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The clinical efficacy analysis of ultrasound-assisted minimally invasive treatment for Jakob Type II humeral lateral condyle fractures in children.

OBJECTIVE: This study explores the clinical efficacy of ultrasound-assisted minimally invasive treatment for Jakob Type II humeral lateral condyle fractures in children. METHODS: A retrospective analysis was conducted on children with Jakob Type II humeral lateral condyle fractures who received treatment at our hospital between January 2021 and December 2024. Based on the surgical procedure, the patients were divided into two groups: the Ultrasound combined with x-ray arthrography-guided closed reduction and percutaneous pin fixation group (UA-CRPP) and the Open reduction percutaneous pin fix

The new, minimally invasive anteromedial-distal approach for extraarticular distal-third humeral shaft fractures. Its evolution and first clinical results.

UNLABELLED: Introduction In 2020, we published a new minimally invasive anteromedial distal approach for plate fixation of the humerus (MIAMDAH) to address extra-articular distal shaft fractures in a cadaveric study. After operating on our first patients, it was noted that the distal MIPO window was too small to comfortably fix the plate distally. So, a wider MIPO window was developed to make the surgical procedure more comfortable. This study aimed to evaluate clinical outcomes in patients who underwent surgery using either the original approach or its modified version and to determine whethe

Operative time, postoperative pain, and functional recovery in MIPO versus ORIF for humeral shaft fractures: a retrospective cohort case series.

BACKGROUND: Minimally invasive plate osteosynthesis (MIPO) for humeral diaphyseal fractures could result in better outcomes than open reduct … Mayo Elbow Performance Score (MEPS). Bone union was assessed using the Radiographic Union Score for Humeral Fractures and bone bridges. Propensity score matching (PSM) was used to adjust for the covariates. Spearman's test assessed correlations. RESULTS: Twenty-eight patients and 13 matches (n = 26) were analyzed after PSM. 24 h pain levels were compared between g …

Does interferential current provide additional benefit to orthopedic rehabilitation for the patients with proximal humeral fractures? A randomized controlled study.

BACKGROUND: Approximately 80% of all proximal humeral fractures (PHFs) are non-displaced or minimally displaced fractures, which can be treated with conservative treatment. This study investigated the effect of interferential current (IFC) added to orthopedic rehabilitation on shoulder function, pain, and disability in patients with PHF. METHODS: This study was a prospective, double-blind, randomized, placebo-controlled conducted in physical medicine and rehabilitation outpatient clinic. Thirty-five patients were randomly separated into the IFC group (n = 18) and the sham group (n = 17). The …

Great tuberosity fixation does not affect healing and clinical outcomes in RSA performed in proximal humeral fractures in elderly patients.

PURPOSE: Aims of our study were to define whether the great tuberosity (GT) positioning fixation in reverse shoulder arthroplasty (RSA) after proximal humeral fracture (PHF) could predict tuberosity healing and its impact on clinical outcomes. METHODS: We enrolled 59 patients treated with cementless reverse shoulder arthroplasty after PHF in our institute between 2012 and 2018. The mean follow-up was 57 months (± 23.4). We divided patients into two groups according to GT positioning after fixation: Group 1 GT in contact and Group 2 GT detached at least 1 mm from humeral diaphysis. Clinical an

Clinical efficacy analysis of minimally invasive intramedullary nailing in the treatment of humeral shaft fractures combined with radial nerve injury.

OBJECTIVE: The aim of this study was to research the therapeutic effectiveness of radial nerve damage paired with a humeral shaft fracture and intramedullary nailing. PATIENTS AND METHODS: Retrospective research was performed on the medical records of 58 individuals who had humeral shaft fractures and radial nerve injuries. The admission period was between June 1, 2020, and June 31, 2022. All study subjects that satisfied the requirements for inclusion were separated, using the random number table approach, into two groups: one for internal fixation (group N), which included 29 cases, and one

A 3D Printed Anatomically Pre-Contoured Plate for the Treatment of Y-T Humeral Condylar Fractures: A Feline Cadaveric Study.

(1) Background: Anatomically pre-contoured plates usually require only minimal or even no intraoperative contouring. For complex cases, such plates also assist the surgeon as an anatomical template during fracture reduction. In this study, we present our experience of using a 3D printing technology for the treatment of bicondylar humeral fractures in feline cadavers. (2) Methods: Surgeries were performed on 15 pairs of front limbs amputated at the scapula. The limbs were obtained from 15 adult cats without obvious pathology of the skeleton. After flexion of the elbow and subperiosteal elevatio…

Intramedullary nailing of humeral shaft fractures: percutaneous nailing in the lateral position through the Neviaser approach is a reliable technique.

