Injury
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Reconstruction of shoulder abduction by multiple nerve fascicle transfer through posterior approach.
To evaluate the feasibility and clinical efficacy of multiple nerve fascicle transfer through posterior approach for reconstruction of shoulder abduction in patients with C5 or upper brachial plexus injury. ⋯ It is feasible to carry out multiple nerve fascicle transfers for early reconstruction of shoulder abduction by posterior approach. Patients who received this procedure achieved good functional recovery and their donor site morbidity/injury was minimal.
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The aim of our study is to analyse the results of our surgical technique for the treatment of proximal humeral fractures and fracture dislocations using locking plates in conjunction with calcium sulphate bone-substitute augmentation and tuberosity repair using high-strength sutures. We used the extended deltoid-splitting approach for fracture patterns involving displacement of both lesser and greater tuberosities and for fracture-dislocations. Optimal surgical management of proximal humeral fractures remains controversial. Locking plates have become a popular method of fixation. However, failure of fixation may occur if they are used as the sole method of fixation in comminuted fractures, especially in osteopenic bone. ⋯ In our experience, we have found the use of locking plates, calcium sulphate bone substitute and tuberosity repair with high-strength sutures to be a safe and reliable method of internal fixation for complex proximal humeral fractures and fracture-dislocations. Furthermore, we have also found the use of the extended deltoid-splitting approach to be safe and to provide excellent exposure facilitating accurate reduction for fixation of the fracture patterns involving displacement of both lesser and greater tuberosities and for fracture-dislocations.
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The aim of this retrospective study was to analyse the results of 20 thumb replantations with special and exhaustive attention on functional outcomes. Twenty patients with traumatic thumb amputation were enrolled in the study. Range of motion, grip strength, sensory recovery, and subjective perception of overall hand function recovery were measured. ⋯ Sensory recovery remained unsatisfactory despite the fact that we did not need to perform any kind of revision surgery as a consequence of inadequate thumb sensibility. For the first time in the existing literature, no functional parameter that contributes to the assessment of the function of replanted thumbs has been excluded. We resume in the same study the analysis of all functional parameters that are useful to define results of thumb replantation.
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The purpose of this study is to report the long-term follow-up result of allograft reconstruction of segmental defect of the humeral head associated with posterior dislocation of the shoulder. Six men underwent operative management of defects of the humeral head involving 40% of the articular surface, following posterior dislocation of the humeral head. The period of time between dislocation and surgery ranged from 7 to 8 weeks. ⋯ The other two patients developed collapse of the graft and osteoarthrosis that were yet evident at 4-year follow-up. These patients required a shoulder arthroplasty 8 years after the procedure. We conclude that the treatment of segmental defects of the humeral head associated with posterior dislocations of the shoulder by allograft reconstruction has a good long-term follow-up result in 50% of the patients.
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A potent mesenchymal stem cell (MSC) population was recently isolated from the Wharton's jelly of human umbilical cord (UC). The aim of the current experiments was to determine the potential of human UC-derived MSC (UC-MSC) in cartilage healing. ⋯ Collagen hydrogel can provide an appropriate 3-D environment for the chondrogenesis of UC-MSCs. UC-MSCs embedded in biocompatible scaffold may have great potential for cartilage engineering.