1
|
Miquel J, Salomó-Domènech M, Santana F, Torrens C. Impact of surrogate outcomes in randomized controlled trials for shoulder rotator cuff tears. Arch Orthop Trauma Surg 2023; 143:6117-6122. [PMID: 37219598 DOI: 10.1007/s00402-023-04911-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 05/15/2023] [Indexed: 05/24/2023]
Abstract
PURPOSE Surrogate outcomes are clinical endpoints that are used as substitutes for direct measures of how a patient feels, functions, or survives. The present study aims to analyze the impact of surrogate outcomes on the results of randomized controlled trials on shoulder rotator cuff tears disorders. METHODS Randomized controlled trials (RCTs) related to rotator cuff tear conditions published up until 2021 were retrieved from the PubMed and ACCESSSS databases. The primary outcome of the article was considered a surrogate outcome when the authors used radiological, physiologic, or functional variables. The result of the article was considered positive when results supported the intervention based on the trial's primary outcome. We recorded the sample size, the mean follow-up, and the type of funding. Statistical significance was set at p < 0.05. RESULTS A total of 112 papers were included in the analysis. The mean sample size was 87.6 patients; mean follow-up period was 25.97 months. Thirty-six out of 112 RCTs used a surrogate outcome as a primary endpoint. More than half of papers using surrogate outcomes reported a positive finding (20 out of 36), while 10 out of 71 RCTs using patient-centered outcomes favored the intervention (14.08%, p < 0.001) [RR = 3.94 (95% CI 2.07-7.51)]. The mean sample size was smaller in trials using surrogate endpoints (75.11 vs 92.35 patients, respectively, p = 0.049), while the follow-up was shorter (14.12 m vs. 31.9 m, p < 0.001). Approximately 25% of the papers that reported surrogate endpoints (22.58%) were industry-funded projects. CONCLUSIONS The substitution of surrogate endpoints for patient-important outcomes in shoulder rotator cuff trials quadruplicates the chances of obtaining a favorable result that favors the analyzed intervention.
Collapse
Affiliation(s)
- Joan Miquel
- Orthopaedics & Trauma Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - M Salomó-Domènech
- Orthopaedics & Trauma Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - F Santana
- Orthopaedics & Trauma Department, Parc de Salut Mar, Barcelona, Spain
| | - C Torrens
- Orthopaedics & Trauma Department, Parc de Salut Mar, Barcelona, Spain
| |
Collapse
|
2
|
Farquharson B, Dixon D, Williams B, Clegg G, Macinnes L, Ramsay P, Torrens C. Developing a behavioural intervention to increase lay-people"s intentions to initiate CPR in the event of Out-of-Hospital Cardiac Arrest (OHCA). Eur J Cardiovasc Nurs 2021. [DOI: 10.1093/eurjcn/zvab060.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Medical Research Council
OnBehalf
BICeP Study Group
Background
Prompt, effective bystander cardiopulmonary resuscitation (CPR) is the single most important factor determining survival from out of hospital cardiac arrest (OHCA), increasing survival up to 4-fold. However only 35%-45% of people trained in CPR actually attempt it when required. This study uses psychological theory and behaviour change techniques (BCTs) to increase the proportion of bystanders who attempt CPR in a real emergency.
Design
Intervention development study
Methods
Intervention content was informed by two recent systematic reviews, which identified barriers to bystander CPR and BCTs within existing training programmes (PROSPERO CRD42018117438; CRD42019126745) and a qualitative study exploring participants’ views (n = 12) of draft text messages. A lay bystander user-involvement panel (n = 7) and an expert advisory group (comprising representatives from CPR training organisations) worked with the research team to co-produce the final intervention and agree the schedule for text message delivery. BCT content was assessed by two independent experts. A framework analysis of interviews was undertaken.
Results
Recognising and addressing fears, and helping people to better prepare for real-life situations were identified to be important to participants. Short, simple texts from a credible source and with a positive tone were strongly preferred, there was a strong aversion to anything "guilt-inducing". Pictures and personalisation were important, rewards less so. Regarding frequency: participants varied but around 1/week was considered adequate by most. A total of n = 35 text-messages with verified BCT content were co-developed with participants.
Conclusions
A text message intervention incorporating BCTs, which is acceptable to intended users and CPR trained individuals has been produced and will be subject to future evaluation.
