Shoulder trauma:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2008
|
| Schriftenreihe: | Orthopedic clinics of North America
39,4 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | Includes bibliographic references and index |
| Beschreibung: | XII S., S. 393 - 552 zahlr. Ill. 26 cm |
| ISBN: | 9781416063315 1416063315 |
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| 245 | 1 | 0 | |a Shoulder trauma |c guest ed. George S. Athwal |
| 264 | 1 | |a Philadelphia [u.a.] |b Saunders |c 2008 | |
| 300 | |a XII S., S. 393 - 552 |b zahlr. Ill. |c 26 cm | ||
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| 490 | 1 | |a Orthopedic clinics of North America |v 39,4 | |
| 500 | |a Includes bibliographic references and index | ||
| 650 | 4 | |a Shoulder / Wounds and injuries | |
| 650 | 4 | |a Shoulder / Wounds and injuries / Treatment | |
| 650 | 4 | |a Shoulder joint / Wounds and injuries / Treatment | |
| 650 | 4 | |a Arthroplasty |x methods | |
| 650 | 4 | |a Fracture Fixation |x methods | |
| 650 | 4 | |a Shoulder Dislocation |x surgery | |
| 650 | 4 | |a Shoulder Fractures |x surgery | |
| 650 | 4 | |a Shoulder joint |x Wounds and injuries |x Treatment | |
| 650 | 4 | |a Shoulder |x Wounds and injuries | |
| 650 | 4 | |a Shoulder |x Wounds and injuries |x Treatment | |
| 650 | 4 | |a Shoulder |x injuries | |
| 650 | 4 | |a Shoulder |x surgery | |
| 700 | 1 | |a Athwal, George S. |e Sonstige |4 oth | |
| 830 | 0 | |a Orthopedic clinics of North America |v 39,4 |w (DE-604)BV000001089 |9 39,4 | |
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Datensatz im Suchindex
| _version_ | 1804138124621643776 |
|---|---|
| adam_text | CONTENTS
Preface xi
George S. Athwal
Classification and Imaging of Proximal Humerus Fractures 393
Ben C. Robinson, George S. Athwal, Joaquin Sanchez-Sotelo, and Damian M. Rispoli
The decision to operate and the selection of the appropriate surgical modality for
proximal humerus fractures are largely based on the fracture pattern. Understanding the
particular fracture pattern in each case is complicated. Most well-accepted classification
systems were developed based on radiographs complemented by intraoperative
findings. Three-dimensional reconstructions based on CT currently available in most
institutions allow a much better understanding of complex fractures. Modern thinking
about fracture classification probably should be revisited in the light of improved
imaging techniques.
Percutaneous Fixation of Proximal Humerus Fractures 405
Brian Magovern and Matthew L. Ramsey
Closed reduction and percutaneous fixation is a viable treatment option for displaced
two-part, three-part, and valgus-impacted four-part proximal humerus fractures.
Despite biomechanical studies demonstrating inferior stability compared with plate
and intramedullary nail constructs, percutaneous fixation offers a minimally invasive
approach with potential clinical advantages. Decreased scarring, improved cosmesis,
and lower rates of avascular necrosis have been reported. Potential complications
include pin migration, infection, avascular necrosis, neurovascular injury, and malunion.
Clinical outcomes have been comparable with conventional techniques, with studies
reporting approximately 70% good to excellent results.
Locked Intramedullary Nailing for Treatment of Displaced Proximal
Humerus Fractures 417
Allan A. Young and Jeffery S. Hughes
Controversy surrounds the optimal technique for fixation of displaced fractures,
although locked intramedullary nailing is emerging as a preferred technique in
managing displaced proximal humerus fractures in appropriately selected patients.
This technique provides stable fracture fixation allowing early postoperative mobi¬
lization critical in ensuring a pain-free shoulder with a functional range of motion.
