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Ugeskr Laeger 2022 May;184(19)

Ortopædkirurgisk Afdeling, Københavns Universitetshospital - Herlev-Gentofte Hospital.

Lateral humeral condyle fractures account for 10-20% of all paediatric elbow fractures. Diagnosis is made on plain radiographs; however, their interpretation is a challenge. Diagnostic MRI is used to apply the Song classification. Read More

Medicine (Baltimore) 2022 May 13;101(19):e29258. Epub 2022 May 13.

Department of Pediatric Surgery, Carl Gustav Carus Medical Faculty, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany.

Background: Supracondylar humerus fractures (SHF) are the second most common fracture in children and the most common fracture in children under seven years. Subtle neurovascular lesions in displaced SHF may be underdiagnosed clinically, but their sequelae can mean life-long symptoms. Here we show that color-coded duplex ultrasound (DUS) could help to identify these patients. Read More

J Orthop Trauma 2022 May 17. Epub 2022 May 17.

Department of Orthopaedic Surgery, Hospital Universitario de La Ribera, Alzira, Valencia (Spain).

Objectives: To analyze the outcomes and complication rates of fibular allografts (FA) as an augmentation technique for proximal humeral fractures (PHF) and determine their appropriate indications.

Data Sources: English and Spanish-language articles in PubMed, MEDLINE, Embase, Web of Science (Core Collection), and Google Scholar databases were systematically reviewed with the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines on April 10, 2020.

Study Selection: Studies of PHF patients treated primarily with FA and locking compression plates (LCP) and with a minimum follow-up of six months were included, and presenting results with standardized clinical scales, radiological values, and operative complications. Read More

Musculoskelet Surg 2022 May 17. Epub 2022 May 17.

Department of Orthopaedic Surgery, AZ Groeninge Hospital, President Kennedylaan 4, 8500, Kortrijk, Belgium.

Purpose: To evaluate the outcomes of patients affected by proximal and middle one-third humeral shaft fractures treated with humeral helical plates.

Material And Methods: From October 2016 to June 2020, twenty-four (twenty women, four men) underwent humeral reduction and fixation with humeral helical plates (A.L. Read More

Arch Orthop Trauma Surg 2022 May 17. Epub 2022 May 17.

Department for Orthopaedic and Trauma Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Joseph-Stelzmann Strasse 24, 50931, Cologne, Germany.

Introduction: In regard of surgical training, the reproducible simulation of life-like proximal humerus fractures in human cadaveric specimens is desirable. The aim of the present study was to develop a technique that allows simulation of realistic proximal humerus fractures and to analyse the influence of rotator cuff preload on the generated lesions in regards of fracture configuration.

Materials And Methods: Ten cadaveric specimens (6 left, 4 right) were fractured using a custom-made drop-test bench, in two groups. Read More

Acupunct Med 2022 May 17:9645284221085578. Epub 2022 May 17.

Nanjing Maigaoqiao Community Health Service Center, Nanjing, China.

Osteoporos Int 2022 May 17. Epub 2022 May 17.

Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.

Healthcare administrative (claims) data are commonly utilized to estimate drug effects. We identified considerable heterogeneity in fracture outcome definitions in a scoping review of 57 studies that estimated osteoporosis drug effects on fracture risk. Better understanding of the impact of different fracture definitions on study results is needed. Read More

Int Orthop 2022 May 16. Epub 2022 May 16.

Department of Orthopaedic Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 162 Ilsan-dong, Wonju, 26426, Korea.

Purpose: The ideal surgical treatment of extra-articular distal-third diaphyseal humeral fractures is controversial in terms of the surgical approach and plate position. The aim of this study was to compare the clinical and radiological outcomes between anterior and posterior plating methods for extra-articular distal-third diaphyseal humeral fractures.

Methods: Twenty-four patients were treated with anterior plating with modified placement of the proximal humeral internal locking system (PHILOS) plate, and 22 patients were treated with posterior plating of the extra-articular distal humerus plate (EADHP). 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 24;6(3):380-384. Epub 2022 Jan 24.

Department of Orthopedics and Traumatology, São João University Hospital Center, Porto, Portugal.

Background: Proximal humerus fractures (PHFs) are frequent and associated with significant health care burden. National epidemiological data are limited. Our objective is to characterize the Portuguese population admitted with PHFs and analyze therapeutic management, the impact of associated lesions, and mortality rate. Read More

JSES Int 2022 May 17;6(3):385-390. Epub 2022 Jan 17.

UT Health San Antonio, Department of Orthopaedics, San Antonio, TX, USA.

Background: Expandable magnetic rods and intramedullary nails are being used in a number of innovative ways, including limb length discrepancy and scoliosis correction. However, recently, the full complement of these devices has been further explored, with the utilization of their compressive capacity to improve fracture healing. The purpose of the present study was to report on early results of compressive magnetic intramedullary nailing for humeral shaft delayed unions and nonunions. Read More

JSES Int 2022 May 28;6(3):374-379. Epub 2022 Jan 28.

Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Background: In recent years, complex and unstable proximal humeral fractures (PHFs) are treated with intramedullary nails (IMNs) in the elderly; however, the postoperative radiographic findings related to the clinical outcome are not clear. This study evaluated the association of clinical outcomes with the radiographic findings of PHFs treated with IMNs.

Methods: We collected data of patients aged >60 years with PHFs treated with IMNs from 2015 to 2019 in 13 associated centers' database (named TRON). Read More

JSES Int 2022 May 28;6(3):434-441. Epub 2022 Jan 28.

Ramsay Générale de Santé, Hôpital privé Jean Mermoz, Centre Orthopédique Santy, Lyon, France.

Background: Various implant designs have been proposed to increase active range of motion (ROM) and avoid notching in patients treated by reverse total shoulder arthroplasty (RSA). The purpose of this study was to investigate the efficacy and safety of an onlay prosthesis design combining a 135° humeral neck-shaft angle with the glenoid component lateralized and inferiorized.

Methods: A retrospective descriptive study was conducted of the clinical and radiological outcomes at the final follow-up (≥24 months) of all RSAs performed by the same surgeon between September 2015 and December 2016 in the study center. Read More

JSES Int 2022 May 26;6(3):331-337. Epub 2022 Feb 26.

ICR Nice - Institute for Reconstructive Bone and Joint Surgery and Sport Surgery, Groupe Kantys, Nice, Provence-Alpes-Côte d'Azur, France.

Background: The Neer classification is among the most widely used systems to describe proximal humerus fractures (PHF) despite the poor interobserver agreement. The purpose of this study was to verify whether or not blinded shoulder surgeons and trainees agree with the authors of articles published in the highest impact-factor orthopedic journals.

Methods: All articles regarding PHF published between 2017 and 2019 in the top 10 orthopedic journals as rated by impact factor were searched. Read More

J Clin Med 2022 Apr 30;11(9). Epub 2022 Apr 30.

Department of Orthopedics and Traumatology, Paracelsus Private Medical University Nuremberg, 90419 Nuremberg, Germany.

Background: Operative management of proximal humeral fractures is still challenging. While antegrade nailing has become a valid option in fracture fixation, risk factors for adverse events, and failure have not been sufficiently clarified.

Methods: All patients of a single trauma center undergoing surgery for proximal humeral fractures with the Targon PH nail between 2014 and 2021 were evaluated retrospectively. Read More

J Clin Med 2022 Apr 21;11(9). Epub 2022 Apr 21.

Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden.

Age-related mortality across fractures in different anatomical regions are sparsely described, since most studies focus on specific age groups or fracture locations. The aim here was to investigate mortality at 30 days and 1 year post-fracture within four different age groups. All patients ≥ 16 years registered in the Swedish Fracture Register (SFR) 2012-2018 were included ( = 262,598 patients) and divided into four age groups: 16-49, 50-64, 65-79, and ≥80 years of age. Read More

J Shoulder Elbow Surg 2022 May 10. Epub 2022 May 10.

Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, USA.

Background: Periprosthetic proximal humerus fractures (PPHFs) are a detrimental complication of shoulder arthroplasty, yet their characterization and management have been poorly studied. We aimed to determine the intra- and inter-observer reliability of four previously described PPHF classification systems to evaluate which classifications are the most consistent.

Methods: We retrospectively reviewed 32 patients (34 fractures) that were diagnosed with a PPHF between 1990 and 2017. Read More

J Orthop Surg Res 2022 May 12;17(1):260. Epub 2022 May 12.

Department of Orthopedics, The Guizhou Provincial Orthopedic Hospital, Guiyang, 550014, Guizhou, China.

Background And Purpose: Open reduction and internal fixation through the posterior approach are standard methods for treating middle-inferior humerus fractures. Given the limited operative field and difficulty in locating the radial nerve, the minimally invasive percutaneous plate osteosynthesis (MIPPO) technique via the posterior approach to treat middle-inferior humerus fractures has rarely been reported. This study aims to evaluate the clinical effect of the preoperative study of the radial nerve position by B-ultrasound and its intraoperative protection combined with MIPPO in managing middle-inferior humerus fractures. Read More

J Shoulder Elbow Surg 2022 May 9. Epub 2022 May 9.

Mercy Health-Cincinnati SportsMedicine and Orthopaedic Center; Cincinnati SportsMedicine Research and Education Foundation, Cincinnati, OH, USA. Electronic address:

Introduction: Reverse shoulder arthroplasty (RSA) was originally indicated for older adults, but outcomes in the oldest patients have not been studied. We report here on patients >85 years old undergoing RSA and hypothesize that RSA is safe, effective and durable.