Collapse
Affiliation(s)
- B Farquharson
- University of Stirling, Stirling, United Kingdom of Great Britain & Northern Ireland
| | - D Dixon
- University of Aberdeen, Aberdeen, United Kingdom of Great Britain & Northern Ireland
| | - B Williams
- Edinburgh Napier University, School of Health & Social Care, Edinburgh, United Kingdom of Great Britain & Northern Ireland
| | - G Clegg
- University of Edinburgh, Edinburgh, United Kingdom of Great Britain & Northern Ireland
| | - L Macinnes
- University of Edinburgh, Edinburgh, United Kingdom of Great Britain & Northern Ireland
| | - P Ramsay
- University of Dundee, Dundee, United Kingdom of Great Britain & Northern Ireland
| | - C Torrens
- University of Stirling, Stirling, United Kingdom of Great Britain & Northern Ireland
| |
Collapse
|
3
|
Miquel J, Martínez R, Santana F, Marimon P, Torrens C. Surgical treatment of proximal humeral fractures with the transosseous suture fixation. J Orthop Surg Res 2021; 16:405. [PMID: 34162416 PMCID: PMC8220733 DOI: 10.1186/s13018-021-02555-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The surgical treatment of displaced proximal humeral fractures is commonly affected by implant-related complications. We evaluated the functional and radiographic results of transosseous suture fixation in a series of displaced proximal humeral fractures (PHF). METHODS Sixty-four patients were retrospectively classified by age, sex, and the Neer fracture classification. Two-part greater tuberosity (2pGT) displaced fractures and 3-part (varus and valgus) and 4-part valgus impacted fractures were managed with fragment reduction and transosseous suture fixation. Patients with minimum follow-up of 24 months and assessed with the Constant-Murley score (CMS) were included. Radiological and medical complications, as well as reinterventions were also recorded. RESULTS Forty-six patients with a mean follow-up of 58 (24-132) and a mean age of 58 years old were analyzed. Patients with 2pGT (n = 10) fractures had a CMS of 76 points (59-89); patients with 3-part fractures (n = 22) had a score of 67 points (13-91); and those with 4-part fractures (n = 14) had a score of 64 (24-76) points. The overall complication rate was 6 out of 46, and 4 patients required reintervention for different reasons. Patients presenting with 3-part varus fractures had significantly lower functional outcomes scores (p = 0.007). Humeral head osteonecrosis was present in 9 patients and significantly affected the functional outcomes (p < 0.05). However, only three out of nine patients with osteonecrosis required subsequent surgery at the indicated follow-up. CONCLUSIONS The fracture reduction and transosseous fixation technique represents a safe technique with low complication and reintervention rates. The presence of humeral head necrosis did not lead to subsequent surgical intervention because no hardware had protruded. LEVEL OF EVIDENCE Level IV, retrospective study.
Collapse
Affiliation(s)
- J Miquel
- Corporació Sanitària Parc Taulí, Parc Taulí, 1., 08208, Barcelona, Spain.
| | - R Martínez
- Consorci Sanitari de l'Anoia, Avda Catalunya, 11, 08700, Igualada, Spain
| | - F Santana
- Parc de Salut Mar, Passeig Marítim, 25-29, 08003, Barcelona, Spain
| | - P Marimon
- Consorci Sanitari de l'Anoia, Avda Catalunya, 11, 08700, Igualada, Spain
| | - C Torrens
- Parc de Salut Mar, Passeig Marítim, 25-29, 08003, Barcelona, Spain
| |
Collapse
|
4
|
Detzen L, Cheat B, Besbes A, Hassan B, Marchi V, Baroukh B, Lesieur J, Sadoine J, Torrens C, Rochefort G, Bouchet J, Gosset M. NLRP3 is involved in long bone edification and the maturation of osteogenic cells. J Cell Physiol 2021; 236:4455-4469. [PMID: 33319921 DOI: 10.1002/jcp.30162] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/28/2020] [Accepted: 11/04/2020] [Indexed: 12/18/2022]
Abstract
Overexpression of the nucleotide-binding leucine-rich repeat protein 3 (NLRP3) inflammasome in chronic auto-immune diseases leads to skeletal anomalies, with severe osteopenia due to the activation of osteoclasts. Reproducing this phenotype in Nlrp3 knock-in mice has provided insights into the role of NLRP3 in bone metabolism. We studied the role of NLRP3 in physiological bone development using a complete Nlrp3 knock-out mouse model. We found impaired skeletal development in Nlrp3-/- mice, resulting in a shorter stature than that of Nlrp3+/+ mice. These growth defects were associated with altered femur bone growth, characterized by a deficient growth plate and an osteopenic profile of the trabeculae. No differences in osteoclast recruitment or activity were observed. Instead, Nlrp3-/- femurs showed a less mineralized matrix in the trabeculae than those of Nlrp3+/+ mice, as well as less bone sialoprotein (BSP) expressing hypertrophic chondrocytes. In vitro, primary osteoblasts lacking NLRP3 expression showed defective mineralization, together with the downregulation of BSP expression. Finally, follow-up by micro-CT highlighted the role of NLPR3 in bone growth, occurring early in living mice, as the osteopenic phenotype diminishes over time. Overall, our data suggest that NLRP3 is involved in bone edification via the regulation of hypertrophic chondrocyte maturation and osteoblast activity. Furthermore, the defect appeared to be transitory, as the skeleton recovered with aging.
