New Case Study: Comminuted Fracture Proximal humerus
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http://nblo.gs/13f1ay
http://youtu.be/HBTdfAPi_Vs
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Medial Triceps to Axillary Nerve Transfer Leer más »
Fuente
Este artículo es originalmente publicado en:
http://www.ncbi.nlm.nih.gov/pubmed/25107599
http://www.jshoulderelbow.org/article/S1058-2746%2814%2900246-8/abstract
De:
Shi LL1, Jiang JJ2, Ek ET3, Higgins LD4.
J Shoulder Elbow Surg. 2015 Feb;24(2):203-9. doi: 10.1016/j.jse.2014.05.006. Epub 2014 Aug 5.
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Copyright © 2015 Elsevier Inc. All rights reserved
BACKGROUND:
Lesser tuberosity osteotomy (LTO) as an approach during total shoulder arthroplasty (TSA) is a reliable technique with strong biomechanical fixation and a low failure rate. Complications have been infrequently reported in the literature.
METHODS:
We report a case series of 5 patients who sustained failure of the LTO repair after primary TSA. The data on the patient demographic characteristics, surgical technique, postoperative care, revision surgery, and clinical outcomes are reported.
RESULTS:
The mean age of the 5 patients was 52 years, all patients were men, and the mean body mass index was 28 kg/m(2). They were followed up for a mean of 29 months (range, 24-38 months). The mean time from initial TSA to diagnosis of LTO failure was 9 weeks (range, 5-12 weeks). Two patients reported no trauma, 2 had minor trauma (using a pulley, rolling over in bed), and 1 sustained a fall. At the latest follow-up, the mean visual analog scale; Single Assessment Numeric Evaluation; University of California, Los Angeles; and American Shoulder and Elbow Surgeons scores were 4 (range, 0-6), 48 (range, 20-70), 19 (range, 11-22), and 63 (range, 48-83), respectively. Only 1 patient required no additional procedures beyond the revision LTO repair. Another patient required a second revision LTO repair. The remaining 3 patients either underwent or were recommended to undergo reverse arthroplasty.
CONCLUSION:
Failure of the LTO repair after TSA may possibly be an under-reported complication that is associated with poor clinical outcomes and limited options for revision surgery. In patients with a high risk of LTO failure, considerations should be made to augment the LTO repair during the index TSA procedure.
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