Additional advantages include the ability to insert by way of a minimally invasive
VOLUME 39 • NUMBER 4 • OCTOBER 2008 v
approach with limited soft tissue dissection, achieve accurate anatomic reduction,
provide a secure construct even in the situation of osteopenic bone or comminution, and
manage fractures of the proximal humerus extending into the shaft.
Open Reduction and Internal Fixation of Proximal Humerus Fractures 429
Darren S. Drosdowech, Kenneth J. Faber, and George S. Athwal
Open reduction of proximal humeral fractures has the advantage of providing direct
control over each fracture fragment and permitting anatomic reduction and fixation with
advanced devices. Modern fixed-angle locking plates designed specifically for proximal
humerus fractures have allowed the expansion of surgical indications permitting
surgeons to address more complicated fractures. Advanced preoperative imaging and
fluoroscopy allow a better understanding of fracture patterns and permit the surgeon to
use this knowledge intraoperatively. Research is required to further validate fracture
classification systems, to develop surgical guidelines for decision making, and to
compare the outcomes of the various treatments options for proximal humerus
fractures.
Hemiarthroplasty for Proximal Humeral Fracture: Restoration of the Gothic Arch 441
Sumant G. Krishnan, Phillip W. Bennion, John R. Reineck, and Wayne Z. Burkhead
Proximal humerus fractures are the most common fractures of the shoulder girdle, and
initial management of these injuries often determines final outcome. When arthroplasty
is used to manage proximal humeral fractures, surgery remains technically demanding,
and outcomes have been unpredictable. Recent advances in both technique and
prosthetic implants have led to more successful and reproducible results. Key technical
points include restoration of the Gothic arch, anatomic tuberosity reconstruction, and
minimal soft tissue dissection.
Reverse Total Shoulder Arthroplasty for Acute Fractures and Failed Management
After Proximal Humeral Fractures 451
Thomas G. Martin and Joseph P. Iannotti
Reverse shoulder arthroplasty (RSA) has a successful clinical record when used for
treatment of arthropathy accompanied by rotator cuff insufficiency. Efforts to use the
| same technology for other conditions involving insufficient cuff function are related to
proximal humeral fracture described in this review for which RSA has shown promise
are treatment of failed hemiarthroplasty for treatment of proximal humeral fractures and
treatment of complex fracture sequelae. Specific conclusions as yet are difficult to reach.
Future studies are needed to determine if supplemental soft tissue procedures or
modification of implant design will serve to improve functional outcome in this difficult-
to-treat subset of patients.
Scapula Fractures 459
Peter C. Lapner, Hans K. Uhthoff, and Steve Papp
Fractures of the scapula are rare and the diagnosis and treatment may be unfamiliar to
some surgeons. This article outlines a diagnostic work-up and treatment approach for
the various types of scapular fractures. The approach helps guide decision making on
operative versus nonoperative treatment based on what is known regarding prognosis
and outcomes of management. Operative technique and fixation strategies are discussed
for the common fracture patterns along with guidelines for postsurgical shoulder
rehabilitation.
vi CONTENTS
Management of Proximal Humeral Nonunions and Malunions 475
Emilie V. Cheung and John W. Sperling
Surgical treatment of proximal humeral nonunions and malunions are technically
challenging. Osteosynthesis with bone grafting for the treatment of nonunions is
indicated in young, active patients with adequate bone stock in the proximal fragment
and preservation of the glenohumeral articular surfaces. Corrective osteotomy may be a
reasonable option for proximal humeral malunions in young patients without evidence
of degenerative joint disease. Arthroplasty for proximal humerus nonunions and
malunions has a guarded outcome because of limitations in shoulder motion, but pain
relief is more consistently improved upon.