Collapse
Affiliation(s)
- L Detzen
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Département de Parodontologie, Service d'Odontologie, AP-HP, Hôpital Rothschild, Paris, France
- Laboratoire d'Excellence INFLAMEX, France
| | - B Cheat
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Laboratoire d'Excellence INFLAMEX, France
| | - A Besbes
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Laboratoire d'Excellence INFLAMEX, France
- Faculté de Médecine Dentaire, Université de Monastir, Monastir, Tunisie
| | - B Hassan
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Laboratoire d'Excellence INFLAMEX, France
| | - V Marchi
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Laboratoire d'Excellence INFLAMEX, France
| | - B Baroukh
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Laboratoire d'Excellence INFLAMEX, France
| | - J Lesieur
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Laboratoire d'Excellence INFLAMEX, France
| | - J Sadoine
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Plateforme Imageries du Vivant, Faculté de Chirurgie Dentaire, Université de Paris, Paris, France
| | - C Torrens
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Laboratoire d'Excellence INFLAMEX, France
| | - G Rochefort
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Laboratoire d'Excellence INFLAMEX, France
| | - J Bouchet
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Laboratoire d'Excellence INFLAMEX, France
| | - M Gosset
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Laboratoire d'Excellence INFLAMEX, France
- Service de Médecine Bucco-Dentaire, AP-HP, Hôpital Charles Foix, Ivry/seine, France
| |
Collapse
|
5
|
Macintyre AK, Torrens C, Campbell P, Maxwell M, Pollock A, Biggs H, Woodhouse A, Williams JM, McLean J. Socioeconomic inequalities and the equity impact of population-level interventions for adolescent health: an overview of systematic reviews. Public Health 2020; 180:154-162. [PMID: 31923881 DOI: 10.1016/j.puhe.2019.11.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 10/29/2019] [Accepted: 11/12/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Despite robust evidence on health inequalities in adulthood, less attention has been paid to inequalities in adolescence. The aim of this overview was to examine systematic review (SR) evidence on the equity impact of population-level interventions intended to improve health, happiness and wellbeing for adolescents. STUDY DESIGN An overview (review of systematic reviews). METHODS Eleven electronic databases were systematically searched to identify SRs of population-level interventions for adolescent health. A secondary data analysis of socioeconomic inequality was conducted to identify whether SRs reported on primary studies in terms of disadvantage, by measures of socioeconomic status (SES) and by differential effects. RESULTS 35,310 review titles were screened; 566 full texts were retrieved and 140 SRs met the predefined selection criteria. Differential intervention effects were considered in 42/140 (30%) SRs, 18/140 (13%) reported primary studies using an SES measure and 16/140 (11%) explicitly reported differential effects. 15/140 SRs (11%) explicitly focused on socioeconomic inequalities; of these 4/15 reported differential intervention effects in more detail, 7/15 concluded there was insufficient primary evidence to identify the impact of interventions on socioeconomic inequalities and 4/15 planned to examine differential effects by SES, but this was not reported further. CONCLUSIONS Our overview identifies that there is limited SR evidence on the equity impact of population-level interventions for adolescent health. Strengthening the evidence on whether interventions narrow or widen inequalities for adolescents must be a priority for public health research.
