Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Oct 2013
Minimally displaced fractures of the greater tuberosity: outcome of non-operative treatment.
Minimally displaced (<3 mm) and non-displaced fractures of the proximal humerus are a common source of disability; nevertheless, there is no agreement on the recommended rehabilitation program in these patients. The purpose of this study was to evaluate the outcome of this group of patients and describe the rehabilitation protocol we have used for the treatment of this injury. ⋯ When the diagnosis of a minimally displaced fracture of the proximal humerus is made, the patient can be reassured that a favorable outcome is anticipated with a staged rehabilitation protocol. Nevertheless, clinicians and patients should be aware that full recovery from the injury may take an average of 8 months.
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J Shoulder Elbow Surg · Oct 2013
Comparative StudyAcromioclavicular joint ligamentous system contributing to clavicular strut function: a cadaveric study.
We hypothesized that the clavicle overrides the acromion during certain shoulder motions for individuals with acromioclavicular (AC) joint separation producing clinical symptoms. We measured 3-dimensional clavicular and scapular motions in AC joint separation models during humerothoracic motions, which should be impacted by the loss of AC joint continuity. ⋯ Scapular and clavicular kinematics were affected in AC separation models. Abduction with humeral internal rotation resulted in a decrease in scapular posterior tilt and upward rotation in AC separation models, and thereby could lead to AC joint articulation dysfunction.
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J Shoulder Elbow Surg · Sep 2013
The prevalence of a large Hill-Sachs lesion that needs to be treated.
A large Hill-Sachs lesion has been considered a risk factor for postoperative recurrence of shoulder instability. However, there are few reports describing the prevalence of Hill-Sachs lesions that engage with the glenoid. The purpose of this study was to clarify the prevalence of engaging Hill-Sachs lesions using the concept of the glenoid track. ⋯ In our series of consecutive 100 cases, the prevalence of engaging Hill-Sachs lesions was 7%. There were 2 types of Hill-Sachs lesions: a wide and large type and a narrow but medially located type.
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J Shoulder Elbow Surg · Sep 2013
Effect of immobilization on rotator cuff reconstruction with acellular dermal matrix grafts in an animal model.
Using a rat model we determined whether immobilization improves tendon-to-bone healing and tendon maturation after rotator cuff reconstruction with acellular dermal matrix (ADM) grafts. ⋯ Remodeling of ADM grafts placed in rat rotator cuff defects was promoted by 2- but not 6-week immobilization.
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J Shoulder Elbow Surg · Sep 2013
ReviewAn assessment of the quality of rotator cuff randomized controlled trials: utilizing the Jadad score and CONSORT criteria.
The AAOS's Clinical Practice Guideline on "Optimizing Care of Rotator Cuff Problems" suggested a lack of high-quality data. Our purpose is to quantify the quality of randomized controlled trials of rotator cuff disorders via the Jadad score, and to apply the 2010 Consolidated Standards of Reporting Trials CONSORT Criteria to determine factors associated with high Jadad scores and areas for improvement. ⋯ The majority of randomized controlled trials of rotator cuff pathology are high-quality studies based on the Jadad score. Adherence to CONSORT criteria is linked to high-quality scores. Future studies should use full CONSORT Criteria.