Methods: Patients with displaced midshaft clavicular fractures were randomized either to nonoperative treatment with a sling or to operative treatment with a stainless steel 3.5-mm reconstruction plate. Outcome measures were the Constant shoulder score, DASH (Disabilities of the Arm, Shoulder and Hand) score, pain, fracture-healing, and complications. The null hypothesis was that the Constant a...

We report a rare case of a 39-year-old man with bilateral posterior dislocated shoulder joints with comminuted fractures of the humeral heads after an epileptic seizure. Posterior shoulder dislocations prove to be a diagnostic challenge and in this case were missed at initial presentation. After a failed attempt of osteosynthesis and removal of material, he received a hemi-prosthesis in separat...

Whether operative treatment for complex proximal humeral fractures has a greater benefit over nonoperative treatment is uncertain. The authors conducted a meta-analysis to include all randomized controlled trials (RCTs) to determine the advantages and disadvantages of operative vs nonoperative treatment. Multiple databases, online registries of RCTs, and proceedings from major meetings were sys...

Nowadays, the exact efficacy of intramedullary devices fixation and plate fixation for adult displaced midshaft clavicle fractures (DMCF) is still debated. This study aims to re-assess the functional outcomes and complications of the two optimal surgical approaches. Cochrane Central Register of Controlled Trials, EMABASE, and PubMed databases were searched for the literature that studied the ef...

Patients: 60 patients (mean age, 26 y, 87% men) with traumatic anterior instability of the shoulder, no shoulder symptoms or surgery before the first traumatic dislocation, ≤4 episodes of anterior dislocation of the shoulder, no clinical evidence of multidirectional instability, and radiological evidence of ≤30% loss of substance of the humeral head. All patients underwent arthroscopy to confir...

Bilateral shoulder dislocations are rare, and if they occurred, posterior type of dislocations is common. Bilateral anterior shoulder dislocations are very rare and occur due to trauma with unique mechanism of injury. We report a case of unreduced simultaneous bilateral anterior dislocations of shoulder without associated fractures in a forty-year-old man following a unique mechanism of injury;...

OBJECTIVE The purpose of this retrospective study was to evaluate the medium-term to longer-term results of type 1 displaced capitellar fractures treated with closed reduction. DESIGN Retrospective case series. PATIENTS Eight consecutive cases (7 adults; 1 child) with type 1 capitellar fractures. INTERVENTION Closed reduction of type 1 capitellar fractures and 4 weeks of postreduction imm...

This updated meta-analysis investigated whether operative treatment is superior to nonoperative treatment in complex proximal humeral fractures. The authors searched the Cochrane Central Register of Controlled Trials, PubMed, and EMBASE. Randomized controlled trials that evaluated operative vs nonoperative treatment for exclusively 3- or 4-part proximal humeral fractures were considered. Six st...

BACKGROUND Fractures of the proximal humerus are common injuries and account for 4-5 percent of all fractures, second only to hip and wrist fractures. The incidence is positively correlated with age and osteoporosis, and is likely to increase. Displaced four-part fractures are among the most severe injuries, accounting for 2-10 percent of proximal humeral fractures. The optimal intervention is ...

Morbidity following un-united and mal-united adult clavicle fractures is being increasingly recognised and the indications for operative treatment of displaced fractures of the clavicle are increasing. Plate fixation options include low contact dynamic compression plates, which are strong, but difficult to contour and cause soft tissue irritation. Reconstruction plates are easier to contour, bu...