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JBJS Case Connect 2021 Jun 11;11(2). Epub 2021 Jun 11.

Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan.

Case: We describe the case of a 38-year-old woman, a yoga instructor, who had pain in the right shoulder and scapular region of 4 months' duration while performing yoga. Radiography and computed tomography diagnosed delayed union of a first rib stress fracture. The delayed union of stress fracture of the first rib was successfully treated with the limiting of yoga activity and low-intensity pulsed ultrasound (LIPUS). Read More

Eur J Orthop Surg Traumatol 2021 Jun 5. Epub 2021 Jun 5.

Department of Traumatology and Hand Surgery, St. Vincentius Clinic, Teaching Hospital Albert-Ludwigs-University Freiburg, Karlsruhe, Germany.

Background: Locked dislocations of the glenohumeral joint are disabling and often painful conditions and the treatment is challenging. This study evaluates the functional outcome and the different prosthetic treatment options for chronic locked dislocations of the glenohumeral joint and a subclassification is proposed.

Methods: In this single-center retrospective case series, all patients with a chronic locked dislocation treated surgically during a four-year period were analyzed. Read More

Arch Orthop Trauma Surg 2021 Jun 2. Epub 2021 Jun 2.

Department of Orthopedics and Traumatology, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.

Background: Surgical decision making in the treatment of proximal humerus fractures (PHFx) is primarily based on fracture classification using standard radiographs. Due to the lack of objective criteria, this classification process is associated with high interobserver variation. In this study, we investigate the fluoroscopic analysis of humerus fractures through the surgical neck using a semi-quantitative determination of distinct angulation patterns of the proximal humerus as they appear in the image intensifier. Read More

Bone Joint J 2021 Jun;103-B(6):1160-1167

Bristol Royal Hospital for Children, Bristol, UK.

Aims: Open tibial fractures are limb-threatening injuries. While limb loss is rare in children, deep infection and nonunion rates of up to 15% and 8% are reported, respectively. We manage these injuries in a similar manner to those in adults, with a combined orthoplastic approach, often involving the use of vascularised free flaps. Read More

Orthop Clin North Am 2021 Jul 7;52(3):257-268. Epub 2021 May 7.

Department of Orthopaedic Surgery, New England Baptist Hospital, 125 Parker Hill Avenue, Boston, MA 02120, USA; Boston Sports and Shoulder Center, 840 Winter Street, Waltham, MA 02451, USA.

Reverse total shoulder arthroplasty (RSA) continues to see tremendous growth as the indications have expanded. A variety of complications have been described, including fractures of the acromion or scapular spine. These fractures are painful and can compromise shoulder stability and functional outcomes following RSA. Read More

Injury 2021 May 1. Epub 2021 May 1.

Department of Traumatology and Orthopaedic Surgery, General University Hospital Gregorio Marañón, C/ Doctor Esquerdo, 46, 28007, Madrid, Spain.. Electronic address:

The treatment of complex articular scapular fractures requires obtaining an anatomic reduction. The experience of the surgeon and the surgical skills needed are still the most important aspect in this surgical field. 3D printed models at a 1:1 scale provides tactile and visual experience. Read More

SICOT J 2021 20;7:36. Epub 2021 May 20.

Department of Surgery, Division of Orthopaedic Surgery, Groote Schuur Hospital, 7935 Cape Town, South Africa.

Introduction: Surgical treatment of displaced acromial and scapula spine fractures may be challenging due to the bony anatomy and variable fracture patterns. This difficulty is accentuated by the limitations of the available scapular plates for fracture fixation. This study compares the quantitative fitting of anatomic scapular plates and clavicle plates, using three-dimensional (3D) printed fractured scapulae. Read More

Indian J Orthop 2021 Jun 31;55(3):708-713. Epub 2020 Oct 31.

Atlas Hospitals, First cross, V.N. Nagar, Trichy, 620002 Tamil Nadu India.