Neurovascular Injuries in Shoulder Trauma 483
Peter C. Zarkadas, Thomas W. Throckmorton, and Scott P. Steinmann
Although the incidence of neurovascular injury following shoulder trauma is relatively
uncommon, a missed diagnosis may have serious clinical ramifications for the patient,
and potential medical and legal implications for the treating surgeon. When treating
these injuries with closed reduction or surgery the neural and vascular structures are at
risk, and therefore a detailed and thorough baseline neurovascular status is essential
before treatment. We suggest a systematic clinical approach when presented with
trauma to the shoulder. This article provides an easily reproducible yet comprehensive
approach to the diagnosis, identification, and treatment of neurovascular injuries
following shoulder trauma.
Management of Acute Clavicle Fractures 491
Won Kim and Michael D. McKee
It has been believed since the time of Hippocrates that clavicle fractures require
little more than benign neglect by clinicians. Although many patients who have
clavicle injuries do achieve adequate healing and functional recovery without
surgical interventions, good outcomes, especially with displaced fractures, are not
universal. Recent literature suggests that a subset of midclavicular injuries may
warrant primary surgical treatment to minimize the incidence of nonunion and/or
symptomatic malunion. Furthermore, certain types of clavicular injuries result in
suboptimal outcomes when managed nonoperatively. This article is based on the
currently available clinical evidence on the evolving management of acute clavicle
fractures.
Anterior Glenohumeral Joint Dislocations 507
Christopher C. Dodson and Frank A. Cordasco
The glenohumeral joint is the most mobile articulation in the body and the most
commonly dislocated diarthroidal joint. Anterior dislocation is by far the most
common direction and can lead to instability of the glenohumeral joint, which ranges
from subtle increased laxity to recurrent dislocation. Overtime, understanding of
anterior shoulder dislocations and the resulting instability has improved. Likewise,
significant advances in arthroscopic equipment have allowed use of the arthroscope to
address anatomically the various lesions that cause instability. This article reviews the
anatomy, pathophysiology, clinical evaluation, and treatment of anterior shoulder
instability.
CONTENTS vii
Traumatic Posterior Glenohumeral Dislocation: Classification, Pathoanatomy,
Diagnosis, and Treatment 519
Marc S. Kowalsky and William N. Levine
Posterior humeral dislocations often go undetected. Proposed explanations for the delay
in diagnosis include failure of the evaluating physician to include the condition in the
differential diagnosis, suboptimal radiographic evaluation and interpretation, and
coincidental injuries such as fractures that can confound the patient s presentation. It is
imperative that the orthopedic surgeon develop a complete understanding of the nature
of this injury and its treatment so that patients who present with this condition can be
diagnosed and treated effectively. This article provides a detailed discussion of the
classification, pathoanatomy, diagnosis, and treatment of traumatic posterior gleno¬
humeral dislocation.
Acromioclavicular and Sternoclavicular Joint Injuries 535
Peter B. MacDonald and Pierre Lapointe
Acromioclavicular (AC) joint injuries are a frequent diagnosis following an acute
shoulder injury. The literature on AC joint dislocation is extensive, reflecting the intense
debate surrounding the topic. The choice of treatment is influenced by factors including
the type of injury, the patient s occupation, the patient s past medical history, the acuity
of the injury, and patient expectations. Sternoclavicular (SC) joint dislocation is an
uncommon injury. The treatment of acute anterior SC joint dislocations is controversial.
It is difficult to study with a well-designed prospective study because of the low
frequency of this injury. Posterior dislocations are much less common than anterior
dislocations. Posterior dislocations, however, are more serious; they are associated with
significant complications and require prompt attention.
Index 547
viii CONTENTS
|
| adam_txt |
CONTENTS
Preface xi
George S. Athwal
Classification and Imaging of Proximal Humerus Fractures 393
Ben C. Robinson, George S. Athwal, Joaquin Sanchez-Sotelo, and Damian M. Rispoli
The decision to operate and the selection of the appropriate surgical modality for
proximal humerus fractures are largely based on the fracture pattern. Understanding the
particular fracture pattern in each case is complicated. Most well-accepted classification
systems were developed based on radiographs complemented by intraoperative
findings. Three-dimensional reconstructions based on CT currently available in most
institutions allow a much better understanding of complex fractures. Modern thinking
about fracture classification probably should be revisited in the light of improved
imaging techniques.
