Whatʼs New in Shoulder and Elbow Surgery

Surgical treatment of proximal humeral fracture with external fixator

“…18 Many surgical techniques have been described to stabilize proximal humeral fractures, including intramedullary nails, plate-and-screw osteosynthesis, tension band wiring, percutaneous pin fixation, and hemiarthroplasty. 15,16,19,20 However, treatment is still controversial and challenging when attempting to restore humeral alignment, joint surface congruity, and rotator cuff function while maintaining humeral head vascularity. 1 Although an anatomic reduction could be expected with an open technique, most cases of open reductioneinternal fixation need wide dissection of soft tissues on the anterolateral surface of the proximal humerus, which often comprise the residual blood supply to the humeral head.…”

“…14 Various operative techniques have been advocated for displaced proximal humeral fractures, including use of tension band sutures, locking and nonlocking plates, intramedullary nails, and prosthetic replacement. 9,15,16,20 Although all these techniques have been proved useful, no single technique is considered to be superior to the others. Through an open approach, the fracture can be reduced anatomically.…”

Arthroscopic Bone Tunnel Augmentation for Rotator Cuff Repair

“…1 Although the ideal method for rotator cuff repair remains an active area of debate, transosseous repair has shown success in clinical reports, 2,3 remaining the clinical gold standard for treatment. 4 Transosseous repair also compares favorably with respect to the biomechanical parameters of footprint recon-struction, 5 static load to failure, 6 cyclic load to failure, 7 and motion at the repair site. 8 Although conflicting data exist advocating the advantages of suture anchors, 9 the cost of transosseous repair can be far lower, and these cost differences increase with the size of the repair.…”

A quantitative method for determining medial migration of the humeral head after shoulder arthroplasty: preliminary results in assessing glenoid wear at a minimum of two years after hemiarthroplasty with concentric glenoid reaming

“…Uncertainty regarding the management of the glenoid side of the articulation led to the recent statement, ''The most appropriate treatment for advanced glenohumeral osteoarthritis remains controversial.'' 35 A literature review indicates that although medial erosion has been commonly observed after all types of shoulder arthroplasty, a quantitative, practical, and reproducible method for measuring the amount and rate of this erosion has yet to be described. This article presents such a method and applies it to shoulders undergoing humeral Figure 2 The transparent anteroposterior (AP) template is superimposed on the radiographic image of an AP view of the shoulder so that the outline of the scapula on the template (dark lines) corresponds to the scapular outline on the radiograph.…”