• Clinics in Shoulder and Elbow
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• v.23 no.3
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• pp.156-158
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• 2020

PHILOS plate fixation in osteoporotic proximal humerus fracture of old age is well-known for high complication rate, especially metal failure, providing various augmentation techniques, such as calcium phosphate cement, allogenous or autologous bone graft. We report a case of polymethyl methacrylate augmentation to provide appropriate reduction with a significant mechanical support. This can be a treatment option for displaced unstable osteoporotic proximal humerus fracture with marked bony defect.

• Clinics in Shoulder and Elbow
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• v.19 no.4
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• pp.223-228
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• 2016

Background: The aim of study was to confirm the clinical effectiveness and results of wide and single anterior approach for fractures occurring along length of humerus. Methods: A total of 23 patients with humeral fracture were enrolled into our study who were able to participate in at least one year of follow-up. Seven patients had segmental comminuted humeral fractures and 16 patients had distal humeral fractures. We made various tractions of the muscles to expose the proximal and the middle third humerus between the biceps and brachialis and the distal humerus by partial splitting of lateral side of biceps through a single incision. Postoperatively, we measured the Mayo elbow performance index (MEPI). Results: we achieved bone union in all 23 patients. Solid union of the bone was achieved at an average 13.9 weeks. Postoperatively, two complications were observed screw loosening and nonunion. Revision surgery was performed in both patients. The patient with bone nonunion was treated using bone grafts. No postoperative infections or peripheral neuropathies were observed. At the final follow-up (average 20 months), we found that the average MEPI functional score of the patients was 91.7 points regardless of the fracture site. Conclusions: Our whole humerus with a single incision was effective for the treatment of segmental comminuted and distal fractures. we believe it is a useful alternative to preexisting methods of fracture fixation.

• Clinics in Shoulder and Elbow
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• v.27 no.1
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• pp.72-78
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• 2024

Background: Clinical outcomes after fixation of distal humerus intraarticular fractures are directly related to the quality of reduction. The use of three-dimensional (3D)-printed fracture models can benefit preoperative planning to ensure good reduction. This review aims to determine if surgery performed with 3D printing assistance are faster and result in fewer complications and improved clinical outcomes than conventional methods. We also outline the benefits and drawbacks of this novel technique in surgical management of distal humerus fractures. Methods: A systematic literature search was carried out in various electronic databases. Search results were screened based on title and abstract. Data from eligible studies were extracted into spreadsheets. Meta-analysis was performed using appropriate computer software. Results: Three randomized controlled trials with 144 cases were included in the final analysis. The 3D-printed group had significantly shorter mean operating time (mean difference, 16.25 minutes; 95% confidence interval [CI], 12.74-19.76 minutes; P<0.001) and mean intraoperative blood loss (30.40 mL; 95% CI, 10.45-60.36 mL; P=0.005) compared with the conventional group. The 3D-printed group also tended to have fewer complications and a better likelihood of good or excellent outcomes as per the Mayo elbow performance score, but this did not reach statistical significance. Conclusions: Three-dimensional-printing-assisted surgery in distal humerus fractures has several benefits in reduced operating time and lower blood loss, indirectly decreasing other complications such as infection and anemia-related issues. Future good-quality studies are required to conclusively demonstrate the benefits of 3D printing in improving clinical outcomes.

• Journal of Haehwa Medicine
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• v.23 no.1
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• pp.157-166
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• 2014

Objective : The purpose of this study is to report the patient with radial nerve injury associated with humerus shaft fracture, who was improved by Korean medical treatments. Methods : The patient was treated by Jungsongouhyul pharmacopuncture, electrical stimulation therapy, physical therapy, and herbal medicine according to "Locating Yang brightness meridians" theory. Coding result, Numeric rating scale(NRS) and digital grip dynamometer were used to evaluate the wrist drop, numbness of fingers and grip power. Results : The patient showed the first sign of recovery after 6 weeks from onset. After 9 weeks from onset, the patient could perform delicate manual activity. Grip power showed noticeable improvement as well as coding result and NRS. Conclusions : The results suggest that providing Korean medical treatments according to "Locating Yang brightness meridians" theory is a good method for treating radial nerve injury associated with humerus shaft fracture. But further studies are required to concretely prove the effectiveness of this method for treating radial nerve injury associated with humerus fracture.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.2
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• pp.106-112
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• 2012

Radial nerve palsy after surgery of humerus fracture is uncommon complication. Occasionally it needs operative treatment because of difficulty to accurate evaluation. We report this case of radial nerve palsy after surgery of humerus shaft fracture with ultrasound examination. We checked the continuity of radial nerve and radial nerve palsy was complete recovered with conservative treatment.

• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.1
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• pp.62-70
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• 2003

Purpose: We examined the kinematics and kinetics of the shoulder in youth baseball pitchers in light of the mechanisms of development of little league shoulder and humeral retrotorsion. Materials and Methods: The joint kinematics and the net force and torque acting on the humerus were calculated in fourteen youth pitchers throwing in a simulated game. Results: The major force component acting on the humerus was a tensile force of 378$\pm$81 N that peaked just after ball release. The predominant torque on the humerus was an external rotation torque about the long axis of the humerus. This torque reached a peak value of 35.3$\pm$6.7 Nm about 73$\%$through the pitching motion. This torque is approximately 66$\%$ of the torque required to fracture of the adult humerus. Conclusions: The direction of the humeral torque was consistent with the development of increased humeral retrotorsion in the throwing arm. Shear stress arising from the high torque during the late cocking phase likely leads to deformation the relatively weak proximal humeral epiphysis. The external rotation torque applied to the humerus during the pitch also agrees with the proposed mechanism for development little league shoulder, which has been hypothesized to be due to rotational stresses acting on the epiphysis during the throwing motion.

• Clinics in Shoulder and Elbow
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• v.17 no.3
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• pp.134-137
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• 2014

To report the fracture of proximal humerus in the lateral anchor site after suture bridge repair. A 57-year-old female patient with shoulder pain on the right-side was admitted through the emergency room following a car accident. Seven weeks before the accident, the patient had undergone surgery at a different hospital for the repair of supraspinatus tendon rupture on the right-side via suture bridge technique. Humerus surgical neck fracture was confirmed by X-ray, and proximal humerus fracture at the anchor site was confirmed by magnetic resonance imaging. Following 7 months of conservative treatment resulted in satisfactory bone union and motion of the shoulder joint. We report the need of close observation during and after the arthroscopic repair of the rotator cuff in patients with osteoporosis.

• Clinics in Shoulder and Elbow
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• v.20 no.4
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• pp.236-239
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• 2017

After dual plating with a locking compression plate for comminuted intraarticular fractures of the distal humerus, the incidence of ulnar nerve injury after surgery has been reported to be up to 38%. This can be reduced by an anterior transposition of the ulnar nerve but some surgeons believe that extensive handling of the nerve with transposition can increase the risk of an ulnar nerve dysfunction. This paper reports ulnar nerve injuries caused by the incomplete insertion of a screw head in dual plating without an anterior ulnar nerve transposition for AO/OTA type C2 distal humerus fractures. When an anatomical locking plate is applied to a distal humeral fracture, locking screws around the ulnar nerve should be inserted fully without protrusion of the screw because an incompletely inserted screw can cause irritation or injury to the ulnar nerve because the screw head in the locking system usually has a slightly sharp edge because screw head has threads. If the change in insertion angle and resulting protruded head of the screw are unavoidable for firm fixation of fracture, the anterior transposition of the ulnar nerve is recommended over a soft tissue shield.

• Clinics in Shoulder and Elbow
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• v.8 no.2
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• pp.166-169
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• 2005

Periosteal chondroma is a slow growing benign chondroid tumor. It erode the surface of cortex and induce a saucer shape defect. Histologically, it occasionally show hypercellularity, mitosis which can lead to the erroneous diagnosis of malignant tumor. Clinical, radiographic and pathological investigations are necessary to establish the diagnosis. Marginal excision proved an effective treatment. To our knowledge, this benign chondroid tumor of humerus has never been previously reported in Korea. We report a case of periosteal chondroma of proximal humerus mimicking periosteal chondrosarcoma.

• Archives of Reconstructive Microsurgery
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• v.14 no.2
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• pp.138-143
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• 2005

In the high radial nerve palsy caused by displaced humeral shaft fracture, radial nerve have to be explored in the fracture site. 5 cases of the ruptured radial nerve at the fracture site of the humerus from January 1993 through January 2005 were treated at first by open reduction and internal fixation with plates and screws fixation and then defective radial nerves were grafted with autogenous sural nerves by microsurgical epineurial and or perineurial neurorrhaphy. At average 30.4 months follow-up, 5 cases were recovered from motor and sensory deficit with solid bony union of the humerus shaft fracture. Authors have confirmed that ruptured radial nerve in the humerus shaft fracture grafted with autogenous sural nerve with microsurgical epineurial and or perineurial neurorrhaphy would be expected good motor and sensory recovery.