Safe Elbow Surgery

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Acta of Shoulder and Elbow Surgery | Volume 4 | Issue 1 | January-June 2020 | Page 20-22 |  Benjamin W. Sears, Mitchell J. Sungelo, Jacqueline E. Bader, Armodios M. Hatzidakis, Charles L. Getz

Authors:  Subbiah Venkatesh Babu [1]

[1] Deparment of Orthopaedics & Trauma Surgery, Sri Sakthi Hospital, Tirunelveli, Tamil Nadu, India.

Address of Correspondence
Dr. S Venkatesh Babu,
Consultant Orthopaedic & Trauma Surgeon, Sri Sakthi Hospital, Tirunelveli, Tamil Nadu, India.
E-mail: drsvbabu@hotmail.com

Abstract

Today, the surgical treatment is being done for most of the elbow diseases and fractures openly, minimally invasive and arthroscopically. The complications after elbow surgery are also in significant proposition. This review exhibits the need of applied anatomical knowledge and operative skills for the surgeon who intends to operate the elbow safely.
Keywords: Safe Surgery, Trauma, Injury, Elbow.

References

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How to Cite this article: Babu SV | Safe Elbow Surgery | Acta of Shoulder and Elbow Surgery | January-June 2020; 4(1): 20-22.

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Proximal Humerus Fracture: Surgical Outcome and Complications in A Prospective Study Of 99 Patients and review of literature

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Acta 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.

References

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How to Cite this article: Attarde D, Verma D, Puram C, Pradhan C, Patil A, Sancheti P, Shyam A | Proximal Humerus Fracture: Surgical Outcome and Complications in A Prospective Study Of 99 Patients and review of literature | Acta of Shoulder and Elbow Surgery | January-June 2020; 4(1): 15-19.

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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 ?

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Acta 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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How to Cite this article: Kamat N, Ajri A, Sodhai VM, Kalamb V, Shyam AK, Sancheti PK | 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 ? | Acta of Shoulder and Elbow Surgery | January-June 2020; 4(1):7-10.

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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

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Acta 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.

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How to Cite this article: Sears BW, Sungelo MJ, Bader JE, Hatzidakis AM, Getz CL | Outcomes Following Open Reduction Internal Fixation of Extra Articular or Simple Articular Distal Humerus Fractures in Patients over 75 Years of Age | Acta of Shoulder and Elbow Surgery | January-June 2020; 4(1):2-6.

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