Humans ; Humeral Fractures/surgery* ; Humerus/surgery*

Posterior dislocation of the shoulder may be missed or neglected at initial presentation especially in developing countries. We present a case of 40-year-old Indian man who had 3-month missed posterior dislocation of the right shoulder along with malunited fracture of the anatomical neck of the humerus. Open reduction and stabilization with modified McLaughlin procedure was performed. Rotational osteotomy of proximal humerus had to be performed as supplementary procedure to keep the humeral head stable in glenoid cavity during functional range of movements. The patient had excellent result of the shoulder at 3 years follow-up.
Humans ; Humerus ; Osteotomy ; Shoulder Dislocation ; surgery ; Shoulder Fractures ; surgery

Fracture Fixation, Internal ; Humans ; Humerus ; surgery ; Shoulder Fractures ; surgery

OBJECTIVETo investigate the relationship of the greater tuberosity and the lateral fin of the prosthesis by using cadaveric research.

METHODSNine pairs of fresh-frozen upper extremity specimens (n = 18) were collected. Two-part anatomical neck fracture models were created by osteotomy along the anatomical neck. A standardized humeral head replacement procedure was carried out. The prosthesis was implanted in 20 degrees and 40 degrees of retroversion respectively, and the distance between the bicipital groove and lateral fin of the prosthesis was measured.

RESULTSThe lateral fins of prostheses in all specimens were located behind the bicipital groove. The average distances were 7.3 mm in 20 degrees retroversion and 4.0 mm in 40 degrees retroversion.

CONCLUSIONIt is better to fix the greater tuberosity over the lateral fin during humeral head replacement.

Arthroplasty, Replacement ; methods ; Humans ; Humerus ; anatomy & histology ; surgery ; Shoulder Fractures ; surgery ; Shoulder Joint ; anatomy & histology ; surgery

Adolescent ; Child ; Female ; Humans ; Humeral Fractures ; surgery ; Humerus ; surgery ; Male ; Traction

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Humeral Fractures ; surgery ; therapy ; Humerus ; physiopathology ; surgery ; Male

Adolescent ; Child ; China ; Female ; Humans ; Humeral Fractures ; surgery ; therapy ; Humerus ; surgery ; Male ; Treatment Outcome

BACKGROUND: The open reduction and internal fixation (ORIF) was a standard treatment approach for fracture at distal humerus intercondylar, whereas the optimal way before ORIF remains inconclusive. We, therefore, performed a systematic review and meta-analysis to assess the efficacy and safety of olecranon osteotomy vs. triceps-sparing approach for patients with distal humerus intercondylar fracture. METHODS: The electronic searches were systematically performed in PubMed, EmBase, Cochrane library, and Chinese National Knowledge Infrastructure from initial inception till December 2019. The primary endpoint was the incidence of excellent/good elbow function, and the secondary endpoints included Mayo elbow performance score, duration of operation, blood loss, and complications. RESULTS: Nine studies involving a total of 637 patients were selected for meta-analysis. There were no significant differences between olecranon osteotomy and triceps-sparing approach for the incidence of excellent/good elbow function (odds ratio [OR]: 1.37; 95% confidence interval [CI]: 0.69-2.75; P = 0.371), Mayo elbow performance score (weight mean difference [WMD]: 0.17; 95% CI: -2.56 to 2.89; P = 0.904), duration of operation (WMD: 4.04; 95% CI: -28.60 to 36.69; P = 0.808), blood loss (WMD: 33.61; 95% CI: -18.35 to 85.58; P = 0.205), and complications (OR: 1.93; 95% CI: 0.49-7.60; P = 0.349). Sensitivity analyses found olecranon osteotomy might be associated with higher incidence of excellent/good elbow function, longer duration of operation, greater blood loss, and higher incidence of complications as compared with triceps-sparing approach. CONCLUSIONS This study found olecranon osteotomy did not yield additional benefit on the incidence of excellent/good elbow function, while the duration of operation, blood loss, and complications in patients treated with olecranon osteotomy might be inferior than triceps-sparing approach.
Elbow Joint/surgery* ; Fracture Fixation, Internal ; Humans ; Humeral Fractures/surgery* ; Humerus ; Olecranon Process/surgery* ; Osteotomy ; Range of Motion, Articular ; Treatment Outcome

Fractures of the proximal humerus are uncommon in young patients. Although bilateral fracture of proximal humerus itself is rare, association with epilepsy and electrocution is frequent. Only one case of traumatic bilateral proximal humerus fracture has been reported in the literature. We report a rare case of bilateral traumatic displaced proximal humerus fractures in a 40 years old male patient, which was treated by means of open reduction and internal fixation with proximal humerus locked pates on both sides and obtained a good functional outcome.
Bone Plates ; Fracture Fixation, Internal ; Humans ; Humerus ; Shoulder Fractures ; surgery ; Treatment Outcome

There are several well defined indications for surgical management of humeral shaft fractures. Operative procedures on the humerus are associated with their own complications. Iatrogenic brachial artery injury as a complication of humeral shaft plating has not been reported previously. We report a case of a 48 years old female, who received operation at a district hospital and was referred to us when the surgeon could not palpate the pulse. CT angiogram showed that there was segmental non-opacification of the brachial artery. There was distal reformation and the thrombosis was decided to be managed conservatively. We believe that the arterial injury was a result of improper surgical technique and the segmental block might be due to improper use of plate holding forceps. This case report makes us aware of a rare complication of operative management of humeral shaft fractures and that basic principles of surgery must be always followed to prevent such injuries.
Bone Plates ; Brachial Artery ; Fracture Fixation, Internal ; Humans ; Humeral Fractures ; surgery ; Humerus ; Iatrogenic Disease