Methods: Sixty-one RSAs were performed in 58 patients >85 years old (16 patients >90 years old), including 40 for arthritis with cuff deficiency, 14 for proximal humerus fracture, and 7 as revisions. Read More

Ortop Traumatol Rehabil 2022 Apr;24(2):133-137

Department of Orthopedics, University Medicine Rostock, Rostock, Germany.

A 17-year-old paraplegic patient sustained a subtrochanteric femoral fracture due to inadequate trauma. The unusual anatomical conditions associated with his congenital paraplegia did not allow treatment with a standard intramedullary implant for the femur. Because his soft tissues were already compromised, alternative options like plate osteosynthesis were considered unfavourable as a salvage procedure. Read More

Indian J Orthop 2022 May 10;56(5):741-751. Epub 2022 Feb 10.

Bone and Soft Tissue Sarcoma Service, Tata Memorial Hospital, Mumbai, India.

Objective: This article aims to review the epidemiology, etio-pathogenesis and updates in clinical diagnostics and management of unicameral bone cysts (UBC).

Methods: A computerized literature search using Cochrane database of systematic reviews, EMBASE and PubMed was performed. MeSH (Medical Subject Headings) terms used in searches included the following sub-headings: "unicameral bone cyst", "epidemiology", "etiology", "pathogenesis", "diagnosis", "management" and "surgery". Read More

Acta Biomed 2022 May 11;93(2):e2021494. Epub 2022 May 11.

Orthopaedic and Trauma Unit, Piedimonte Matese Hospital, ASL CASERTA, Italy.

Clin Shoulder Elb 2022 May 2. Epub 2022 May 2.

Department of Orthopedics, Mubadala Healthpoint, Sheikh Zayed Sports City, Abu Dhabi, UAE.

Intraoperative periprosthetic humeral fractures are a rare but debilitating complication of reverse shoulder arthroplasty and can occur during multiple stages of the procedure. Prior biceps tenodesis has been found to reduce cortical humeral strength and predispose the patient to humeral fracture. We present a case of a 68-year-old female with a previous history of biceps tenodesis due to an irreparable rotator cuff tear. Read More

Clin Shoulder Elb 2022 Apr 4. Epub 2022 Apr 4.

Shoulder and Elbow Unit, Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands.

Background: Distal humerus fractures (DHFs) are challenging to treat due to the locally complex osseous and soft tissue anatomy. Adequate exposure of the articular surface of the distal humerus is crucial when performing an anatomical reconstruction of the elbow. Even though "triceps-on" approaches are gaining popularity, one of the most commonly used surgical treatments for DHF is olecranon osteotomy. Read More

J Pediatr Orthop 2022 May 12. Epub 2022 May 12.

Department of Orthopedics and Scoliosis Surgery, Texas Children's Hospital.

Background: Supracondylar humerus fractures (SCHF) are the most common elbow fracture type in children, and one of the most common pediatric fracture types overall. Excellent outcomes are generally reported with closed reduction and pinning (CRPP), but the technique involves leaving the pins outside the skin. External pins can act as a nidus for infection. Read More

J Pediatr Orthop 2022 May 11. Epub 2022 May 11.

Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY.

Background: Unnecessary transfers of nonemergent pediatric musculoskeletal injuries to regional trauma centers can be costly. The severity of fracture displacement in supracondylar humerus fractures dictates the risk of complications, the urgency of transfer and the need for surgical treatment. The purpose of this study is to examine the transfer patterns of Gartland type II pediatric supracondylar humerus fractures to identify strategies for improving patient care, improving health care system efficiency, and reducing costs. Read More

JBJS Rev 2022 May 1;10(5). Epub 2022 May 1.

NYU Langone Orthopedic Hospital, New York, NY.

»: The majority of proximal humeral fractures (PHFs) in patients who are ≥65 years of age are treated nonoperatively, but certain complex fracture patterns benefit from surgical intervention. However, there continues to be debate regarding the indications for surgery and the optimal surgical treatment (repair versus replacement) in this population.

»: Reverse total shoulder arthroplasty (RTSA) has grown in popularity for surgical treatment of fracture-dislocations and displaced complex PHFs in patients who are ≥65 years of age; it has definite advantages over surgical repair and hemiarthroplasty, but this finding requires additional higher-quality evidence. Read More

Case Rep Orthop 2022 29;2022:6041577. Epub 2022 Apr 29.

Department of Orthopaedics and Traumatology, Venizeleio and Pananio General Hospital of Heraklion Crete, Greece.

Introduction: Neglected distal humerus fractures are rare injuries, which the orthopaedic surgeon will not deal many times in his career. We present a case of a young patient with such an injury, who was treated with a corrective osteotomy and fixation, resulting in a very good outcome. This case report highlights the importance of surgical intervention for distal humerus fracture malunion. Read More