Background: Scapular fractures are uncommon injuries of upper extremity resulting mostly from high-energy trauma. Extra-articular fractures form the majority of them. Un-displaced fractures can be managed conservatively with good results. Read More

Hand (N Y) 2021 Apr 21:1558944721998008. Epub 2021 Apr 21.

Division of Hand Surgery and Microsurgery, ABC Medical School, Sto. André, SP, Brazil.

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. Read More

Trauma Case Rep 2021 Jun 18;33:100470. Epub 2021 Mar 18.

Department of Orthopaedic Surgery, Toyohashi Municipal Hospital, Toyohashi, Japan.

In several cases of treatment of acromion fractures of the scapula, plate fixation provides more rigidity to the fractured area. However, no specific plates are available for the acromion because of high interindividual variation in the shape of the acromion. We report two cases of acromion fractures operated using a mesh plate (Depuy Synthes, West Chester, PA, USA), which acts as a versatile, low-profile implant, being cut according to the specific fracture pattern and anatomical fitting. Read More

Arch Orthop Trauma Surg 2021 Apr 12. Epub 2021 Apr 12.

Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Muenster, Waldeyer Str. 1, 48149, Muenster, Germany.

Introduction: The number of atraumatic stress fractures of the scapular spine associated with reverse shoulder arthroplasty is increasing. At present, there is no consensus regarding the optimal treatment strategy. Due to the already weakened bone, fractures of the scapular spine require a high fixation stability. Read More

JBJS Case Connect 2020 Oct-Dec;10(4):e2000477

1Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois.

Case: A 46-year-old man underwent open reduction and internal fixation (ORIF) of left scapular, humerus, and clavicle fractures after a snowmobile accident. He subsequently developed severe left infraspinatus weakness with electromyogram evidence of suprascapular entrapment at the spinoglenoid notch. Intraoperatively, suprascapular nerve compression from an ossified spinoglenoid ligament was observed. Read More

Skeletal Radiol 2021 Mar 25. Epub 2021 Mar 25.

Radiology Department, University of Missouri, Columbia, MO, USA.

Objective: To investigate factors which affect radiographic diagnosis of Hill-Sachs fractures, and find criteria which improve detection.

Materials And Methods: Retrospective search was made for the term "Hill Sachs" within MRI reports in our local PACS system, and cases with post-reduction radiographs were included in the study. Prospective diagnoses and subspecialty MSK training of the interpreting radiologist of record were recorded. Read More

J Orthop Case Rep 2020 Nov;10(8):88-92

Department of Orthopaedic Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

Introduction: Chronic posterior dislocation is a very rare injury. Various methods have been described for its treatment. This report describes a rare case of post-traumatic chronic posterior dislocation of the shoulder. Read More

Turk J Pediatr 2021 ;63(1):161-166

School of Medicine, Universidade Sao Francisco, Braganca Paulista, Brasil.

Background: Epileptic seizures might be associated with an increased risk of fractures, either as a result of trauma after a fall or as a result of excessive muscle contraction. In the pediatric population, excessive muscle contraction is a more significant risk factor for fractures, due to the lack of maturity in the musculoskeletal system, while antiepileptic therapy itself can lead to a reduction of bone density. Proximal humeral fractures in the pediatric population are not frequent but both proximal humeral fractures and shoulder dislocation increase the chance of brachial plexus injuries and peripheral nerve lesions. Read More

Vet Surg 2021 Mar 8. Epub 2021 Mar 8.

Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.

Objective: To report on technical aspects and outcomes after scapulohumeral arthrodesis (SHA) with a locking compression plate (LCP) in small equids.

Study Design: Retrospective multicenter case series.

Animals: Client-owned Shetland Ponies, Miniature Shetlands, and American Miniature Horses (n = 15). Read More

JSES Int 2021 Mar 7;5(2):261-265. Epub 2020 Dec 7.

Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA.

Background: The purpose of this study was to determine factors associated with early symptomatic acromial and scapular spine fractures in patients who underwent reverse total shoulder arthroplasty (RTSA).