Percutaneous Fixation of Proximal Humerus Fractures 405
Brian Magovern and Matthew L. Ramsey
Closed reduction and percutaneous fixation is a viable treatment option for displaced
two-part, three-part, and valgus-impacted four-part proximal humerus fractures.
Despite biomechanical studies demonstrating inferior stability compared with plate
and intramedullary nail constructs, percutaneous fixation offers a minimally invasive
approach with potential clinical advantages. Decreased scarring, improved cosmesis,
and lower rates of avascular necrosis have been reported. Potential complications
include pin migration, infection, avascular necrosis, neurovascular injury, and malunion.
Clinical outcomes have been comparable with conventional techniques, with studies
reporting approximately 70% good to excellent results.
Locked Intramedullary Nailing for Treatment of Displaced Proximal
Humerus Fractures 417
Allan A. Young and Jeffery S. Hughes
Controversy surrounds the optimal technique for fixation of displaced fractures,
although locked intramedullary nailing is emerging as a preferred technique in
managing displaced proximal humerus fractures in appropriately selected patients.
This technique provides stable fracture fixation allowing early postoperative mobi¬
lization critical in ensuring a pain-free shoulder with a functional range of motion.
Additional advantages include the ability to insert by way of a minimally invasive
VOLUME 39 • NUMBER 4 • OCTOBER 2008 v
approach with limited soft tissue dissection, achieve accurate anatomic reduction,
provide a secure construct even in the situation of osteopenic bone or comminution, and
manage fractures of the proximal humerus extending into the shaft.
Open Reduction and Internal Fixation of Proximal Humerus Fractures 429
Darren S. Drosdowech, Kenneth J. Faber, and George S. Athwal
Open reduction of proximal humeral fractures has the advantage of providing direct
control over each fracture fragment and permitting anatomic reduction and fixation with
advanced devices. Modern fixed-angle locking plates designed specifically for proximal
humerus fractures have allowed the expansion of surgical indications permitting
surgeons to address more complicated fractures. Advanced preoperative imaging and
fluoroscopy allow a better understanding of fracture patterns and permit the surgeon to
use this knowledge intraoperatively. Research is required to further validate fracture
classification systems, to develop surgical guidelines for decision making, and to
compare the outcomes of the various treatments options for proximal humerus
fractures.
Hemiarthroplasty for Proximal Humeral Fracture: Restoration of the Gothic Arch 441
Sumant G. Krishnan, Phillip W. Bennion, John R. Reineck, and Wayne Z. Burkhead
Proximal humerus fractures are the most common fractures of the shoulder girdle, and
initial management of these injuries often determines final outcome. When arthroplasty
is used to manage proximal humeral fractures, surgery remains technically demanding,
and outcomes have been unpredictable. Recent advances in both technique and
prosthetic implants have led to more successful and reproducible results. Key technical
points include restoration of the Gothic arch, anatomic tuberosity reconstruction, and
minimal soft tissue dissection.
Reverse Total Shoulder Arthroplasty for Acute Fractures and Failed Management
After Proximal Humeral Fractures 451
Thomas G. Martin and Joseph P. Iannotti
Reverse shoulder arthroplasty (RSA) has a successful clinical record when used for
treatment of arthropathy accompanied by rotator cuff insufficiency. Efforts to use the
| same technology for other conditions involving insufficient cuff function are related to
proximal humeral fracture described in this review for which RSA has shown promise
are treatment of failed hemiarthroplasty for treatment of proximal humeral fractures and
treatment of complex fracture sequelae. Specific conclusions as yet are difficult to reach.
Future studies are needed to determine if supplemental soft tissue procedures or
modification of implant design will serve to improve functional outcome in this difficult-
to-treat subset of patients.
