite this article:
The aim of this study was to analyse the effect of altered viewing
perspectives on the measurement of the glenopolar angle (GPA) and
the differences between these measurements made on 3D CT reconstructions
and anteroposterior (AP) scapular view radiographs. The influence of the viewing perspective on the GPA was assessed,
as were the differences in the measurements of the GPA between 3D
CT reconstructions and AP scapular view radiographs in 68 cadaveric
scapulae.Aims
Materials and Methods
The glenopolar angle assesses the rotational
alignment of the glenoid and may provide prognostic information
and aid the management of scapula fractures. We have analysed the
effect of the anteroposterior (AP) shoulder radiograph rotational
offset on the glenopolar angle in a laboratory setting and used
this to assess the accuracy of shoulder imaging employed in routine
clinical practice. Fluoroscopic imaging was performed on 25 non-paired scapulae
tagged with 2 mm steel spheres to determine the orientation of true
AP views. The glenopolar angle was measured on all the bony specimens
rotated at 10° increments. The mean glenopolar angle measured on
the bone specimens in rotations between 0° and 20° and thereafter
was found to be significantly different (p <
0.001). We also obtained
the AP radiographs of the uninjured shoulder of 30 patients treated
for fractures at our centre and found that none fitted the criteria
of a true AP shoulder radiograph. The mean angular offset from the
true AP view was 38° (10° to 65°) for this cohort. Radiological
AP shoulder views may not fully project the normal anatomy of the scapular
body and the measured glenopolar angle. The absence of a true AP
view may compromise the clinical management of a scapular fracture. Cite this article:
The ideal treatment for traumatic anterior dislocation
of the shoulder in the skeletally immature patient is controversial.
The aim of this study is to evaluate the outcomes after either conservative
and/or surgical treatment using the Latarjet technique. A retrospective
series of 49 out of 80 patients were reviewed. We found no significant differences
between either treatment method regarding functional scores and
pain levels. Although not statistically significant, post-surgical
patients showed better signs of shoulder stability than others who
have a higher rate of recurrence. Further, 92% of the post-surgical
group had returned to the same level of activity Cite this article:
