Total elbow arthroplasty is a relatively rare procedure compared with total knee or total hip arthroplasty. Total elbow arthroplasty for bony ankylosis is even rarer, and the results are often unsatisfactory. We report a patient who gained good mobility of the elbow after total elbow arthroplasty for the treatment of fractured arthrodesis site with which the patient had lived with for 12 years.
Ankylosis ; Arthrodesis* ; Arthroplasty* ; Arthroplasty, Replacement, Hip ; Elbow* ; Humans ; Knee

We report a case of an 86-year-old man diagnosed with bilateral elastofibroma dorsi who was managed conservatively after a two year follow-up. An elastofibroma dorsi is a benign, slow-growing tumor that is most often located in the inferior periscapular area in elderly patients. It should be considered to differentiate them from other soft tissue tumors located at the inferior periscapular region. Increased awareness of these characteristics will decrease the incidence of a misdiagnosis of elastofibroma dorsi as a malignancy and avoid unnecessary surgery.
Aged ; Aged, 80 and over ; Diagnostic Errors ; Follow-Up Studies ; Humans ; Incidence ; Shoulder* ; Unnecessary Procedures

Reports of bowing and pseudarthrosis of the humerus and clavicle are rare. Most patients with congenital pseudoarthrosis of the clavicle involving the right side and midportion of clavicle tended to heal better than congenital pseudoarthrosis of the tibia. We experienced a patient who had special features in terms of location, pseudoarthrosis pattern, and neurofibromatosis, and report on this case here.
Clavicle* ; Humans ; Humerus ; Neurofibromatoses* ; Pseudarthrosis* ; Tibia

Multiple rice bodies are a rare disorder that is most commonly observed in chronic rheumatoid arthritis patients and as a complication of chronic inflammation in the bursa. However, it can occur in the absence of an underlying systemic disorder. Although it resembles synovial chondromatosis clinically and on imaging, the condition can be discriminated by an analysis of the radiographic and MR appearances. We encountered a case of multiple rice body formation with subacromial bursitis on the shoulder of a 37-year old man suffering from pain and motion limitation. The patient was treated by arthroscopic removal of the multiple rice bodies and a subacromial bursectomy. We present this case with a review of the relevant literature.
Adult ; Arthritis, Rheumatoid ; Arthroscopy ; Bursitis ; Chondromatosis, Synovial ; Humans ; Inflammation ; Shoulder

A posterior shoulder dislocation with a fracture is rare. Most fractures are impression fractures of the humeral head or lesser tuberosity fractures. However, there are no reports of a complete rupture of the rotator cuff with a combined posterior glenohumeral dislocation. We report a unique case of a posterior shoulder dislocation with an avulsion fracture of the greater tuberosity and a complete rupture of infraspinatus, teres minor and subscapularis tendons, which were treated surgically.
Humeral Head ; Rotator Cuff* ; Rupture* ; Shoulder Dislocation* ; Shoulder* ; Tendons

PURPOSE: The distal clavicle has a biomechanical structure different from that of the proximal or middle 1/3 clavicle, and delayed union or nonunion occurs frequently in a distal clavicle fracture. The authors obtained favorable results from an open reduction and bone grafting of the distal clavicle nonunion. We report the results together with review of the relevant literature. MATERIALS AND METHODS: The subjects were 8 patients (average age, 38.9) who had undergone surgery for distal clavicle nonunion from August 2003 to May 2006. Nonunion occurred after surgical treatment in 4 cases, and after conservative treatment in the other 4. In all cases, the patients complained of pain. RESULTS: The mean follow-up duration was 14 months, and radiological union was observed in 8 weeks on average. In all cases, the range of shoulder joint motion was normal at the end of the follow-up observation. In the functional evaluation, 7 cases showed excellent results and 1 case showed good results. CONCLUSION: Surgical treatment is a safe and reliable treatment for distal clavicle fracture nonunion because it can achieve early rehabilitation and union.
Bone Transplantation ; Clavicle* ; Follow-Up Studies ; Humans ; Rehabilitation ; Shoulder Joint