BACKGROUND: Displaced humeral shaft fractures are frequently treated by osteosynthesis in the active patient. We aimed to evaluate the results of intramedullary nailing (IMN) in the lateral position with the Neviaser approach and to compare them with those from IMN nailing in the standard position and conventional approach. METHODS: In the retrospectively evaluated, single-center study, we compared 20 cases of long IMN for fractures of the proximal or middle third of the humerus shaft (Multilock; Synthes Laboratory) in the lateral position with the percutaneous Neviaser approach with 52 cases

Lateral Wall Integrity of the Greater Tuberosity Is Important for the Stability of Osteoporotic Proximal Humeral Fractures After Plate Fixation.

BACKGROUND: Previous studies assessing surgical fixation of osteoporotic proximal humeral fractures have primarily focused on medial calcar support. In this study, we utilized a specific model for 2-part surgical neck fracture of the osteoporotic proximal humerus to investigate how severe comminution of the greater tuberosity (GT) lateral wall affects biomechanical stability after fixation with a plate. METHODS: Ten matched pairs of cadaveric humeri (right and left) were assigned to either a surgical neck fracture alone (the SN group) or a surgical neck fracture with GT lateral wall comminuti…

Outcomes of Intramedullary Nailing Versus Plate Fixation in the Management of Humeral Shaft Fractures: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis aimed to compare the outcomes of intramedullary nailing (IMN) and open reduction with internal fixation (ORIF) in treating traumatic humeral shaft fractures in adults (18 years and above). A comprehensive literature search was conducted in databases including PubMed, Google Scholar, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL). The primary outcome was time to union, while secondary outcomes included non-union rates, incidences of iatrogenic radial nerve palsy, surgical site infections, and intra-operative comminution. Twenty-six

Ipsilateral Distal Both Bone Forearm and Lateral Humeral Condyle Fractures With Posterolateral Elbow Dislocation: A Rare Injury in a Child.

Lateral humeral condyle fractures are common in children, but concomitant elbow dislocation is rare. This case report involves a 10-year-old girl with an ipsilateral distal both-bone forearm fracture and a lateral humeral condyle fracture accompanied by a posterolateral elbow dislocation. Closed reduction of the elbow was performed in the emergency department without delay, and the patient was operated on as soon as possible. Closed reduction percutaneous pinning (CRPP) was performed for the distal radius fracture. The Weiss type III lateral humeral condyle fracture was reduced through a later

Low risk of postoperative ulnar nerve affection in surgically treated distal humeral fractures when the nerve is released in situ.

BACKGROUND: Adult distal humeral fractures (DHF) comprise 2%-5% of all fractures and 30% of all elbow fractures. Treatment of DHF may be technically demanding due to fracture complexity and proximity of neurovascular structures. Open reduction and internal fixation (ORIF) are often the treatment of choice, but arthroplasty is considered in case of severe comminution or in elderly patients with poor bone quality. Ulnar nerve affection following surgical treatment of distal humerus fractures is a well-recognized complication. AIM: To report the risk of ulnar nerve affection after surgery for ac…

Kirschner wire versus external fixation in the treatment of proximal humeral fractures in older children and adolescents: a comparative study.

OBJECTIVE: The purpose of this study was to compare the therapeutic effects of Kirschner wire fixation and external fixation in the treatment of proximal humeral fractures in older children and adolescents. METHODS: A retrospective analysis was performed on the clinical data of older children and adolescents who underwent surgery at our institution for proximal humeral fractures between April 2014 and May 2022. One group (n = 28) underwent fracture reduction and Kirschner wire fixation, and the other group (n = 23) underwent external fixation. During the follow-up, the differences in shoulder…

Cyclic Stability of Locking Plate Augmented with Intramedullary Polymethyl Methacrylate (PMMA) Strut Fixation for Osteoporotic Humeral Fractures: A Biomechanical Study.

The locking plate may provide improved fixation in osteoporotic bone; however, it has been reported to fail due to varus collapse or screw p … to investigate the influence of an intramedullary PMMA strut on the stability of unstable proximal humeral fractures in an osteoporotic synthetic model. Two fixation techniques, a locking plate alone (non-strut group) and the same fixation augmented with an intramedullary PMMA strut (with-strut group), were cyclically tested in 20 artificial humeral models. Axiall …

Are Outcomes Comparable for Repair of AO/OTA Type 13C1 and Type 13C2 Distal Humeral Fractures Using the Paratricipital Approach?