Collapse
Affiliation(s)
- A K Macintyre
- Centre for Health Policy, University of Strathclyde, Lord Hope Building, 141 St. James Road, Glasgow, G4 0LT, UK.
| | - C Torrens
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, UK
| | - P Campbell
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, UK
| | - M Maxwell
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Unit 13 Scion House, University of Stirling Innovation Park, Stirling, FK9 4NF, UK
| | - A Pollock
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, UK
| | - H Biggs
- Mental Health Foundation, Merchants House, 30 George Square, Glasgow, G2 1EG, UK
| | - A Woodhouse
- Children in Scotland, Level 1, Rosebery House, 9 Haymarket Terrace, Edinburgh, EH12 5EZ, UK
| | - J M Williams
- University of Edinburgh, Room 2.4, Doorway 6, Medical Quad, Teviot Place, Edinburgh, EH8 9AG, UK
| | - J McLean
- Mental Health Foundation, Merchants House, 30 George Square, Glasgow, G2 1EG, UK
| |
Collapse
|
6
|
Palaiologou E, Etter O, Goggin P, Chatelet DS, Johnston DA, Lofthouse EM, Doherty R, Pearson-Farr J, Sengers BG, Torrens C, Cleal JK, Page AM, Lewis RM. Human placental villi contain stromal macrovesicles associated with networks of stellate cells. J Anat 2019; 236:132-141. [PMID: 31512233 PMCID: PMC6904625 DOI: 10.1111/joa.13082] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2019] [Indexed: 12/26/2022] Open
Abstract
Placental function is essential for fetal development and establishing the foundations for lifelong health. The placental villous stroma is a connective tissue layer that supports the fetal capillaries and villous trophoblast. All the nutrients that cross the placenta must also cross the stroma, and yet little is known about this region. This study uses high‐resolution three‐dimensional imaging to explore the structural complexity of this region within the placental villi. Serial block‐face scanning electron microscopy and confocal microscopy were used to image the placental villous stroma in three‐dimensions. Transmission electron microscopy (TEM) was used to generate high resolution two‐dimensional images. Stereological approaches were used to quantify volumes of stromal constituents. Three‐dimensional imaging identified stromal extracellular vesicles, which constituted 3.9% of the villous stromal volume. These stromal extracellular vesicles were ovoid in shape, had a median length of 2750 nm (range 350–7730 nm) and TEM imaging confirmed that they were bounded by a lipid bilayer. Fifty‐nine per cent of extracellular vesicles were in contact with a fibroblast‐like stellate cell and these vesicles were significantly larger than those where no contact was observed. These stellate cells formed local networks with adherent junctions observed at contact points. This study demonstrates that the villous stroma contains extracellular macrovesicles which are considerably larger than any previously described in tissue or plasma. The size and abundance of these macrovesicles in the villous stroma highlight the diversity of extracellular vesicle biology and their roles within connective tissues.
Collapse
Affiliation(s)
- E Palaiologou
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - O Etter
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - P Goggin
- Biomedical Imaging Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - D S Chatelet
- Biomedical Imaging Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - D A Johnston
- Biomedical Imaging Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - E M Lofthouse
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - R Doherty
- Biomedical Imaging Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - J Pearson-Farr
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - B G Sengers
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK.,Institute for Life Sciences, University of Southampton, Southampton, UK
| | - C Torrens
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.,Institute for Life Sciences, University of Southampton, Southampton, UK
| | - J K Cleal
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.,Institute for Life Sciences, University of Southampton, Southampton, UK
| | - A M Page
- Biomedical Imaging Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - R M Lewis
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.,Institute for Life Sciences, University of Southampton, Southampton, UK
| |
Collapse
|
7
|
Noguera L, Trigo L, Melero V, Santana F, Torrens C. Reverse shoulder arthroplasty for acute proximal humeral fractures: Postoperative complications at 7 days, 90 days and 1 year. Injury 2019; 50:371-375. [PMID: 30642623 DOI: 10.1016/j.injury.2019.01.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 12/29/2018] [Accepted: 01/04/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND In the last decade, the biomechanics of reverse shoulder arthroplasty (RSA) for proximal humeral fractures in the elderly have led to more functional outcomes and greater pain relief. However, its use has also introduced a significant rate of complications. The purpose of this study is to assess the complication rate of RSA in these cases as well as the relationship to ASA score and basic disease history. METHODS We evaluate patients who underwent RSA due to acute proximal humeral fractures at three hospitals from 2010 to 2016. We analyze previous disease and anticoagulant treatment, American Society of Anesthesiologists (ASA) Physical Status Classification, and the transfusion rate to correlate these factors with major and minor postoperative complications at 7, 90, and 365 days. RESULTS We include 103 patients (104 shoulders) over 65 years of age. Mean age is 77.31 years (62-91), 20 of which are male. The overall rate of complications is 25%, with 17.4% minor and 7.6% major complications. We observe a statistically significant relationship between a higher ASA score (3,4) and major complication at 90 days (p = 0.024) and a trend (p = 0.072) towards a higher ASA score with minor complication during the first week. Rheumatoid disease significantly increases major complications at 90 days (p = 0.037). The transfusion rate is 11.5%. CONCLUSIONS The overall major complication rate of RSA for acute fractures is low in the elderly population. Although, the patient's history (e.g. previous rheumatoid pathology, neurological diseases, or anticoagulant treatment) as well as their ASA score should be considered before RSA surgery. The higher the ASA score and the presence of rheumatoid disease, leads to a higher rate of major complications during the first 90 days after surgery. LEVEL OF EVIDENCE Level IV; Case series; Treatment study.
