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Eur J Trauma Emerg Surg 2022 Jun 25. Epub 2022 Jun 25.

Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.

Purpose: Elbow dislocations are at risk for persistent instability and stiffness of the joint. Treatment with a hinged external fixation provides elbow joint stability, and allows early mobilization to prevent stiffness. Mounting a hinged elbow fixator correctly, however, is technically challenging. Read More

Arthrosc Sports Med Rehabil 2022 Jun 31;4(3):e1015-e1022. Epub 2022 Mar 31.

Steadman Philippon Research Institute, Vail, Colorado.

Purpose: The purpose of this study was to compare outcomes between anterior shoulder instability patients with and without glenolabral articular disruption (GLAD) lesions after undergoing arthroscopic Bankart repair and to evaluate potential risk factors for inferior outcomes and recurrent instability.

Methods: Prospectively collected data were retrospectively reviewed for patients who underwent arthroscopic Bankart repair with and without GLAD lesions at a minimum of 2 years follow-up. Consecutive patients were matched by age, sex, and number of anchors. Read More

Ann Med Surg (Lond) 2022 Jun 4;78:103914. Epub 2022 Jun 4.

Department of Traumatology and Orthopedics, Mohammed VI University Hospital, Oujda, Morocco.

Introduction: The terrible triad of the elbow (TTE) is a lesion associating a dislocation of the elbow, a fracture of the radial head, and a fracture of the coronoid process, with a high potential of complication. The treatment is based on the restoration of bone lesions and external capsular ligament repair. The systematic repair of the medial collateral ligament (MCL) is still debated in the literature. Read More

Int Orthop 2022 Jun 20. Epub 2022 Jun 20.

Department of Orthopedics and Traumatology, Hôpital Pellegrin, Place Amélie Raba-Léon, 33000, Bordeaux, France.

Purpose: The aims of this study are to summarize (1) the history of terrible triad injury (TTi) treatment and (2) the clinical and biomechanical data that engendered its evolution.

Methods: A literature search was performed using five electronic databases. Results were discussed as a chronologic review of the relevant literature between 1920 and 2022. Read More

J Taibah Univ Med Sci 2022 Jun 16;17(3):529-532. Epub 2021 Oct 16.

Orthopedic Department, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, KSA.

In children, traumatic radial head dislocation (RHD) is usually associated with ulnar fracture or deformation as reported in a Monteggia injury or its Monteggia variant. Isolated traumatic RHD is extremely rare and exceptional. Traumatic RHD is frequently missed on initial radiographs, particularly if it is isolated. Read More

Acta Ortop Bras 2022 15;30(2):e244517. Epub 2022 Apr 15.

Universidade Federal de São Paulo (Unifesp), Orthopedics and Traumatology Department, Sports Traumatology Center, São Paulo, SP, Brazil.

Objective: This study aims to understand the way fighting athletes respond to bone block surgery in the treatment for shoulder instability.

Methods: Prospective clinical study with competitive fighters with shoulder instability who underwent bone block surgery from 2013 to 2016, followed by a postoperative rehabilitation protocol. For the evaluation, eight combat athletes with anterior shoulder instability were treated, with a total of nine shoulders, since one athlete underwent bilateral surgery. Read More

Sci Rep 2022 Jun 17;12(1):10238. Epub 2022 Jun 17.

Department of Orthopedics, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, Guangxi, China.

The present study aimed to explore the influence of ulnar bow on the surgical treatment of Bado type I missed Monteggia fracture in children. A retrospective review of 28 patients was conducted between November 2010 and June 2020. All patients were treated with open reduction of the radial head and ulnar opening wedge osteotomy without annular ligament reconstruction. Read More

Tech Hand Up Extrem Surg 2022 Apr 5. Epub 2022 Apr 5.

Department of First Orthopaedic, Georgios Papanikolaou Hospital, Aristotle University, Thessaloniki.

The task of achieving a good clinical outcome on patients with chronic elbow dislocation is arduous. Any stabilization method used should be robust enough in order to allow for early elbow motion. Immobilization of the elbow for a prolonged time period may lead to stiffness and heterotopic ossification. Read More

Int J Clin Pract 2022 31;2022:6414247. Epub 2022 Jan 31.

Department of Orthopedic Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Background: This study aimed to evaluate the injury mechanism of medial epicondylar fractures in children and adolescents and its association with increased carrying angle (CA) as a predisposing factor.

