Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · May 2015
The long-term outcome of displaced mid-third clavicle fractures on scapular and shoulder function: variations between immediate surgery, delayed surgery, and nonsurgical management.
Conservative management for uncomplicated displaced clavicle fractures is common practice. Delay of surgical fixation may result in less favorable outcomes. ⋯ We support the conservative management of uncomplicated displaced clavicle fractures but recognize that a lower threshold for early surgery should be considered where optimal shoulder function is required.
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J Shoulder Elbow Surg · May 2015
Use of reverse total shoulder arthroplasty in the Medicare population.
Reverse shoulder arthroplasty (RSA) has been Food and Drug Administration approved in the United States since 2004 but did not obtain a unique code until 2010. Therefore, the use of this popular procedure has yet to be reported. The purpose of this study was to examine the use and reimbursement of RSA compared with total shoulder arthroplasty (TSA) and shoulder hemiarthroplasty (SHA). ⋯ RSA is performed with similar frequency to TSA and almost twice as much as SHA in the Medicare population. Lower-volume surgeons perform most RSAs, and a majority of surgeons perform more RSAs than all anatomic shoulder arthroplasties combined.
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The aim of this research was to develop a rat model for vascularized composite allotransplantation (VCA) of the elbow. ⋯ We developed an animal model for elbow VCA. Immunosuppressed animals regained nearly normal function of forelimbs and maintained grossly normal elbow cartilage. Without cyclosporine treatment, the elbow transplants were rejected.
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J Shoulder Elbow Surg · May 2015
Randomized Controlled TrialAdministration of analgesics after rotator cuff repair: a prospective clinical trial comparing glenohumeral, subacromial, and a combination of glenohumeral and subacromial injections.
Local analgesic injections are commonly used for pain relief after shoulder surgery. The aim of this study was to compare the efficacy of local injections administered in the glenohumeral joint, the subacromial space, or both locations after arthroscopic rotator cuff repair. ⋯ Injection of local analgesics after arthroscopic rotator cuff repair relieves postoperative pain regardless of the injection location.
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J Shoulder Elbow Surg · May 2015
Which parameters affect medium- to long-term results after angular stable plate fixation for proximal humeral fractures?
Very little information on medium- to long-term results is available for surgically treated proximal humeral fractures. The aim of this prospective treatment study was to present long-term results after angular stable plate fixation of displaced proximal humeral fractures and to detect which specific patient- and fracture-related parameters affect the clinical outcome. ⋯ Good medium- to long-term results after angular stable plate fixation of displaced proximal humeral fracture can be expected. A reconstruction within a range of 15° in both anteroposterior and axillary views and <5-mm tuberosity displacement should be the aim of head-preserving surgery to prevent complications, such as secondary fracture displacement and screw perforation, and a less favorable long-term result.