Journal of shoulder and elbow surgery
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The number of times an article has been cited has been used as a marker of its influence in a medical specialty. The purpose of this study was to determine the 50 most cited articles in shoulder surgery and their characteristics. ⋯ Articles that introduced instruments for outcome evaluation or that introduced classification systems (methodologic) were highly cited regardless of the date of publication. The top 50 list presented provides residency and fellowship directors with a group of "classic" articles in the subspecialty of orthopedic shoulder surgery that can be included in reading curriculums for their trainees.
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J Shoulder Elbow Surg · Dec 2012
Comparative StudyThe influence of ultrasound guidance in the rate of success of acromioclavicular joint injection: an experimental study on human cadavers.
Injections of the acromioclavicular joint (ACJ) are performed routinely in patients with ACJ arthritis, both diagnostically and therapeutically. The aim of this prospective controlled study was to estimate the frequency of successful intra-articular ACJ injections with the aid of sonographic guidance versus non-guided ACJ injections. ⋯ The use of ultrasound significantly improves the accuracy of ACJ injection.
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J Shoulder Elbow Surg · Dec 2012
Comparative StudyClosed reduction techniques in acute anterior shoulder dislocation: modified Milch technique compared with traction-countertraction technique.
To perform closed manual reduction of acute anterior shoulder dislocation using the traction-countertraction technique requires sedation (TCTS) and the participation of 2 people. We studied the modified Milch (MM) technique, a positional reductive maneuver that requires 1 operator, without patient sedation or analgesia. ⋯ The results showed that the Milch technique was effective, safe, shortened hospital stay, and was well tolerated. We recommend the modified Milch technique as a first-line maneuver for acute anterior shoulder dislocations without associated fractures.
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J Shoulder Elbow Surg · Nov 2012
Randomized Controlled Trial Comparative StudyMilch versus Stimson technique for nonsedated reduction of anterior shoulder dislocation: a prospective randomized trial and analysis of factors affecting success.
The shoulder is regarded as the most commonly dislocated major joint in the human body. Most dislocations can be reduced by simple methods in the emergency department, whereas others require more complicated approaches. We compared the efficacy, safety, pain, and duration of the reduction between the Milch technique and the Stimson technique in treating dislocations. We also identified factors that affected success rate. ⋯ The success rate and time to achieve reduction without sedation were superior for the Milch technique compared with the Stimson technique. Early implementation of reduction measures and low pain levels at presentation favor successful reduction, which--in combination with oral pain medication--constitutes an acceptable and reasonable management alternative to reduction with sedation.
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J Shoulder Elbow Surg · Nov 2012
Randomized Controlled Trial Comparative StudyProspective randomized study of arthroscopic rotator cuff repair using an early versus delayed postoperative physical therapy protocol.
This study evaluated patient outcomes and rotator cuff healing after arthroscopic rotator cuff repair using a postoperative physical therapy protocol with early passive motion compared with a delayed protocol that limited early passive motion. ⋯ Patients in the early group and delayed group both demonstrated very similar outcomes and range of motion at 1 year. There was a slightly higher rotator cuff healing rate in the delayed passive range of motion group compared with the early passive range of motion group (91% vs 85%).