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Acta of Shoulder and Elbow Surgery by http://asesjournal.com/ is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
ISSN 2457-0338
Superior Capsular Reconstruction for Shoulder with an Irreparable Massive Posterosuperior Rotator Cuff Tear – A Case Report
/0 Comments/in Uncategorized /by ASESADMIN2016Acta of Shoulder and Elbow Surgery | Volume 4 | Issue 1 | January-June 2020 | Page 11-14 | Dinesh Chidambaram
Authors: Dinesh Chidambaram [1]
[1] Department of Orthopaedics, Royal Care Superspeciality
Hospital, Neelambur, Coimbatore, Tamil Nadu, India.
Address of Correspondence
Dr. Dinesh Chidambaram,
Consultant Trauma and Arthroscopy Surgeon,
Royal Care Superspeciality Hospital, Neelambur,
Coimbatore, Tamil Nadu, India.
E-mail: dineshchidambaram75@gmail.com
Abstract
A 65 year old gentleman presented with complaints of progressive pain over right shoulder for the past six months following fall onto his right shoulder one year back. He was diagnosed with massive retracted irreparable posterosuperior rotator cuff tear, for which superior capsular reconstruction with fascia lata autograft was performed. At 9 months follow up, patient has normal range of shoulder movements without any pain.
Keywords: Superior capsular reconstruction, Fascia lata graft
References
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Proximal Humerus Fracture: Surgical Outcome and Complications in A Prospective Study Of 99 Patients and review of literature
/0 Comments/in Vol 4 | Issue 1| Jan-June 2020 /by ASESADMIN2016Acta of Shoulder and Elbow Surgery | Volume 4 | Issue 1 | January-June 2020 | Page 15-19 | Dheeraj Attarde, Dhruv Verma, Chetan Puram, Chetan Pradhan, Atul Patil, Parag Sancheti, Ashok Shyam
Authors: Dheeraj Attarde [1], Dhruv Verma [1], Chetan Puram [1], Chetan Pradhan [1], Atul Patil [1], Parag Sancheti [1], Ashok Shyam [1,2]
[1] Department of Orthopaedics, Sancheti Institute of Orthopaedics and Rehabilitation, Pune, India.
[2] Indian Orthopaedic Research Group, Thane, India.
Address of Correspondence
Dr. Dheeraj Attarde,
Sancheti Institute of Orthopaedics and Rehabilitation, Pune, India.
E-mail: dheerajattarde@yahoo.co.in
Abstract
Objective: To report the outcomes of proximal humerus fracture operated with angular stability locking plate with regards to fracture pattern.
Design: Prospective clinical study.
Setting: Level 1 trauma center.
Patients: During a 24-month period, 99 patients with proximal humerus fracture with OTA type 11A, 11B, 11c were treated operatively with open reduction and internal fixation with angular stability locking plate at a level 1 trauma center. 37 patients were OTA type 11A, 33 and 29 patients were OTA 11B and OTA 11C respectively.
Main Outcome Measurements: Radiological outcome, functional outcome and complication of proximal humerus fractures with respect to fracture pattern, age, and gender.
Results: At 1 year follow up DASH score, Constant Murley score and range of motion showed a significant difference with respect to fracture type. Outcome was better in <50years of age group while gender showed no difference. Varus collapse was observed with 5 cases, stiffness and restricted mobility in 4 patients, implant loosening and avascular necrosis in 3 patients each, post op infection, rotator cuff weakness, screw backout, screw penetration and sub acromial impingement due to superior plate placement was found in 1 patient each.
Conclusions: Angular Locking plate fixation for proximal humerus fracture gives satisfactory results, good functional and radiological outcome. Occurrence of complications is independent of age and gender. Older patients (>50 years of age) have inferior functional outcomes as compared to younger patients (<50 years of age).
Keywords: PHILOS, Angular stability locking compression plate, Proximal humerus fracture, Neer’s fracture.
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Does addition of Remplissage procedure cause external rotation deficit in the patient undergoing standard Bankart repair for recurrent shoulder dislocation with engaging Hill-Sach’s lesions ?
/0 Comments/in Vol 4 | Issue 1| Jan-June 2020 /by ASESADMIN2016Acta of Shoulder and Elbow Surgery | Volume 4 | Issue 1 | January-June 2020 | Page 7-10 | Nilesh Kamat, Ashutosh Ajri, Vivek M Sodhai, Vikrant Kalamb, Ashok K Shyam, Parag K Sancheti
Authors: Nilesh Kamat [1], Ashutosh Ajri [1], Vivek M Sodhai [1], Vikrant Kalamb [1], Ashok K Shyam [1,2], Parag K Sancheti [1]
[1] Department of Orthopaedics, Sancheti Institute of Orthopaedics and Rehabilitation, Pune, India.
[2] Indian Orthopaedic Research Group, Thane, India.
