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   2009| April-June  | Volume 3 | Issue 2  
    Online since December 1, 2009

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Treatment of mid-shaft clavicle fractures: A comparative study
David S Thyagarajan, Marion Day, Colin Dent, Rhys Williams, Richard Evans
April-June 2009, 3(2):23-27
DOI:10.4103/0973-6042.57895  PMID:20661396
We retrospectively evaluated 51 patients (17 in each of three groups) with mid shaft clavicle fractures. Group 1 underwent intramedullary stabilization using clavicle pins. Group 2 underwent open reduction and internal fixation using plates and group 3 underwent non operative treatment with a sling. Group1 patients progressed to union within 8 to 12 weeks. In Group 2, six patients had scar related pain and two had prominent metal work and discomfort and in group 3, three patients developed non union and one had symptomatic malunion. Our results suggest that the displaced and shortened midshaft clavicle fractures require operative fixation and the techniques of clavicle pinning resulted in less complications, short hospital stay and good functional outcome.
  14 7,562 179
Bilateral posterior fracture-dislocation of the shoulder: Report of two cases
Rui Claro, Ricardo Sousa, Marta Massada, Joaquim Ramos, Jose M Lourenco
April-June 2009, 3(2):41-45
DOI:10.4103/0973-6042.57935  PMID:20661400
Bilateral posterior fracture-dislocation of the shoulder is a very rare injury. Almost 50% of bilateral posterior dislocations are due to a convulsive seizure, rising to 90% if the dislocations are associated with fractures. Electric shock accounts for less than 5% of bilateral posterior dislocations of the shoulder. A systematization of the clinical and radiological approach, followed by an early diagnosis and proper surgical treatment is essential. Authors report 2 cases of bilateral posterior fracture-dislocation of the shoulder, one caused by a convulsive seizure and the other by an electric shock. A review of literature and a treatment protocol are also presented.
  2 3,875 62
Surgery of subacromial syndrome with application of plasma rich in growth factors
A Jimenez-Martin, J Angulo-Gutierrez, J Gonzalez-Herranz, JM Rodriguez-De La Cueva, J Lara-Bullon, R Vazquez-Garcia
April-June 2009, 3(2):28-33
DOI:10.4103/0973-6042.57932  PMID:20661397
Background: Our objective was to evaluate clinical recovery of patients with subacromial syndrome, after administering them plasma rich in growth factors (PRGF) by means of the Constant, University of California Los Angeles (UCLA) and Dissabilities of Arm, Shoulder and Hand (DASH) tests. Materials and Methods: Prospective cohort study involving two groups - group A, treated with PRGF (52 patients); and group B, without PRGF treatment (79 patients). We analyzed the clinical situation preoperatively (time 1), at 1 month (time 2) and after rehabilitation (time 3). Results: We considered 131 patients (71.2% were men, with median age of 53.7 years). Different approaches were used - traditional (62.5%), mini-open (22.5%) and arthroscopic (15%), without significant differences (P= .71). We observed improvement in the Constant test results at time 2 (59.8 ± 11.5 points in group A vs. 13.2 ± 7.1 points in group B; P < .05) and at time 3 (79.3 ± 11.6 points in group A vs. 59.7 ± 20.1 points in group B; P < .05). We found improvement in the UCLA test results at time 2 (23.2 ± 5.8 points in group A vs. 4.72 ± 1.1 points in group B; P < .05) and at time 3 (32.1 ± 5.3 points in group A vs. 22.1 ± 7.35 points in group B; P < .05). We also observed improvement in the DASH test results at time 2 (45.2 ± 17.2 points in group A vs. 118.3 ± 7.6 points in group B, P < .05) and at time 3 (37.3 ± 12.6 points in group A vs. 69 ± 25.7 points in group B). Time of rehabilitation reduced significantly: 2.53 months in group A vs. 4.96 months in group B (P < .05). No significant differences were observed in surgical times: 88 minutes (group A) vs. 97 minutes (group B). Conclusion: In our experience, PRGF should be indicated in subacromial syndrome and cuff involvement, as shown by the improvement in our results in terms of better results of tests, reduction in rehabilitation time and no increase in operation time.
  2 3,384 57
Twelve years' experience of the mini-Bankart repair for recurrent anterior dislocation of the shoulder
Alan Cooney, Satyajit Sinha, Alexander Craig Campbell
April-June 2009, 3(2):46-48
DOI:10.4103/0973-6042.57936  PMID:20661401
Stabilization for recurrent anterior shoulder dislocation can be achieved through either an open or arthroscopic approach. The former tends to have a lower recurrence rate but longer rehabilitation. The technique of mini-Bankart repair has been used at this establishment since 1996. We retrospectively reviewed the patients that had undergone this procedure. We describe our experience of the mini-Bankart procedure and the results in 24 patients with a mean follow-up of 56 months (range, 12-144 months). The technique is a direct mini-approach to the shoulder joint, preserving the inferior portion of subscapularis. Where present, a Bankart lesion is repaired with two GII Mitek anchors (Ethicon) and the capsule reefed. There were no incidences of repeat anterior dislocation, and the average time period taken to return to work was 8.8 weeks. We recommend this technique due to its low recurrence rate and satisfactory return to normal function.
  1 3,242 63
Acutely calcified hematoma mimicking a displaced medial epicondyle fracture
Addie Majed, Joanna Thomas, Philip Ahrens
April-June 2009, 3(2):34-36
DOI:10.4103/0973-6042.57933  PMID:20661398
We present an interesting and unusual case of an acutely calcified pin-site infection hematoma mimicking a displaced cartilaginous medial epicondyle, in a child with a Gartland type III fracture. The treatment of such pathology could be confusing and may interfere with the correct clinical decision-making process. To our knowledge, this is the first presentation of such a case.
  - 3,508 27
Beware of glenoid dysplasia mimicking bone trauma in the injured shoulder
Robin M Seagger, Jeremy Loveridge, Mark A.A Crowther
April-June 2009, 3(2):37-40
DOI:10.4103/0973-6042.57934  PMID:20661399
The term 'primary glenoid dysplasia' is used to describe a rare developmental abnormality of the shoulder. The symptomatic presentation of glenoid dysplasia has two definite age-related peaks. The first peak is in adolescents and young adults; they generally present with symptoms of instability related to high levels of activity. The second is in the fifth or sixth decade when presumed degenerative changes occur in the gleno-humeral joint. It can crop up as an incidental finding, during chest X-ray, for example, or may present as marked upper limb disability. This study reports an unusual presentation of this rare condition and describes it with clear illustrations of radiological and surgical investigations and treatment undertaken. It is presented as an 'aide-memoire' for orthopedic surgeons to consider this diagnosis when confronted with unusual X-rays or scans in their practice.
  - 3,316 39
Simultaneous occurrence of acute posterior shoulder dislocation and posterior shoulder-fracture dislocation after epileptic seizure
Cem Copuroglu, Bilal Aykac, Beyti Tuncer, Mert Ozcan, Erol Yalniz
April-June 2009, 3(2):49-51
DOI:10.4103/0973-6042.57937  PMID:20661402
  - 2,482 40