Materials And Methods: We evaluated 37 patients with medial epicondylar fractures who were surgically treated at our institution. Medical records and plain radiographs were reviewed to determine the mechanism of injury and the humerus-elbow-wrist angle (HEWA) and CA of the uninjured arm. Read More

J Orthop Surg Res 2022 Jun 7;17(1):303. Epub 2022 Jun 7.

University Centre for Orthopaedic, Trauma- and Plastic Surgery (OUPC), University Hospital Carl Gustav Carus, Technical University Dresden, Fetscherstraße 74, 01307, Dresden, Germany.

Background: Monteggia fractures and Monteggia-like lesions result after severe trauma and have high complication rates. Preliminary biomechanical studies suggested a correlation between ulnar fracture localization and clinical result.

Objectives: Key objective was to evaluate whether the site of the ulnar fracture can be correlated to clinical outcome after open reduction and internal stabilization. Read More

J Orthop Surg Res 2022 Jun 3;17(1):300. Epub 2022 Jun 3.

Department of Pediatric Orthopedics, Shenzhen Children's Hospital of China Medical University, Shenzhen, Guangdong Province, People's Republic of China.

Background: Fractures are the most common type of unintentional injury in children, with traumatic upper limb fractures accounting for approximately 80% of all childhood fractures. Many epidemiological investigations of upper limb fractures in children have been conducted, but with the development of society, the patterns of childhood fractures may have changed. This study aimed to analyze the epidemiology and economic cost factors of upper limb fractures in Chinese children. Read More

Bull Hosp Jt Dis (2013) 2022 Jun;80(2):180-185

Background: Adult Monteggia fracture variants are rare but potentially devastating injuries to the elbow generally requiring surgical treatment. Monteggia injuries with co- existing fractures of the radial head and coronoid present a surgical challenge due to the need to adequately expose all components of the injury for internal fixation or arthroplasty. In this study, we evaluated the clinical outcomes following surgical treatment of adult Monteggia fracture variants in which a coexisting radial head or coronoid fracture was ad- dressed through a single extensile posterior trans-olecranon approach. Read More

Bone Joint J 2022 Jun;104-B(6):747-757

Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, China.

Aims: The aim of this study was to investigate the feasibility of application of a 3D-printed megaprosthesis with hemiarthroplasty design for defects of the distal humerus or proximal ulna following tumour resection.

Methods: From June 2018 to January 2020, 13 patients with aggressive or malignant tumours involving the distal humerus (n = 8) or proximal ulna (n = 5) were treated by en bloc resection and reconstruction with a 3D-printed megaprosthesis with hemiarthroplasty, designed in our centre. In this paper, we summarize the baseline and operative data, oncological outcome, complication profiles, and functional status of these patients. Read More

Skeletal Radiol 2022 May 28. Epub 2022 May 28.

University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, MD, Baltimore, USA.

Objective: Deep learning has the potential to automatically triage orthopedic emergencies, such as joint dislocations. However, due to the rarity of these injuries, collecting large numbers of images to train algorithms may be infeasible for many centers. We evaluated if the Internet could be used as a source of images to train convolutional neural networks (CNNs) for joint dislocations that would generalize well to real-world clinical cases. Read More

J Orthop Case Rep 2022 Jan;12(1):41-44

Department of Orthopaedics, "Panagiotis and Aglaia Kyriakou" Athens General Children's Hospital, Athens, Greece.

Introduction: Monteggia injuries are relatively rare in the pediatric population. They can be missed leading to complications arising from a chronic radial head dislocation. There is limited information about their proper management in the literature. Read More

J Orthop Case Rep 2022 Jan;12(1):22-25

Department of Orthopaedics, Dr. D. Y. Patil Medical College and Hospital, Navi Mumbai, Maharashtra, India.

Introduction: Anterior dislocation of the elbow is comparatively less frequent and is often associated with fractures of the distal humerus. Such injuries require surgical intervention at the earliest but with the surge of COVID-19 pandemic and different protocols being followed by surgeons, such cases are getting neglected. We present a 5-week-old neglected anterior dislocation of the right elbow joint with lateral condyle and medial epicondyle humerus fracture and a unique cantilever K-wiring technique used for its treatment. Read More

Yonago Acta Med 2022 May 22;65(2):166-170. Epub 2022 Apr 22.

Division of Orthopedic Surgery, Department of Sensory of Motor Organs, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan.