Collapse
Affiliation(s)
- L Noguera
- Department of Orthopaedic Surgery and Traumatology, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona (UAB), Carrer de Sant Quintí, 89, 08041, Barcelona, Spain.
| | - L Trigo
- Department of Orthopaedic Surgery and Traumatology, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona (UAB), Carrer de Sant Quintí, 89, 08041, Barcelona, Spain
| | - V Melero
- Department of Orthopaedic Surgery and Traumatology, Parc Sanitari Sant Joan de Déu, Hospital Sant Boi de Llobregat, Carrer del Dr. Antoni Pujadas, 40, 08830, Sant Boi de Llobregat, Barcelona, Spain
| | - F Santana
- Department of Orthopaedic Surgery and Traumatology, Parc de Salut Mar, Hospital del Mar & Hospital de l'Esperança, Universitat Autonoma de Barcelona (UAB), Passeig Marítim 25-29, 08003, Barcelona, Spain
| | - C Torrens
- Department of Orthopaedic Surgery and Traumatology, Parc de Salut Mar, Hospital del Mar & Hospital de l'Esperança, Universitat Autonoma de Barcelona (UAB), Passeig Marítim 25-29, 08003, Barcelona, Spain
| |
Collapse
|
8
|
Miquel J, Santana F, Palau E, Vinagre M, Langohr K, Casals A, Torrens C. Retaining or excising the supraspinatus tendon in complex proximal humeral fractures treated with reverse prosthesis: a biomechanical analysis in two different designs. Arch Orthop Trauma Surg 2018; 138:1533-1539. [PMID: 30062459 DOI: 10.1007/s00402-018-3016-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE We aimed to biomechanically evaluate the effect of the supraspinatus tendon on tuberosity stability using two different reverse shoulder arthroplasty (RSA) models for complex proximal humeral fractures (PHFs). METHODS Four-part proximal humeral fractures were simulated in 20 cadaveric shoulders. Two different RSA designs were implemented: a glenosphere-medialized model and a glenosphere-lateralized model. Tuberosities were reconstructed, and displacement of bony fragments was measured (mm) by placing three sensors: in the humeral diaphysis (D), in the greater tuberosity (GT), and in the lesser tuberosity (LT). Axial forces were induced and measured in Newton (N). The test was performed twice in each specimen, with and without the supraspinatus tendon. The regression line (RL) was measured in mm/N. RESULTS In the medialized model, the GT-D displacement was greater in the supraspinatus preserving model than that in the tendon excision model (p < 0.001), as well as for the LT-D displacement (p < 0.001). In the lateralized model, GT-D displacement and GT-LT distance were greater in the preserving model than that in the excision model (p < 0.001, p = 0.04). CONCLUSION The supraspinatus tendon resection leads to a more biomechanically stable tuberosity construct when performing RSA for PHFs, while the rest of the rotator cuff tendons (infraspinatus and teres minor) are retained in the greater tuberosity. LEVEL OF EVIDENCE Basic science study. Cadaveric study.