Scapula Fractures 459
Peter C. Lapner, Hans K. Uhthoff, and Steve Papp
Fractures of the scapula are rare and the diagnosis and treatment may be unfamiliar to
some surgeons. This article outlines a diagnostic work-up and treatment approach for
the various types of scapular fractures. The approach helps guide decision making on
operative versus nonoperative treatment based on what is known regarding prognosis
and outcomes of management. Operative technique and fixation strategies are discussed
for the common fracture patterns along with guidelines for postsurgical shoulder
rehabilitation.
vi CONTENTS
Management of Proximal Humeral Nonunions and Malunions 475
Emilie V. Cheung and John W. Sperling
Surgical treatment of proximal humeral nonunions and malunions are technically
challenging. Osteosynthesis with bone grafting for the treatment of nonunions is
indicated in young, active patients with adequate bone stock in the proximal fragment
and preservation of the glenohumeral articular surfaces. Corrective osteotomy may be a
reasonable option for proximal humeral malunions in young patients without evidence
of degenerative joint disease. Arthroplasty for proximal humerus nonunions and
malunions has a guarded outcome because of limitations in shoulder motion, but pain
relief is more consistently improved upon.
Neurovascular Injuries in Shoulder Trauma 483
Peter C. Zarkadas, Thomas W. Throckmorton, and Scott P. Steinmann
Although the incidence of neurovascular injury following shoulder trauma is relatively
uncommon, a missed diagnosis may have serious clinical ramifications for the patient,
and potential medical and legal implications for the treating surgeon. When treating
these injuries with closed reduction or surgery the neural and vascular structures are at
risk, and therefore a detailed and thorough baseline neurovascular status is essential
before treatment. We suggest a systematic clinical approach when presented with
trauma to the shoulder. This article provides an easily reproducible yet comprehensive
approach to the diagnosis, identification, and treatment of neurovascular injuries
following shoulder trauma.
Management of Acute Clavicle Fractures 491
Won Kim and Michael D. McKee
It has been believed since the time of Hippocrates that clavicle fractures require
little more than benign neglect by clinicians. Although many patients who have
clavicle injuries do achieve adequate healing and functional recovery without
surgical interventions, good outcomes, especially with displaced fractures, are not
universal. Recent literature suggests that a subset of midclavicular injuries may
warrant primary surgical treatment to minimize the incidence of nonunion and/or
symptomatic malunion. Furthermore, certain types of clavicular injuries result in
suboptimal outcomes when managed nonoperatively. This article is based on the
currently available clinical evidence on the evolving management of acute clavicle
fractures.
Anterior Glenohumeral Joint Dislocations 507
Christopher C. Dodson and Frank A. Cordasco
The glenohumeral joint is the most mobile articulation in the body and the most
commonly dislocated diarthroidal joint. Anterior dislocation is by far the most
common direction and can lead to instability of the glenohumeral joint, which ranges
from subtle increased laxity to recurrent dislocation. Overtime, understanding of
anterior shoulder dislocations and the resulting instability has improved. Likewise,
significant advances in arthroscopic equipment have allowed use of the arthroscope to
address anatomically the various lesions that cause instability. This article reviews the
anatomy, pathophysiology, clinical evaluation, and treatment of anterior shoulder
instability.
CONTENTS vii
Traumatic Posterior Glenohumeral Dislocation: Classification, Pathoanatomy,
Diagnosis, and Treatment 519
Marc S. Kowalsky and William N. Levine
Posterior humeral dislocations often go undetected. Proposed explanations for the delay
in diagnosis include failure of the evaluating physician to include the condition in the
differential diagnosis, suboptimal radiographic evaluation and interpretation, and
coincidental injuries such as fractures that can confound the patient's presentation. It is
imperative that the orthopedic surgeon develop a complete understanding of the nature
of this injury and its treatment so that patients who present with this condition can be
diagnosed and treated effectively. This article provides a detailed discussion of the
classification, pathoanatomy, diagnosis, and treatment of traumatic posterior gleno¬
humeral dislocation.