Address of Correspondence
Dr. Vivek Sodhai
Clinical Fellow, Department of Orthopaedics,
Sancheti Institute Of Orthopaedics and Rehabilitation, Pune, India.
E-mail: vivek.sodhai89@gmail.com
Abstract
Background: To determine the effect of Remplissage procedure with Bankart repair compared to standard Bankart repair alone on resultant external rotation of the shoulder in patients of anterior shoulder instability with engaging Hill-Sach’s lesion.
Methods: Out of 46 patients, 18 patients underwent arthroscopic Remplissage combined with Bankart repair (group I) and the other 28 patients underwent arthroscopic standard Bankart repair alone (group II). Clinical outcomes were retrospectively evaluated by assessing the range of motion, complications, recurrence rates, and functional results were assessed utilizing the UCLA and ROWE score.
Results: Average follow-up period of 23.88 ± 5.26 (range, 12-48) months. Average external rotation loss compared to normal side in group I was of 5.00° ± 0.44° (range, 70°-90°)( p=0.031) in external rotation in abduction and 1.67° ± 0.18° (range, 75°-90°)( p=0.36 ) in external rotation in neutral at the last follow up and in group II it was 0.86°±0.35° (range, 70°-90°)( p=0.559 ) in external rotation in abduction and 0.89° ± 0.38° (range, 70°-90°)( p=0.646 ) in external rotation in neutral at the last follow-up. The average UCLA score was 34.00 ± 1.46 (range, 32-35) in group I and 33.29 ± 1.86 (range, 30-35) in group II (p=0.154). Average Rowe score was 92.22 ± 6.24 (range, 95-100) in the group I and 96.55±5.99 (range, 90-100) in the group II (p=0.025).
Conclusion: The addition of Remplissage procedure with standard Bankart repair causes significant loss of external rotation in abduction in patients of engaging Hill-Sach’s lesion compared to standard Bankart repair alone.
Level of Evidence: Level III
Keywords: Anterior shoulder instability, Remplissage procedure, Bankart’s repair, External rotation, Hill-Sach’s lesion.
References
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6. Elkinson I, Giles JW, Faber KJ, Boons HW, Ferreira LM, Johnson JA, et al. The effect of the Remplissage procedure on shoulder stability and range of motion: an in vitro biomechanical assessment. J Bone Joint Surg Am 2012;94(11):1003–12. Doi: 10.2106/JBJS.J.01956
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Outcomes Following Open Reduction Internal Fixation of Extra Articular or Simple Articular Distal Humerus Fractures in Patients over 75 Years of Age
/0 Comments/in Vol 4 | Issue 1| Jan-June 2020 /by ASESADMIN2016Acta of Shoulder and Elbow Surgery | Volume 4 | Issue 1 | January-June 2020 | Page 2-6 | Benjamin W. Sears, Mitchell J. Sungelo, Jacqueline E. Bader, Armodios M. Hatzidakis, Charles L. Getz
Authors: Benjamin W. Sears [1], Mitchell J. Sungelo [2], Jacqueline E. Bader [1], Armodios M. Hatzidakis [1], Charles L. Getz [3]
[1] Western Orthopaedics, 1830 Franklin St Ste 450 Denver, CO 80218
[2] University of Colorado School of Medicine, 13001 E. 17th Place Aurora, CO 80045
[3] Rothman Institute, 925 Chestnut St Philadelphia, PA 19107
Address of Correspondence
Dr. Benjamin W. Sears,
Western Orthopaedics, 1830 Franklin St Ste 450 Denver, CO 80218
E-mail: bwsears@gmail.com
Abstract
Introduction: Treatment of distal humerus fractures in the aged population remains controversial due to concerns for bone quality, healing capacity, and integrity of the surrounding soft tissue envelope. We evaluated outcomes of open reduction internal fixation (ORIF) in patients aged ≥75 years with extra articular or simple articular distal humerus fractures (AO Type A or B).
Methods: Between 2011 to 2016, 13 patients 75 years of age or older identified in the last five years at two tertiary elbow centers as having undergone ORIF for AO Type A or B distal humerus fractures were retrospectively reviewed.
Results: The final average Mayo Elbow Performance Scores (MEPS) was 83.1 (range, 50-100). Average range of motion included lack of extension to 15° (range, 0-40°), and an average flexion to 128° (range, 115-140°). Average time to union was 12.2 weeks; however, two patients treated with percutaneous pinning resulted in nonunion. One required conversion to total elbow arthroplasty for pain with osseous collapse. There were no triceps or ulnar nerve issues, and no associated perioperative medical complications.
Conclusions: ORIF for AO Type A or B distal humerus fractures in the elderly population provides for immediate/early, functional use of the extremity, predictable union, limited perioperative complications and no long-term weight bearing restrictions. Conversion to total elbow arthroplasty can be utilized as a salvage procedure.
Level of evidence: Level IV.
