Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Mar 2014
Clinical outcomes of reverse total shoulder arthroplasty in patients aged younger than 60 years.
Reverse total shoulder arthroplasty (RTSA) has been indicated primarily for patients aged older than 65 years with symptomatic rotator cuff deficiency, poor function, and pain. However, conditions that benefit from RTSA are not restricted to an elderly population. This study evaluates a consecutive series of RTSA patients aged younger than 60 years. ⋯ RTSA can improve shoulder function in a younger, complex patient population with poor preoperative functional ability. This study's success rate was 75% at 2.8 years. This is a limited-goals procedure, and longer-term studies are required to determine whether similar results are maintained over time.
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J Shoulder Elbow Surg · Mar 2014
Comparative StudyComparison of the subjective elbow value and the Mayo elbow performance score.
The aim of this study was to evaluate the subjective elbow value (SEV) and compare it with the Mayo Elbow Performance Score (MEPS). The SEV is defined as the patient's subjective estimation of the elbow as a percentage of a normal elbow, which would correspond to 100%. ⋯ The SEV is an easily administered, responsive, valid tool to assess the condition of the elbow. It should be considered an adjunct to currently used scores because it only detects the subjective condition of the elbow.
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J Shoulder Elbow Surg · Mar 2014
A new "virtual" patient pathway for the management of radial head and neck fractures.
Minimally displaced radial head and neck fractures are common and the outcome with conservative treatment is generally excellent. A new protocol was introduced to manage patients with these suspected fractures at a major urban hospital. Simple, undisplaced fractures without other associated injuries or instability were discharged with structured advice but no further face-to-face review. Patients with more complex injuries were reviewed at a "virtual clinic." The aim of this study was to examine the outcome of this process in terms of patient flow, satisfaction, reattendance, and reintervention. ⋯ In this study, patients with suspected Mason I or II fractures were managed with limited face-to-face follow-up with high satisfaction rates. The reintervention rate was extremely low. This process has significant benefits to patients, who have fewer hospital visits, and to orthopaedic departments, which have more time to devote to complex cases.
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J Shoulder Elbow Surg · Mar 2014
Acute lateral dislocated clavicular fractures: arthroscopic stabilization with TightRope.
Type IIA, IIB, and V lateral clavicular fractures (Craig modification of the Neer classification) are characterized by a constant displacement and are associated with a high rate of nonunion. The aim of this study is to verify whether the reduction and arthroscopic stabilization of these clavicular fractures with coracoclavicular cerclage provide stable fixation to allow for bone healing. To date, the treatment of these fractures is still controversial in young active patients in whom functional requirements are to be met. ⋯ The arthroscopic procedure with the TightRope allows for fracture healing with no loss of reduction in the acromioclavicular joint and full return to everyday activities.
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J Shoulder Elbow Surg · Mar 2014
Association of suprascapular neuropathy with rotator cuff tendon tears and fatty degeneration.
The mutual influence of suprascapular neuropathy (SSN) and rotator cuff tendon tears on muscle pathology is unclear. Debate continues as to how retracted cuff tears can lead to SSN and whether SSN or tendon retraction causes muscle fatty degeneration. ⋯ The exact association and etiology of SSN in patients with rotator cuff pathology remain unclear. SSN is correlated to tendon tear size, but it does not have significant influence on fatty degeneration of either supraspinatus or infraspinatus.