Collapse
Affiliation(s)
- Joan Miquel
- Orthopaedics and Trauma Department, Consorci Sanitari de l'Anoia, Avinguda de Catalunya, 11, 08700, Igualada, Barcelona, Spain.
| | - F Santana
- Orthopaedics and Trauma Department, Parc de Salut Mar. Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - E Palau
- Orthopaedics and Trauma Department, Hospital de Viladecans, Barcelona, Spain
| | - M Vinagre
- Center of Research of Biomedical Engineering Universitat Politècnica de Catalunya, Barcelona, Spain
| | - K Langohr
- Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Department of Statistics and Operations Research, Universitat Politècnica de Barcelona/Barcelonatech, Barcelona, Spain
| | - A Casals
- Center of Research of Biomedical Engineering Universitat Politècnica de Catalunya, Barcelona, Spain.,Institute for Bioenginering of Catalonia (IBEC), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - C Torrens
- Orthopaedics and Trauma Department, Parc de Salut Mar. Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| |
Collapse
|
9
|
Marcano-Fernández F, Balaguer-Castro M, Fillat-Gomà F, Ràfols-Perramon O, Torrens C, Torner P. Teaching Patients How to Reduce a Shoulder Dislocation: A Randomized Clinical Trial Comparing the Boss-Holzach-Matter Self-Assisted Technique and the Spaso Method. J Bone Joint Surg Am 2018; 100:375-380. [PMID: 29509614 PMCID: PMC5882288 DOI: 10.2106/jbjs.17.00687] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND There are many different techniques for reducing acute anterior dislocations of the shoulder, and their use depends on surgeon preference. The objective of this study was to compare the pain experienced by a patient performing a self-reduction technique with the pain felt during a reduction performed by a trained physician. METHODS The study was carried out at the emergency department of a tertiary referral center. Patients between 18 and 60 years of age with an acute anterior shoulder dislocation were randomly allocated into 2 groups. In 1 group the emergency doctor actively guided the reduction process with the Spaso technique (Sp group), and in the other group the patient used the Boss-Holzach-Matter (also known as Davos or Aronen) self-reduction technique (BHM group). The pain experienced by the patient during the reduction was recorded by means of a visual analogue scale (VAS) ranging from 0 to 10. Other recorded data included demographic characteristics, reduction time, and success rate. RESULTS Of 378 patients assessed for eligibility from May 2015 until February 2017, 197 did not meet the inclusion criteria, 58 met exclusion criteria, 22 declined to participate, and 41 withdrew before randomization. Sixty acute anterior shoulder dislocations were randomized into the Sp group (n = 30) or the BHM group (n = 30). The BHM group experienced significantly less pain during reduction than the Sp group (p = 0.047), with mean pain scores of 3.57 (standard deviation [SD] = 2.1]) and 5.26 (SD = 2.9), respectively. No significant difference between groups was found with respect to reduction time (105 seconds [range, 10 to 660 seconds] in the Sp group and 90 seconds [range, 5 to 600 seconds] in the BHM group; p = 0.6) or success rate (67% and 77%, respectively; p = 0.39). CONCLUSIONS The self-reduction technique results in less pain than, and is as efficient in achieving reduction of anterior shoulder dislocations as, the Spaso technique. These findings favor the use of the self-assisted method as an effective first-line treatment for shoulder dislocations seen in the emergency department as well as its use by patients with recurrent dislocation. LEVEL OF EVIDENCE Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Collapse
Affiliation(s)
- F.A. Marcano-Fernández
- Orthopedic Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain,E-mail address for F.A. Marcano-Fernández:
| | - Mariano Balaguer-Castro
- Orthopedic Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - F. Fillat-Gomà
- Orthopedic Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Ona Ràfols-Perramon
- Orthopedic Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - C. Torrens
- Orthopedic Department, Hospital del Mar de Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - P. Torner
- Orthopedic Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| |
Collapse
|
10
|
Miquel J, Fernández-Muñoz S, Romero A, Pelfort X, Torrens C. Do we publish what we preach? Analysis of Spanish Shoulder and Elbow Surgery Society publication rates. Rev Esp Cir Ortop Traumatol (Engl Ed) 2018. [DOI: 10.1016/j.recote.2017.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
11
|
Miquel J, Fernández-Muñoz S, Santana F, Torrens C. Do we publish what we preach? Analysis of the European Society for Surgery of the Shoulder and Elbow Congress publication rates. J Orthop Surg Res 2017; 12:119. [PMID: 28738879 PMCID: PMC5525281 DOI: 10.1186/s13018-017-0620-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 07/13/2017] [Indexed: 11/10/2022] Open
Abstract