Acromioclavicular and Sternoclavicular Joint Injuries 535
Peter B. MacDonald and Pierre Lapointe
Acromioclavicular (AC) joint injuries are a frequent diagnosis following an acute
shoulder injury. The literature on AC joint dislocation is extensive, reflecting the intense
debate surrounding the topic. The choice of treatment is influenced by factors including
the type of injury, the patient's occupation, the patient's past medical history, the acuity
of the injury, and patient expectations. Sternoclavicular (SC) joint dislocation is an
uncommon injury. The treatment of acute anterior SC joint dislocations is controversial.
It is difficult to study with a well-designed prospective study because of the low
frequency of this injury. Posterior dislocations are much less common than anterior
dislocations. Posterior dislocations, however, are more serious; they are associated with
significant complications and require prompt attention.
Index 547
viii CONTENTS |
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| series | Orthopedic clinics of North America |
| series2 | Orthopedic clinics of North America |
| spelling | Shoulder trauma guest ed. George S. Athwal Philadelphia [u.a.] Saunders 2008 XII S., S. 393 - 552 zahlr. Ill. 26 cm txt rdacontent n rdamedia nc rdacarrier Orthopedic clinics of North America 39,4 Includes bibliographic references and index Shoulder / Wounds and injuries Shoulder / Wounds and injuries / Treatment Shoulder joint / Wounds and injuries / Treatment Arthroplasty methods Fracture Fixation methods Shoulder Dislocation surgery Shoulder Fractures surgery Shoulder joint Wounds and injuries Treatment Shoulder Wounds and injuries Shoulder Wounds and injuries Treatment Shoulder injuries Shoulder surgery Athwal, George S. Sonstige oth Orthopedic clinics of North America 39,4 (DE-604)BV000001089 39,4 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=016807945&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Shoulder trauma Orthopedic clinics of North America Shoulder / Wounds and injuries Shoulder / Wounds and injuries / Treatment Shoulder joint / Wounds and injuries / Treatment Arthroplasty methods Fracture Fixation methods Shoulder Dislocation surgery Shoulder Fractures surgery Shoulder joint Wounds and injuries Treatment Shoulder Wounds and injuries Shoulder Wounds and injuries Treatment Shoulder injuries Shoulder surgery |
| title | Shoulder trauma |
| title_auth | Shoulder trauma |
| title_exact_search | Shoulder trauma |
| title_exact_search_txtP | Shoulder trauma |
| title_full | Shoulder trauma guest ed. George S. Athwal |
| title_fullStr | Shoulder trauma guest ed. George S. Athwal |
| title_full_unstemmed | Shoulder trauma guest ed. George S. Athwal |
| title_short | Shoulder trauma |
| title_sort | shoulder trauma |
| topic | Shoulder / Wounds and injuries Shoulder / Wounds and injuries / Treatment Shoulder joint / Wounds and injuries / Treatment Arthroplasty methods Fracture Fixation methods Shoulder Dislocation surgery Shoulder Fractures surgery Shoulder joint Wounds and injuries Treatment Shoulder Wounds and injuries Shoulder Wounds and injuries Treatment Shoulder injuries Shoulder surgery |
| topic_facet | Shoulder / Wounds and injuries Shoulder / Wounds and injuries / Treatment Shoulder joint / Wounds and injuries / Treatment Arthroplasty methods Fracture Fixation methods Shoulder Dislocation surgery Shoulder Fractures surgery Shoulder joint Wounds and injuries Treatment Shoulder Wounds and injuries Shoulder Wounds and injuries Treatment Shoulder injuries Shoulder surgery |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=016807945&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
| volume_link | (DE-604)BV000001089 |
| work_keys_str_mv | AT athwalgeorges shouldertrauma |