This report describes a rare case of brachial artery dissection associated with closed elbow dislocation caused by a snowboarding injury. After peripheral ischaemic findings in the right upper extremity were confirmed, urgent duplex-sonography was performed to diagnose the brachial artery injury. Urgent revascularisation surgery was promptly performed, and arterial dissection was diagnosed by intraoperative findings, in which the adventitia of the brachial artery was intact and the intima was disrupted. Read More

Eur J Orthop Surg Traumatol 2022 May 24. Epub 2022 May 24.

Shoulder and Elbow Unit. Traumatology and Orthopaedic Surgery Department, Universitat Autónoma de Barcelona, Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain.

Purpose: The aim of this study is to review our experience with the pectoralis-major-pedicled bone window for the revision of shoulder arthroplasty.

Methods: This study used the retrospective case series of six patients who underwent a pectoralis-major-pedicled bone window for revision of shoulder arthroplasty, with a minimum follow-up of 2 years. Demographic, clinical, and radiological data were analyzed. Read More

J Shoulder Elbow Surg 2022 May 20. Epub 2022 May 20.

Department of Orthopedic Surgery, Tufts Medical Center, Boston, MA, USA. Electronic address:

Background: The treatment of proximal humerus fracture-dislocations can be challenging given the extensive injury to the proximal humeral anatomy and increased risk of devascularization of the humeral head often seen in these injuries. The purpose of this study is to undertake a systematic review of the literature on the functional outcomes, rate of revision, and short- and long-term complications for proximal humerus fracture-dislocations treated with open reduction and internal fixation (ORIF).

Methods: The PubMed and OVID Embase databases were queried for literature reporting on proximal humerus fracture dislocations treated with ORIF. Read More

Int J Surg Case Rep 2022 Jun 10;95:107178. Epub 2022 May 10.

Orthopedics and Traumatology Department, University Hospital Mohamed Taher Maâmouri Nabeul-Tunisia.

Shoulder Elbow 2022 Jun 19;14(3):341-348. Epub 2021 Nov 19.

Department of Orthopaedic Surgery, Rijnstate Hospital Arnhem, the Netherlands.

This review gives a summary of the records of shoulder dislocation management throughout history until the point that anaesthetics were introduced and modern medicine improved dislocation management exponentially. A dislocation is a mechanical injury that has been managed in different ways throughout history. The shoulder reduction methods described in Hippocrates Corpus have been described and adjusted throughout history by later physicians. Read More

Int J Surg Case Rep 2022 Jun 11;95:107190. Epub 2022 May 11.

Orthopedics and Trauma, Faculty of Medicine, Hashemite University, Jordan.

Introduction: Isolated acute distal radioulnar joint (DRUJ) dislocation is a rare injury that should be early recognized and treated promptly to avoid the limitation and disability associated with delayed diagnosis and management.

Case Presentation: We present a patient with a traumatic dorsal isolated DRUJ dislocation who was successfully treated with a closed reduction and k-wire pinning along with cast immobilization.

Discussion: Previous reports of distal radioulnar joint dislocation have described the mechanics of this injury as well as a guidance to diagnosis and treatment. Read More

Front Surg 2022 29;9:875475. Epub 2022 Apr 29.

Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China.

Objectives: This study aimed to introduce a sternoclavicular joint (SCJ)-specific plate for the treatment of medial-end clavicle fracture and evaluate the clinical and radiological results of this method.

Methods: From January 2006 to December 2020, 31 patients with displaced medial-end clavicle fractures were included in this study, with 8 patients with accompanying SCJ dislocation. Abduction and forward elevation of the shoulder, the Visual Analogue Scale (VAS), and the American Shoulder and Elbow Surgeons Score (ASES) were used for evaluation before index surgery and at the latest follow-up. Read More

JSES Int 2022 May 22;6(3):338-342. Epub 2022 Feb 22.

Icahn School of Medicine - Mount Sinai Hospital, Department of Orthopaedics, New York, NY, USA.

Background: Humeral head pseudosubluxation (HHPS) in relation to the glenohumeral joint is a common finding following fractures of the proximal humerus. The temporary inferior subluxation of the humeral head may be secondary to a transient axillary nerve neuropraxia, pain inhibition of the deltoid, or hemarthrosis or capsular disruption that alters the physiologically negative pressure in the glenohumeral joint. Despite the frequency of this finding, it is not well described in the literature. Read More

JSES Int 2022 May 12;6(3):396-400. Epub 2022 Jan 12.

Shoulder and Elbow Unit, Joint Research, OLVG, Amsterdam, the Netherlands.

