Altered Glenohumeral Biomechanics in Proximal Humeral Fracture Malunion.

MedStar author(s):
Citation: Journal of the American Academy of Orthopaedic Surgeons. 29(23):e1167-e1175, 2021 Dec 01.PMID: 33369973Institution: MedStar Union Memorial HospitalDepartment: Curtis National Hand Center | Orthopaedic SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Shoulder Fractures | *Shoulder Joint | Biomechanical Phenomena | Bone Plates | Cadaver | Humans | Shoulder | Shoulder Fractures/su [Surgery]Year: 2021Local holdings: Available online from MWHC library: Oct 1993 - present, Available in print through MWHC library: 1999 - presentISSN:
  • 1067-151X
Name of journal: The Journal of the American Academy of Orthopaedic SurgeonsAbstract: DISCUSSION: Varus and antecurvatum proximal humerus deformities as small as 15degree were associated with notable alterations in glenohumeral joint mechanics. With valgus and retrocurvatum deformity, statistically significant joint alterations occurred only at higher deformity levels. Copyright (c) 2020 by the American Academy of Orthopaedic Surgeons.INTRODUCTION: There is little biomechanical evidence to support the traditional guideline that 45degree represents acceptable proximal humerus deformity. We evaluated glenohumeral contact pressure (GP) and area, subacromial contact pressure, and joint abduction to assess biomechanical changes with different proximal humerus deformities.METHODS: Fifteen fresh-frozen cadaver shoulders were used. Intact specimens were tested on a custom dynamic shoulder frame. Subsequently, a surgical neck fracture was made in each specimen and fixed using a custom dual hinge plate for fixation of 15degree, 30degree, and 45degree deformities in varus, valgus, antecurvatum, retrocurvatum, and combined varus-antecurvatum and valgus-retrocurvatum. Specimens were then retested.RESULTS: Compared with the intact state, GP was markedly lower with all levels of varus and varus-antecurvatum deformity. Valgus and combined valgus-retrocurvatum deformity of 45degree led to notable increases in GP compared with the intact state. Varus deformities of 30degree and 45degree caused significant increases in subacromial pressures and limited abduction markedly from 60degree to 54.2degree and 44.6degree (P < 0.001).All authors: Abbasi P, Lobao MH, Mistretta KL, Murthi AM, Parks BG, Wright MAOriginally published: Journal of the American Academy of Orthopaedic Surgeons. Publish Ahead of Print, 2020 Dec 24.Fiscal year: FY2022Fiscal year of original publication: FY2021Digital Object Identifier: ORCID: Date added to catalog: 2021-02-17
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 33369973 Available 33369973

Available online from MWHC library: Oct 1993 - present, Available in print through MWHC library: 1999 - present

DISCUSSION: Varus and antecurvatum proximal humerus deformities as small as 15degree were associated with notable alterations in glenohumeral joint mechanics. With valgus and retrocurvatum deformity, statistically significant joint alterations occurred only at higher deformity levels. Copyright (c) 2020 by the American Academy of Orthopaedic Surgeons.

INTRODUCTION: There is little biomechanical evidence to support the traditional guideline that 45degree represents acceptable proximal humerus deformity. We evaluated glenohumeral contact pressure (GP) and area, subacromial contact pressure, and joint abduction to assess biomechanical changes with different proximal humerus deformities.

METHODS: Fifteen fresh-frozen cadaver shoulders were used. Intact specimens were tested on a custom dynamic shoulder frame. Subsequently, a surgical neck fracture was made in each specimen and fixed using a custom dual hinge plate for fixation of 15degree, 30degree, and 45degree deformities in varus, valgus, antecurvatum, retrocurvatum, and combined varus-antecurvatum and valgus-retrocurvatum. Specimens were then retested.

RESULTS: Compared with the intact state, GP was markedly lower with all levels of varus and varus-antecurvatum deformity. Valgus and combined valgus-retrocurvatum deformity of 45degree led to notable increases in GP compared with the intact state. Varus deformities of 30degree and 45degree caused significant increases in subacromial pressures and limited abduction markedly from 60degree to 54.2degree and 44.6degree (P < 0.001).

English

Powered by Koha