Background Scientific congresses have become the most expedient method to communicate novel findings on any research topic. However, an important question is whether this information will be published in peer-reviewed journals. Our aim was to determine the publication rate of the abstracts presented at the European Society for Surgery of the Shoulder and Elbow Congress and analyze factors that may influence this rate. Methods A total of 398 abstracts reported in the Abstract Book from the 2008 European Society for Surgery of the Shoulder and Elbow Congress were examined and categorized by oral and poster presentations, topic, and the number of authors listed. A search in PubMed and Google Scholar for subsequent peer-reviewed publications was performed in September 2015. The time to publication after the meeting had been held; the type of journal and its impact factor at the time to publication were recorded for those abstracts that reached peer-reviewed journal publication. Results The overall publication rate for the 2008 European Society for Surgery of the Shoulder and Elbow oral and poster presentations was 45.20% after 7 years. The mean time to publication was 18.53 months, and the mean impact factor value was 2.32. Oral presentations were significantly better represented in journals than posters (64.40 vs. 35.40%, p < 0.001). Abstracts with a greater number of authors listed had better publication rates (p < 0.001). Conclusion Less than half of the oral presentations and posters at the 21st European Society for Surgery of the Shoulder and Elbow Congress were published in peer-reviewed journals. Oral presentations with a higher number of authors had an increased likelihood of being published.
Collapse
Affiliation(s)
- J Miquel
- Orthopaedics & Trauma Department, Consorci Sanitari de l'Anoia, Avinguda Catalunya 11, 08700, Igualada, Spain.
| | - S Fernández-Muñoz
- Orthopaedics & Trauma Department, Consorci Sanitari de l'Anoia, Avinguda Catalunya 11, 08700, Igualada, Spain
| | - F Santana
- Orthopaedics & Trauma Department, Parc de Salut Mar. Barcelona, Passeig Marítim 25-29, 08003, Barcelona, Spain
| | - C Torrens
- Orthopaedics & Trauma Department, Parc de Salut Mar. Barcelona, Passeig Marítim 25-29, 08003, Barcelona, Spain
| |
Collapse
|
12
|
Zeller-Plumhoff B, Roose T, Katsamenis OL, Mavrogordato MN, Torrens C, Schneider P, Clough GF. Phase contrast synchrotron radiation computed tomography of muscle spindles in the mouse soleus muscle. J Anat 2017; 230:859-865. [PMID: 28369928 DOI: 10.1111/joa.12606] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2017] [Indexed: 12/29/2022] Open
Abstract
Muscle spindles are skeletal muscle sensory organs involved in the sensation of position and movement of the body. We have explored the capability of phase contrast computed tomography to visualise muscle spindles in murine skeletal muscle. In particular, we have validated the visualisation of nerve fibres through phase contrast computed tomography using light microscopy on stained histological sections. We further present the first three-dimensional visualisation of muscle spindles in mouse soleus skeletal muscle in conjunction with the neurovascular bundle associated with it.
Collapse
Affiliation(s)
- B Zeller-Plumhoff
- Faculty of Engineering and the Environment, University of Southampton, Southampton, UK.,Helmholtz-Zentrum für Material- und Küstenforschung, Geesthacht, Germany
| | - T Roose
- Faculty of Engineering and the Environment, University of Southampton, Southampton, UK
| | - O L Katsamenis
- Faculty of Engineering and the Environment, University of Southampton, Southampton, UK.,μ-VIS X-ray Imaging Centre, University of Southampton, Southampton, UK
| | - M N Mavrogordato
- Faculty of Engineering and the Environment, University of Southampton, Southampton, UK.,μ-VIS X-ray Imaging Centre, University of Southampton, Southampton, UK
| | - C Torrens
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - P Schneider
- Faculty of Engineering and the Environment, University of Southampton, Southampton, UK
| | - G F Clough
- Faculty of Medicine, University of Southampton, Southampton, UK
| |
Collapse
|
13
|
Isart A, Sánchez JF, Santana F, Puig L, Cáceres E, Torrens C. [Morbidity and mortality of surgically treated proximal humerus fractures]. Rev Esp Cir Ortop Traumatol (Engl Ed) 2014; 58:223-8. [PMID: 24928529 DOI: 10.1016/j.recot.2014.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 10/30/2013] [Accepted: 02/04/2014] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The aim of the present study is to analyse the factors associated with mortality and the capacity to perform daily life activities (DLA) in patients with surgically treated proximal humeral fractures. METHODS A retrospective study was conducted on 94 patients with a surgically treated proximal humeral fracture, with a mean follow-up of 8 years (2 - 12 years). A correlation analysis was performed to determine the relationship between the type of fracture, surgical technique, comorbidities and mortality and DLA. The Student t test was used for statistical analysis. RESULTS A total of 72 patients were identified, 18.6% of them died during follow-up, all diagnosed with some comorbidity. There was no correlation between mortality, type of fracture or the technique used. Most of the patients (85.4%) had comorbidities, and 79.5% were completely independent for DLA. Although there was no relationship with the type of fracture, there was a significant reduction in the performing of DLA in patients treated with hemiarthroplasty, and in patients with neurological disorders. CONCLUSIONS There was a mortality of 18.6% among patients with surgically treated proximal humerus fractures. The majority of surgically treated patients were fully independent for DLA at long-term follow-up.