Methods: We retrospectively evaluated all RTSAs performed by the senior author between 1/1/2013 and 6/1/2019. We evaluated patient demographics including gender, age, prevalence of comorbidities including osteoporosis, inflammatory arthritis, diabetes, and endocrine disorders such as hypothyroidism. Read More

J Shoulder Elbow Surg 2021 Mar 4. Epub 2021 Mar 4.

University of Utah School of Medicine, Salt Lake City, UT, USA.

Background: Acromial (ASF) and scapular spine (SSF) stress fractures are well-recognized complications of reverse shoulder arthroplasty (RSA), but much of the current data are derived from single-center or single-implant studies with limited generalizability. This study from the American Shoulder and Elbow Surgeons (ASES) Complications of Reverse Shoulder Arthroplasty Multicenter Research Group determined the incidence of ASF/SSF after RSA and identified preoperative patient characteristics associated with their occurrence.

Method: Fifteen institutions including 21 ASES members across the United States participated in this study. Read More

Ann Thorac Surg 2021 Mar 3. Epub 2021 Mar 3.

Department of Cardiothoracic Surgery, Shenzhen Longgang Central Hospital, the Ninth People's Hospital of Shenzhen City, Shenzhen, China.

Background: Video-assisted thoracoscopic surgery (VATS) for internal fixation of rib fracture is a promising approach for treating rib fractures and flail chest. Currently, the standard practice is to make one or several incisions on the chest wall, which will inevitably aggravate the original trauma.

Methods: We retrospectively analyzed the data of patients with rib fractures who were treated with memory alloy for internal fixation by complete VATS using a thoracoscopic transthoracic memory alloy rib coaptation board and an implantation tool through the clip applier method or the puncture, traction and suspension method at our hospital from October 2016 to June 2019. Read More

J Shoulder Elbow Surg 2021 Mar 3. Epub 2021 Mar 3.

ICR-Institut de Chirurgie Réparatrice Locomoteur & Sport, Nice, France. Electronic address:

Background: Despite its potential biomechanical advantages, reverse shoulder arthroplasty (RSA) is still considered to be particularly high risk in rheumatoid patients who are osteoporotic and immunodeficient. Our purpose was to report prosthesis survival, complications, and outcomes of RSA in patients with rheumatoid arthritis (RA) at minimum 5-year follow-up.

Methods: We conducted a retrospective multicenter study including 65 consecutive primary RSAs performed in 59 patients with RA between 1991 and 2010. Read More

Radiol Case Rep 2021 Apr 17;16(4):989-993. Epub 2021 Feb 17.

John H. Stroger Hospital of Cook County, Chicago, IL, USA.

A 46-year-old Asian male with history of atraumatic fracture of femur (requiring the use of a walker), muscle cramps and loosening teeth presents to Endocrine clinic. He had elevated parathyroid hormone, severely low phosphorus, elevated bone-specific ALP, with normal serum and urine calcium. He was found to have elevated FGF 23 levels, but initial functional and anatomic imaging was negative for any localizing tumor. Read More

BMJ Case Rep 2021 Mar 2;14(3). Epub 2021 Mar 2.

Orthopedic Surgery, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochigi, Japan.

A 44-year-old woman with distal clavicular malunion and scapular dyskinesis, causing limited shoulder elevation, underwent clavicular osteotomy 2 years postinjury. We used three-dimensional (3D) surface data from both injured and intact sides for correction of the distal clavicular shape by closing wedge osteotomy. The plate position and screw directions were decided preoperatively. Read More

Clin Shoulder Elb 2021 Mar 2;24(1):42-52. Epub 2021 Mar 2.

Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Reverse shoulder arthroplasty is an ideal treatment for glenohumeral dysfunction due to cuff tear arthropathy. As the number of patients treated with reverse shoulder arthroplasty is increasing, the incidence of complications after this procedure also is increasing. The rate of complications in reverse shoulder arthroplasty was reported to be 15%-24%. Read More

Acta Orthop Belg 2020 Sep;86(3):509-524

Postoperative scapular fractures are infrequent complications of reverse total shoulder arthroplasty (RTSA). The aim of this study is to discuss the functional outcome, clinical outcome and pain scores of these fractures and to analyze these outcome results based on fracture location. A systematic review in accordance with the PRISMA guidelines was conducted. Read More

JSES Int 2021 Jan 10;5(1):121-137. Epub 2020 Sep 10.