Background: It is unclear whether greater tuberosity fractures (GTF) in the setting of a shoulder dislocation are due to an avulsion of the rotator cuff or a result of an extensive Hill-Sachs lesion (HSL). To explore whether these lesions have similar etiology, the primary aim of this study is to compare the postinjury morphology of the proximal humerus after GTF and HSL.

Methods: Computed tomography scans of 19 patients with HSL and 18 patients with GTF after first-time shoulder dislocations were analyzed. Read More

JSES Int 2022 May 14;6(3):343-348. Epub 2022 Feb 14.

Department of Orthopedics and Traumatology, Sports Traumatology Center, Federal University of São Paulo, São Paulo, São Paulo, Brazil.

Background: Although there is a low incidence of shoulder instability in women, this population is still representative and is often associated with lower rates of return to sports. Few studies have evaluated the results of the Latarjet procedure in this population.

Methods: This was a prospective cohort study of female athletes who underwent the Latarjet procedure between 2013 and 2018. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2022 May;36(5):582-586

Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing Jiangsu, 210008, P. R. China.

Objective: To investigate the effectiveness of a single threaded anchor fixation under shoulder arthroscopy in the treatment of fresh bony Bankart injury.

Methods: Between January 2017 and May 2021, 12 patients with fresh bony Bankart injury caused by trauma were treated with a single threaded anchor fixation under shoulder arthroscopy. There were 10 males and 2 females with an average age of 38. Read More

J Am Acad Orthop Surg Glob Res Rev 2022 May 1;6(5). Epub 2022 May 1.

From the Department of Orthopaedics and Traumatology, the University Center of Health Sciences, University of Guadalajara "Benemerito Antiguo Hospital Civil de Guadalajara Fray Antonio Alcalde," Instituto de Reconstrucción Articular y Medicina Deportiva de Occidente, Guadalajara, Jalisco Mexico (Tafoya-Arreguín); Orthopaedics and Traumatology, the University Center of Health Sciences, University of Guadalajara "Benemerito Antiguo Hospital Civil de Guadalajara Fray Antonio Alcalde," Guadalajara, Jalisco Mexico (Tafoya-Arreguín, Dr. Castillo-González, and Dr. Pellegrini-Verduzco); the Department of Orthopaedics and Traumatology, the University Center of Health Sciences, University of Guadalajara "Benemerito Antiguo Hospital Civil de Guadalajara Fray Antonio Alcalde," Guadalajara, Jalisco Mexico (Tafoya-Arreguín, Dr. Martínez-Ruíz, and Dr. Arce-Rosas); the Department of Orthopaedics and Traumatology, Hospital Regional de Tepatitlán, Tepatitlán de Morelos, Jalisco, Mexico (Tafoya-Arreguín, Dr. Esqueda-Godoy); and the Instituto de Reconstrucción Articular y Medicina Deportiva de Occidente, Guadalajara, Jalisco, Mexico (Tafoya-Arreguín).

Objective: To describe the clinical outcomes of interposition arthroplasty with transposition of the medial epicondyle to the coronoid process and articulated external fixation in patients with untreated chronic dislocation of the elbow.

Methods: Fourteen consecutive patients diagnosed with untreated chronic elbow dislocation performed a complete radiological and physical examination. The same surgeon treated all patients with a same technique. Read More

Ortop Traumatol Rehabil 2022 Apr;24(2):79-86

Klinika Ortopedii i Ortopedii Dziecięcej, Centralny Szpital Kliniczny Uniwersytetu Medycznego w Łodzi, Polska / Orthopedics and Pediatric Orthopedics Department, Central Teaching Hospital of the Medical University of Lodz, Poland.

Background: The term Monteggia fracture refers to a class of injuries encompassing the fracture of the proximal end of the ulna with subluxation or dislocation of the radial head. These injuries account for 0.4-1% of all forearm fractures in children. Read More

Arch Orthop Trauma Surg 2022 May 9. Epub 2022 May 9.

Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria.

Introduction: This study investigated the anatomic feasibility of a new surgical therapy option for radial head arthrosis using an autologous vascularized bone graft of the second metatarsal and proximal fibula to recreate the proximal radiohumeral joint.

Materials And Methods: Upper and lower extremities of eleven body donors were evaluated using CT prior to anatomic dissection. Several distinct anatomic parameters were measured on the ipsi- and contralateral radial and fibular head and the second metatarsal base: bone diameter, articular surface diameter, head height, metaphyseal (neck) diameter, articular surface radius, total articular surface area, and angulation of the articular surfaces (facet). Read More