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B. Type 3B fractures with three trochlea fragments or more in the elderly were the most difficult to treat with open reduction and internal fixation and possibly 1-term total elbow arthroplasty.

This study aimed to investigate the results, indications, and limitations of absorbable pin fixation for osteochondritis dissecans of the humeral capitellum in the separation stage.

This study included 35 patients (mean age, 14.0 years). Patients were divided into two groups Group A included those who obtained complete union within 6 months and Group B included those who did not observe complete union within 6 months. The clinical findings were compared between the groups.

There were 26 and 6 patients in Groups A and B, respectively. Two patients did not obtain complete union. Clinical outcomes improved after the procedure. https://www.selleckchem.com/products/pexidartinib-plx3397.html In univariate analysis, delayed union was associated with larger major diameter (

= .0004) and more depth (

= .03) of the osteochondral fragment measured by computed tomography, the presence of osteosclerosis in the subchondral bed on X-ray imaging (

= .003), and the presence of comminution of subchondral bone on ultrasound imaging (

= .01). In multivariate analysis, there was a significant difference only in the major diameter of the osteochondral fragment (

= .03). Receiver operating characteristic curves analysis shows that if the major diameter of the osteochondral fragment is 11 mm or less, 85% of patients achieve complete union of the osteochondral fragments within 6 months.

Absorbable pin fixation may be considered for the osteochondral fragments with major diameter of 11 mm or less and should not be considered for patients who demonstrate osteosclerosis in the subchondral bed or comminution of subchondral bone.

Absorbable pin fixation may be considered for the osteochondral fragments with major diameter of 11 mm or less and should not be considered for patients who demonstrate osteosclerosis in the subchondral bed or comminution of subchondral bone.

Little is known about the optimal timing of early return to sports after which the osteochondritis dissecans (OCD) lesion can completely heal. The aims of this study were to investigate the clinical outcomes of nonoperative treatment and elucidate the relationship between the radiographic findings and the timing for the return to sports.

We performed a retrospective review of 32 patients who presented with stable OCD of the capitellum and were treated nonoperatively for a minimum of 3months. The mean follow-up period was 22.1 months. OCD lesions were assessed qualitatively and quantitatively on anteroposterior radiographs of the elbow at 45° of flexion every 3months. The width of the OCD lesion (OCDw) and lateral width of the normal capitellum were measured and were associated with return to sports activities.

In 21 patients (66%), the progression of ossification was seen at a mean period of 4.1 months. Eighteen (56%) had partial union at a mean period of 4.3 months. Twenty-nine cases (91%) returned to nificant predictor of successful nonoperative treatment and complete union. Surgery should be considered for lesions without the progression of ossification during the first 3months. We propose both an OCD lesion width of <8.0 mm and a lateral normal width of >2.0 mm as radiographic landmarks of the timing of the return to sports.

2.0 mm as radiographic landmarks of the timing of the return to sports.

The ulnar collateral ligament (UCL) complex of the elbow plays a primary role in valgus and posteromedial stability of the elbow. The anterior oblique ligament (AOL) of the UCL is believed to provide the majority of resistance to external forces on the medial elbow. The transverse ligament (TL) of the UCL is generally thought to have minimal contribution to the elbow's overall stability. However, recent studies have suggested a more significant role for the TL. The primary aim of this study was to identify the TL's contribution to the stability of the elbow joint in determining the joint stiffness and neutral zone variation in internal rotation.

Twelve cadaveric elbows, set at a 90° flexion angle, were tested by applying an internal rotational force on the humerus to generate a medial opening torque at the level of the elbow. The specimens were preconditioned with 10 cycles of humeral internal rotation with sinusoidal torque ranging from 0 to 5 Nm. Elbow stiffness measures and joint neutral zone were firsontribution to the elbow's overall stability.

The TL had no contribution to internal rotation elbow joint stiffness at a flexion angle of 90°. However, sequential sectioning of the TL was found to significantly increase the joint neutral zone when compared with the native cadaveric elbow at a flexion angle of 90°. This provides evidence toward the TL having some form of contribution to the elbow's overall stability.

The purpose of this study was to identify nerves at risk when using a minimally invasive plate osteosynthesis precontoured long proximal humerus locking plate and to evaluate the risk of injury to deltoid insertion and brachialis muscle.

Ten cadaveric upper limb specimens were used. A transdeltoid anterolateral approach was performed proximally and a second anterior approach was performed distally. A 14-hole "low" long precountored ALPS locking plate (Biomet Trauma; Zimmer Biomet, Warsaw, IN, USA) was used. Subsequently, anatomic dissection to measure the anatomic relationship of the plate with the deltoid insertion, with the brachialis muscle, and with the axillary, radial, and musculocutaneous nerves was performed.

The mean humeral length was 302 mm (standard deviation 52.3, 99% confidence interval 259.3-344.6). In 6 specimens, the axillary nerve was located at the level of the third row of holes of the plate; in 3 specimens, at the level of the fourth row; and in one specimen, at the level of the sec; however, the distances between the plate and the nerves remain low, so caution should be maintained. Despite the curved design of the plate, the deltoid insertion is partially compromised in all cases.

The outcomes and complication rates of patients with isolated greater tuberosity fractures are not well documented. The present study aimed to evaluate the reoperation rates, types of reoperations, and complications for patients undergoing open reduction internal fixation and those undergoing initial nonoperative treatment of isolated greater tuberosity fractures.

An administrative claims database was queried from 2010 to 2018 for adult patients treated with open reduction internal fixation or initial nonoperative treatment within 6 weeks of sustaining a closed isolated greater tuberosity fracture. Reoperation rates, types of reoperations, local/surgical complications, and systemic complications for two cohorts were collected, and statistical analysis was performed using R statistical software for patients initially treated operatively and nonoperatively. Complication rates were compared using multivariate logistic regression, while demographic data were compared using chi-square analysis.

Of the 8509 patients who were documented to have sustained a closed isolated greater tuberosity fracture, 333 patients underwent operative treatment and 8176 patients received initial nonoperative treatment within the first 6 weeks of diagnosis.