PURPOSE: To determine the causes of the surgical treatment results in glenoid fracture by a retrospective analysis. MATERIALS AND METHODS: From March 1999 to February 2004, 9 patients who underwent an open reduction due to a glenoid fracture were reviewed. The modified Ideberg classification was used. There were 1, 3, 2, 1 and 2 cases of modified Ideberg type I, II, III, V, and VI, respectively. The internal fixators were a reconstruction plate, a small plate, a one-third tubular plate, a small screw, and a cannulated screw in 6, 1, 3, 3 and 1 case, respectively. The constant score and Adam's functional assessment method were used to evaluate the postoperative shoulder function. RESULTS: The average time for fracture union was 7 weeks. The functional assessment was excellent in 4 cases, good in 3 cases, and fair in 2 cases. There were two complications related to surgery; articular screw encroachment, and inferior glenoid bone resorption without instability. CONCLUSION: A glenoid fracture with glenohumeral instability or displaced that was treated by open surgery showed good clinical results. Moreover, the more comminuted fracture had a lower functional score.
Bone Resorption ; Classification ; Fractures, Comminuted ; Humans ; Internal Fixators ; Retrospective Studies ; Scapula ; Shoulder

PURPOSE: To evaluate the result and complication of treatment using Locking Compression Plate (LCP) for fracture of proximal humerus. MATERIALS AND METHODS: Between 2004 and 2006, 21 patients with two-part and three-part fractures of the proximal humerus were treated by LCP fixation. Their average age was 54.9 years. Postoperative mean follow-up period was 22.9 months. The reduction was qualified and complication were assessed with final radiographs. The functional outcome was evaluated by Neer's rating system. RESULTS: By Neer's functional evaluation, mean score of shoulder function was 86.3 and 18 case (86%) had excellent or satisfactory results. There was one case of nonunion but no infection or avascular necrosis of the humeral head. No correlation was found between the final result and the type of fracture, age, gender or quality of reduction. CONCLUSION: We obtained satisfactory result of LCP fixation for fracture of proximal humerus in this study. LCP fixation for proximal humerus fracture is a reliable method to obtain satisfactory reduction, rigid fixation and early exercise.
Follow-Up Studies ; Humans ; Humeral Head ; Humerus* ; Necrosis ; Shoulder

PURPOSE: It is very important to evaluate and fix coronoid process fractures because they are a critical element for a stable, effective elbow function. The lateral view of the elbow joint is used for a radiographic evaluation of the coronoid but an understanding of the fracture pattern is often difficult because of overlap of the radial head and obliquity of the fracture line. We developed the coronoid view, which is a new radiograph for an evaluation of the coronoid process fracture, and discuss its advantages for a postoperative follow-up. MATERIALS AND METHODS: The coronoid view was designed for an evaluation of the anteromedial fragment of the coronoid process. After the patient sat on his side, the shoulder was abducted 45degrees and the elbow was flexed 90degrees The X-ray beam was shot perpendicular to the table. Since shoulder was abducted 45degrees the fracture line of the coronoid process can be parallel to the X-ray beam, and the radial head can be cleared. CONCLUSION: The coronoid view can be a good alternative radiograph for an evaluation of a coronoid process fracture because the beam is parallel to the fracture line. The coronoid view can be particularly useful in postoperative patient follow-up where computed tomography is impractical due to metal implants and cost.
Elbow ; Elbow Joint ; Follow-Up Studies ; Head ; Humans ; Shoulder

PURPOSE: The current study reports the clinical results of total elbow arthroplasties (TEA) which were Performed on patients with poor clinical and radiological results after initial surgeries for elbow fractures or dislocations. MATERIALS AND METHODS: The clinical outcomes of twelve consecutive patients who underwent TEA after failed surgeries for elbow fractures or dislocations from january, 1995 to December, 2005 were evaluated. The initial diagnoses were distal humeral fractures in 8 cases and fracture-dislocations in 4 cases. The Mean period from the initial operations to the TEAs was 12 months. The mean folloow up period after TEA was 43 months. RESULTS: The mean range of motion, in terms of active extension, activeflexion, supination, and pronation, improved from 14.2degrees, 96.7degrees, 50.8degrees and 53.3degrees to 5.4degrees, 122.1degrees, 63.3degrees and 67.5degrees, respectively (p<0.05).RAdiolucent lines were found in 3 cases, which were 1 case of type 3, and 2 cases of type 4. All three loosening cases underwent revision TEAs. The mean postoperative Mayo elvow performance score was 79 point. There were 6 cases of excellent, 2 cases of good, and 4 cases in poor. CONCLUSION: Good clinical results were obtained after TEA performed in failed surgeries for elbow fractures of dislocations.
Arthroplasty* ; Diagnosis ; Dislocations* ; Elbow* ; Humans ; Humeral Fractures ; Pronation ; Range of Motion, Articular ; Supination ; Tea