Clavicle fractures

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Clavicle fractures are commonly caused by falls on the shoulder or outstretched hand. They are classified based on location (medial, middle, lateral). Most are managed non-operatively with a sling or figure-of-eight bandage. Early surgery is indicated for fractures in young patients from high-energy trauma, comminuted fractures, fractures with skin jeopardy, or >20mm of shortening. Floating shoulder injuries and open or lateral fractures also typically require surgery. Surgical management involves open reduction and internal fixation followed by a short period of protected motion and early return to sports. Studies show reliable healing and functional outcomes when surgery is performed for appropriately indicated fractures.

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The overhead athlete

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$Femoral neck fractures$ $Femoral neck fractures$

Femoral neck fractures

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Femoral neck fractures most commonly occur in elderly patients due to osteoporosis and osteopenia. Displaced fractures have higher rates of complications like nonunion and osteonecrosis compared to non-displaced fractures. Treatment depends on fracture displacement and patient factors, ranging from non-surgical management of non-displaced fractures to internal fixation, hemiarthroplasty, or total hip arthroplasty for displaced fractures. Large randomized controlled trials have shown that arthroplasty results in better functional outcomes and fewer reoperations compared to internal fixation for displaced fractures in healthy elderly patients.

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The document discusses anterior glenohumeral instability, including epidemiology, pathoanatomy, diagnosis, and management options. It notes that anterior dislocations are most common in athletes under age 25, with the primary pathology being a Bankart lesion. Diagnosis involves history, physical exam including tests like the apprehension test, and imaging like x-rays and MRI. Treatment depends on factors like number of dislocations, age, and physical exam findings, ranging from rehabilitation to surgical procedures.

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The document discusses various types of shoulder injuries including fractures and dislocations. It describes the anatomy of the shoulder joint and then covers specific fractures of the clavicle, scapula, and humerus. Treatment options for each injury are discussed, including nonsurgical treatments like slings or bandages and indications for surgical intervention. Various types of shoulder dislocations are also outlined, along with their mechanisms, clinical presentations, diagnoses, and approaches to reduction.

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This study evaluated 114 patients who underwent arthroscopic surgery for shoulder instability to determine if humeral or glenoid bone loss were factors in recurrence. The mean age was 28 and most patients were male athletes. Glenoid and Hill-Sachs lesions were common. Recurrence occurred in 5 patients who all had Hill-Sachs lesions and participated in overhead/contact sports. Reoperation was successful in these 5 cases. Overall, 94.6% of patients were satisfied with the procedure and returned to work and sports without bone loss appearing to significantly increase recurrence risk.

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Shoulder arthroplasty

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This document summarizes shoulder arthroplasty. It discusses that shoulder lesions requiring arthroplasty are less common than hip and knee lesions. It outlines the indications for shoulder arthroplasty, which include osteoarthritis, rheumatoid arthritis, rotator cuff tear arthropathy, avascular necrosis, post-traumatic arthritis, and severe proximal humeral fractures. The options for shoulder arthroplasty procedures are hemiarthroplasty, total shoulder arthroplasty, and reverse total shoulder arthroplasty. Complications that can occur include instability, infection, heterotopic ossification, stiffness, periprosthetic fractures, and axillary nerve injury.

$Clavicle fractures$ $Clavicle fractures$

Clavicle fractures

sfkneerobot

Clavicle fractures are common injuries that can often be treated non-operatively. However, there are some cases where operative fixation is recommended, such as when there is significant shortening or angulation of the bone fragments. While non-operative treatment can have good outcomes, it carries a risk of nonunion or residual pain. Operative fixation aims to restore normal anatomy, but also risks complications from the hardware. There is variability in healing outcomes both between patients and between operative and non-operative treatment methods, and more research is still needed to determine the best approach in different situations.