Keywords: Distal humerus fracture, Elderly, ORIF, Arthroplasty, Fixation, Osteoporosis, Percutaneous pinning, Locked plates.
References
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Derotational humerus osteotomy and teres major tenotomy for recurrent posterior shoulder instability: A case report
/0 Comments/in Vol 3 | Issue 2| July-Dec 2019 /by ASESADMIN2016Acta of Shoulder and Elbow Surgery | Volume 3 | Issue 2 | July-December 2019 | Page 6-10 | Jad Chbib Abi Raad, Denis Bouttens, Simon Lebbos, Christophe Obry
Authors: Jad Chbib Abi Raad [1], Denis Bouttens [1], Simon Lebbos [1], Christophe Obry [1].
[1] Department of Orthopaedics, Fondation Hopale – Institut Calot (France)
Address of Correspondence
Dr. Jad Chbib Abi Raad ,
Fondation Hopale – Institut Calot (France)
E-mail: jadabiraad@gmail.com
jad.chbib-abi-raad@hopale.com
Abstract
Posterior instability represents about 10 percent of shoulder instabilities. It enclose dislocation or more frequently posterior sub luxation. Posterior instability can be also associated with constitutional laxity and multidirectional instability. The factors related to this instability depends of the etiology (traumatic, atraumatic), bony factors (glenoid and humeral head, defects, ante and retroversions) and the soft tissues. We describe a case of 28 year old lady, with recurrent posterior shoulder instability despite 3 previous interventions (2 posterior bone blocks and a glenoid osteotomy). For the treatment we combined two techniques: Derotational humerus osteotomy and Teres major tenotomy. We found that Derotational humerus osteotomy can be used as an alternative for glenoid osteotomy, or after failed glenoid osteotomy, to treat the instability. It can be associated with teres major tenotomy which was previously described mainly for voluntary posterior dislocation.
Keywords: Posterior instability, Posterior subluxation , Laxity, Derotational osteotomy, Teres major tenotomy, voluntary, involuntary.
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osteotomy and teres major tenotomy for recurrent posterior shoulder instability: A Case report. Acta of Shoulder and Elbow Surgery July – Dec 2019; 3(2): 6-10.
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Randomized controlled trial comparing local autologous bloodinjection and polidocanol injection for treatment of lateral epicondylosis of elbow
/0 Comments/in Vol 3 | Issue 2| July-Dec 2019 /by ASESADMIN2016Acta of Shoulder and Elbow Surgery | Volume 3 | Issue 2 | July – Dec 2019 | Page 2-5 | Rajendra Didel, Saurabh Kumar
Authors: Rajendra Didel [1], Saurabh Kumar [2].
[1] Department of Orthopaedics, Govt Medical College, Pali, Rajasthan, India.
[2] Department of Orthopaedics, U.C.M.S & G.T.B Hospital, Delhi, India.
Address of Correspondence
Dr. Saurabh Kumar,
U.C.M.S & G.T.B Hospital, Delhi, India.
E-mail: srbrai@gmail.com
Abstract
Background: Lateral epicondylosis has been found to occur in approximately 2% of general population. It’s etiology and management still remains controversial. Various studies have shown benefits with local injection of autologous blood and polidocanol individually. However, there is paucity of studies comparing the results between these both, hence we envisage to compare the clinical and functional outcomes of local autologous blood versus polidocanol injection for the treatment of lateral epicondylosis of elbow.
Materials and methods: 60 patients (age group- 18 to 60 years)with clinically diagnosed lateral epicondylosis of elbow were enrolled for the study. They were randomized into 2 groups. Group I (n = 30) was treated with autologous blood injection and Group II (n = 30) with polidocanol injection after Nirschl staging. Patients were evaluated clinically at 6& 12 weeks after the injection and were again staged by Nirschl staging on both the visits.
Results: 34 patients successfully completed 12 weeks follow-up and were included in the analysis. It was observed that clinical outcomes in terms of Nirschl score at 6 and 12 weeks was better in Group I as compared to Group II. Statistical comparison between the two groups revealed that mean values of Nirschl score were lower in group I (4.41+1.004 and 3.71+1.532 at 6 weeks and 12 weeks of follow-up respectively) as compared to group II (4.76+1.300 and 4.47+1.281at 6 weeks and 12 weeks follow-up respectively). Down staging of disease symptom was clinically better in group I (16/17) as compared to group II (11/17). However the difference in the mean values of Nirschl score between the groups was not statistically significant (p=0.342).
Conclusion: Although autologous blood injection showed a better clinical improvement as compared to polidocanol injection, the difference was not statistically significant between these both.
Keywords: Lateral epicondylosis, Autologous blood injection, Polidocanol injection
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blood injection and polidocanol injection for treatment of lateral epicondylosis
of elbow. Acta of Shoulder and Elbow Surgery July – Dec 2019; 3(2): 2-5.
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