ASES Multicenter Taskforce for RSA Complications, Rosemont, IL, USA.

Background: Globally, reverse shoulder arthroplasty (RSA) has moved away from the Grammont design to modern prosthesis designs. The purpose of this study was to provide a focused, updated systematic review for each of the most common complications of RSA by limiting each search to publications after 2010. In this part II, the following were examined: (1) instability, (2) humerus/glenoid fracture, (3) acromial/scapular spine fractures (AF/SSF), and (4) problems/miscellaneous. Read More

JSES Int 2021 Jan 1;5(1):114-120. Epub 2020 Dec 1.

Tohto Bunkyo Hospital, Department of Orthopaedics, Bunkyo-ku, Tokyo, Japan.

Background: Reverse shoulder arthroplasty normally has adequate functional outcomes in patients with cuff tear arthropathy. The present study aimed to investigate the midterm clinical outcomes of reverse shoulder arthroplasty in Japanese patients with rheumatoid arthritis.

Methods: Between July 2014 and May 2016, reverse shoulder arthroplasty was performed in 14 rheumatic shoulders with joint destruction and rotator cuff tears. Read More

World J Clin Cases 2021 Jan;9(1):284-290

Department of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu 42601, South Korea.

Background: Acromial and scapular spine fractures after reverse total shoulder arthroplasty (RTSA) are a well-known complication that may negatively impact the effects of long-term outcomes. However, to the best of our knowledge, there has been no report of simultaneous bilateral fractures of the acromion or scapular spine that occurred following staged RTSA.

Case Summary: A 79-year-old right-handed male visited our outpatient clinic with a chief complaint of pain and limited motion of both shoulder joints for a one-year duration. Read More

JBJS Case Connect 2021 Jan 14;11(1):e20.00277. Epub 2021 Jan 14.

Department of Orthopaedic Surgery, Regions Hospital, St. Paul, Minnesota.

Case: We present the case of a 40-year-old man with a fracture to the superior angle of the scapula who was treated nonoperatively for 10 months-leading to a symptomatic nonunion. The patient underwent reconstruction of the nonunion for a painful shoulder and was followed clinically for 3 years. He demonstrated major improvement in function and symptoms. Read More

A A Pract 2020 Dec 17;14(14):e01365. Epub 2020 Dec 17.

From the Department of Anesthesiology, Ganga Medical Centre & Hospitals Pvt Ltd, Coimbatore, Tamil Nadu, India.

A 40-year-old healthy male patient underwent open reduction and internal fixation with screws and plate for a comminuted fracture of the right scapula under ultrasound-guided "scapular block" with optimal sedation. We coined the term "scapular block" for an innovative combination of previously described regional anesthesia techniques to cover all dermatomes, myotomes, and osteotomes involved in scapula surgery. It is a combination of 5 target blocks (selective superior trunk block, selective supraclavicular nerve block, subclavian perivascular block, suprascapular nerve block, and erector spinae plane block) via 3 approaches (interscalene, supraclavicular, and paraspinal). Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 Jan;35(1):76-81

Department of Bone & Joint Surgery, Affiliated Hospital of Southwest Medical University, Luzhou Sichuan, 646000, P.R.China;Sichuan Provincial Laboratory of Orthopaedic Engineering, Luzhou Sichuan, 646000, P.R.China.

Objective: To investigate the effectiveness of double internal fixations of clavicle and scapula and intraoperative reduction of glenopolar angle in the treatment of floating shoulder injuries.

Methods: Between January 2010 and June 2019, 13 patients with floating shoulder injury were treated with double internal fixation of clavicle and scapula and intraoperative reduction of glenopolar angle. There were 11 males and 2 females with an average age of 48 years (range, 25-65 years). Read More