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This study evaluated outcomes of a mini-open repair technique for Achilles tendon ruptures using a retrospective case series of 19 patients over an average follow-up period of 24 months. Clinical outcomes were assessed using the VISA-A score and Visual Analog Pain Scale (VAS). The mean post-operative VISA-A score was 92 and VAS score was significantly reduced from 5.5 pre-operatively to 0.9, indicating pain relief. Complications occurred in two patients but overall results demonstrated the mini-open technique provided minimal complications and high patient satisfaction while allowing for early mobilization. However, the study was limited by its small sample size and lack of pre-operative clinical measurements other than the VAS

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U01 clavicle ac_sc_joints1

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$Clavicle fractures$ $Clavicle fractures$

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The document summarizes information about clavicle fractures, including their epidemiology, anatomy, mechanisms of injury, classification systems, treatment options, and evidence for management approaches. Specifically, it finds that: 1) Clavicle fractures are among the most common fractures and midshaft fractures account for 69-80% of cases. 2) They are often caused by a direct blow to the shoulder and result in characteristic deformities from surrounding muscle and ligament forces. 3) Nonoperative treatment is usually indicated for nondisplaced fractures but recent evidence shows displaced or shortened fractures have higher risks of poor outcomes like pain, weakness and nonunion.

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$clavicle fracture new -1.pptx$ $clavicle fracture new -1.pptx$

clavicle fracture new -1.pptx

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Clavicle fractures are common injuries, especially in young active individuals. The majority occur in the midshaft region due to its thin bone and lack of muscle protection. Treatment depends on the location and degree of displacement/shortening. Nondisplaced fractures are usually treated nonsurgically with slings or strapping. Displaced fractures may require plate fixation, intramedullary nails, or coracoclavicular ligament repair/reconstruction to achieve union and restore function. Complications can include nonunion, malunion, hardware irritation, and neurovascular injury.

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$General management of fractures$ $General management of fractures$

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Meniscus Transplant and Replacement

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Comparison of Modified Kessler Technique versus Four Strand Cruciate Techniqu...

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Introduction: : Hand Tendon injuries are not uncommon. Achieving a satisfactory range of motion and preventing tendon rupture after repair of flexor tendon injuries remains a challenge to hand surgeons..Objectives: To compare functional outcome of tendon repair with Modified Kessler and four strand cruciate techniques.Material and Methods: Randomized control trial was conducted from July 2013 to June 2015. Both male and female patients of age 18 to 60 years who had clean lacerated injury proximal to wrist crease (Zone V) were eligible for inclusion in the study. Patients with dirty or infected wounds, or those having multiple injuries other than tendons, having injury to extensor tendons were excluded from the study. Arm A comprised of patients who underwent modified Kessler repair and Arm B included patients whose repair was done via four strand cruciate repair technique. The final outcome at 8 weeks was compared by using Strickland’s evaluation system. Results: A total of 140 fingers of 44 patients with sharp wrist laceration injury of long flexor tendons of fingers were included in this study. The average age of patients was 28.05 ± 10.42 years. Out of 44 patients, 28 (63.64%) were males and 16 (36.36%) females. At 8th week, satisfactory functional outcome (excellent group according to Strickland evaluation) was observed in 65.7% (46/70) fingers in four strand cruciate repair technique and in 28.6% (20/70) fingers in standard modified Kessler repair technique and the difference was statistically significant (P<0.001). Conclusion: Four strand cruciate repair technique is better than standard modified Kessler method for repair of long flexor tendons of fingers.

Comparison of Modified Kessler Technique versus Four Strand Cruciate Techniqu...