BACKGROUND: Studies have reported favorable outcomes using the paratricipital approach for fixation of distal humeral intra-articular fractures. However, literature evaluating the clinical results of the approach remains limited. The objective of this study was to compare clinical outcomes between type 13C2 and type 13C1 distal humeral fractures after open reduction and internal fixation performed using the same approach and same type of plate. METHODS: A total of 52 adults with type 13C1 or 13C2 distal humeral fractures were treated surgically at our institution during 2006 to 2018. We retro…

Operative Treatment of Proximal Humeral Fractures with Reverse Total Shoulder Arthroplasty in Patients ≥65 Years Old: A Critical Analysis Review.

»: The majority of proximal humeral fractures (PHFs) in patients who are ≥65 years of age are treated nonoperatively, but certain complex fracture patterns benefit from surgical intervention. However, there continues to be debate regarding the indications for surgery and the optimal surgical treatment (repair versus replacement) in this population. »: Reverse total shoulder arthroplasty (RTSA) has grown in popularity for surgical treatment of fracture-dislocations and displaced complex PHFs in patients who are ≥65 years of age; it has definite advantages over surgical repair and hemiarthropla…

In-hospital Complications Are More Likely to Occur After Reverse Shoulder Arthroplasty Than After Locked Plating for Proximal Humeral Fractures.

BACKGROUND: Currently, there seems to be a paradigm change in the surgical treatment of proximal humeral fractures in patients aged 65 years and older, with a considerable increase in the use of reverse total shoulder arthroplasty (RTSA) compared with angular stable internal fixation (locking plate fixation). However, even among shoulder specialists there is controversy regarding the best treatment strategy. QUESTIONS/PURPOSES: To evaluate for (1) a greater risk of in-hospital major adverse events, (2) a greater risk for in-hospital surgical complications, and (3) a greater risk of 30-day mor…

Intercalary prosthetic replacement is a reliable solution for metastatic humeral shaft fractures: retrospective, observational study of a single center series.

BACKGROUND: Treatments for metastatic fracture of the humeral shaft continue to evolve as advances are made in both oncological and operative management. The purposes of this study were to critically evaluate the effectiveness of intercalary endoprostheses in treating metastatic humeral shaft fractures and to clarify the surgical indications for this technique. METHODS: Sixty-three patients treated surgically for 66 metastatic fractures of the humerus shaft were retrospectively reviewed. Intramedullary nailing (IMN) was performed in 16 lesions, plate fixation (PF) in 33 lesions, and prostheti

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… Intercalary prosthetic reconstruction for pathologic diaphyseal humeral fractures due to metastatic tumors: outcomes and improvements. J Shoulder Elbow Surg. 2018;27(11):2013–2020. doi: 10.1016/j.jse.2018.03.027. 20. Zheng K, Yu XC, Hu YC, Shao ZW, Xu M, Wang BC, Wang F. …

Anterolateral approach with two incisions versus posterior median approach in the treatment of middle- and distal-third humeral shaft fractures.

BACKGROUND: The surgical approaches remain controversial for the treatment of middle and distal-third humeral shaft (MDTHS) fractures. This study compared clinical effects of the anterolateral approach with two incisions (AATI) and the posterior median approach (PMA) in the treatment of MDTHS fractures. METHODS: A retrospective analysis was carried out. One hundred sixty-six patients with MDTHS fractures were selected from January 2015 to January 2017 in Xi'an Hong Hui Hospital. According to surgical approaches, patients were divided into AATI (86 cases) and PMA group (80 cases). All patients

Increased scapular spine fractures after reverse shoulder arthroplasty with a humeral onlay short stem: an analysis of 485 consecutive cases.

BACKGROUND: Scapular stress fractures after reverse shoulder arthroplasty (RSA) are a potentially serious complication with modern lateralized and onlay implants. The aim of this study was to report the scapular spine stress fracture rate after RSA with an onlay, 145° humeral stem, analyzing potential fracture risk factors and clinical outcomes in a large cohort of patients. METHODS: A consecutive series of 485 RSAs were implanted with the Aequalis Ascend Flex stem. Data collection included preoperative and postoperative clinical and radiographic assessment findings (rotator cuff Goutallier g