Crimsonpublisherssmoaj

Introduction: Hand Tendon injuries are not uncommon. Achieving a satisfactory range of motion and preventing tendon rupture after repair of flexor tendon injuries remains a challenge to hand surgeons. Objectives: To compare functional outcome of tendon repair with Modified Kessler and four strand cruciate techniques. Material and Methods: Randomized control trial was conducted from July 2013 to June 2015. Both male and female patients of age 18 to 60 years who had clean lacerated injury proximal to wrist crease (Zone V) were eligible for inclusion in the study. Patients with dirty or infected wounds, or those having multiple injuries other than tendons, having injury to extensor tendons were excluded from the study. Arm A comprised of patients who underwent modified Kessler repair and Arm B included patients whose repair was done via four strand cruciate repair technique. The final outcome at 8 weeks was compared by using Strickland’s evaluation system. Results: A total of 140 fingers of 44 patients with sharp wrist laceration injury of long flexor tendons of fingers were included in this study. The average age of patients was 28.05 ± 10.42 years. Out of 44 patients, 28 (63.64%) were males and 16 (36.36%) females. At 8th week, satisfactory functional outcome (excellent group according to Strickland evaluation) was observed in 65.7% (46/70) fingers in four strand cruciate repair technique and in 28.6% (20/70) fingers in standard modified Kessler repair technique and the difference was statistically significant (P< 0.001). Conclusion: Four strand cruciate repair technique is better than standard modified Kessler method for repair of long flexor tendons of fingers. https://crimsonpublishers.com/smoaj/fulltext/SMOAJ.000518.php For more Open access journals in Crimson Publishers Please click on link: https://crimsonpublishers.com/ For more Articles on Open Access Peer Reviewed High Impact Factor journals Please click on link: https://crimsonpublishers.com/smoaj/index.php

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Biceps tendon ruptures

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The document discusses biceps tendon ruptures, including the anatomy of the biceps muscle and different types of ruptures. Proximal ruptures can be traumatic or degenerative and are often associated with rotator cuff tears. Surgical management of proximal ruptures involves long head of biceps tenodesis, though the optimal site and technique are debated. Distal ruptures occur when the tendon is loaded during contraction and early repair is recommended for active individuals with distal ruptures.

Tendon transfers around the shoulder

Puneet Monga

This document discusses tendon transfers around the shoulder for conditions such as brachial plexus injuries and irreparable rotator cuff tears. It provides guidelines for tendon transfers, including using synergistic muscles with a straight line of pull. It describes procedures like the latissimus dorsi transfer to restore shoulder function for massive rotator cuff tears. The document also discusses tendon transfers combined with shoulder arthroplasty to restore shoulder rotation.

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arm balance asana - Comprehensive understanding of arm balancing asana

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Clavicle fractures

1. Clavicle Fractures Puneet Monga MAC Educational meet Aug’13

2. Mechanism of Injury

3. Mechanisms Fall on the shoulder Fall on outstretched hand

4. Displacement

5. Presentation • Look for Skin under jeopardy • Neuro-vascular injury

6. Classification

7. Classification Classified by thirds (Medial, Middle and Lateral) Most Common

8. Management

9. Non operative Majority non-operative management Sling vs Figure of 8 bandage • Prospective randomized trial of 61 patients • Simple sling-Less discomfort • Functional and cosmetic results identical • Alignment of healed fractures unchanged from the initial displacement in both groups Andersen et al., Acta Orthop Scand 58: 71-4, 1987.

10. Indications for surgery Young patients with high energy trauma

11. Comminuted fractures

12. Skin under jeopardy

13. Bony overlap > 20 mm shortening associated with increased risk of nonunion and poor functional outcome at 3 years (Hill et al, JBJS 1997: 79B: 537-9)

14. Floating shoulder

15. Floating shoulder

16. Open fractures Surgical Emergency

17. Lateral end fractures

18. Lateral end fractures

19. Surgical management Open Reduction and Internal Fixation

24. Post-op • Protect Soft tissues 2 weeks. • Build up as able; Early return to sports

25. Outcomes

26. Our results • 70 clavicle fractures • 3 plate fractures • 2 loosening Sinnott, Monga. Audit of Clavicle Fractures, WWL NHS Trust 2012

27. Summary Early surgery for with and leads to & reliable in the absence of