Collapse
Affiliation(s)
- A Isart
- Servicio de Cirugía Ortopédica y Traumatología, Institut Universitari Dexeus (ICATME), Barcelona, España.
| | - J F Sánchez
- Servicio de Cirugía Ortopédica y Traumatología, Hospital del Mar, Barcelona, España
| | - F Santana
- Servicio de Cirugía Ortopédica y Traumatología, Hospital del Mar, Barcelona, España
| | - L Puig
- Servicio de Cirugía Ortopédica y Traumatología, Hospital del Mar, Barcelona, España
| | - E Cáceres
- Servicio de Cirugía Ortopédica y Traumatología, Institut Universitari Dexeus (ICATME), Barcelona, España
| | - C Torrens
- Servicio de Cirugía Ortopédica y Traumatología, Institut Universitari Dexeus (ICATME), Barcelona, España; Servicio de Cirugía Ortopédica y Traumatología, Hospital del Mar, Barcelona, España
| |
Collapse
|
14
|
Musa MG, Torrens C, Clough GF. The microvasculature: a target for nutritional programming and later risk of cardio-metabolic disease. Acta Physiol (Oxf) 2014; 210:31-45. [PMID: 23758932 DOI: 10.1111/apha.12131] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 04/03/2013] [Accepted: 06/03/2013] [Indexed: 12/25/2022]
Abstract
There is compelling evidence that microvascular deficits affecting multiple tissues and organs play an important role in the aetiopathogenesis of cardio-metabolic disease. Furthermore, both in humans and animal models, deficits in small vessel structure and function can be detected early, often before the onset of macrovascular disease and the development of end-organ damage that is common to hypertension and obesity-associated clinical disorders. This article considers the growing evidence for the negative impact of an adverse maternal diet on the long-term health of her child, and how this can result in a disadvantageous vascular phenotype that extends to the microvascular bed. We describe how structural and functional modifications in the offspring microcirculation during development may represent an important and additional risk determinant to increase susceptibility to the development of cardio-metabolic disease in adult life and consider the cell-signalling pathways associated with endothelial dysfunction that may be 'primed' by the maternal environment. Published studies were identified that reported outcomes related to the microcirculation, endothelium, maternal diet and vascular programming using NCBI PubMed.gov, MEDLINE and ISI Web of Science databases from 1980 until April 2013 using pre-specified search terms. Information extracted from over 230 original reports and review articles was critically evaluated by the authors for inclusion in this review.
Collapse
Affiliation(s)
- M. G. Musa
- Vascular Research Group; Human Development and Health; Faculty of Medicine; University of Southampton; Southampton UK
| | - C. Torrens
- Vascular Research Group; Human Development and Health; Faculty of Medicine; University of Southampton; Southampton UK
| | - G. F. Clough
- Vascular Research Group; Human Development and Health; Faculty of Medicine; University of Southampton; Southampton UK
| |
Collapse
|
15
|
Martínez-Díaz S, Torrens C, Corrales M, Melendo E, Cáceres E. Estudio de concordancia y reproducibilidad en la evaluación de las radiotransparencias humerales en las hemiartroplastias cementadas de hombro. Rev Esp Cir Ortop Traumatol (Engl Ed) 2009. [DOI: 10.1016/j.recot.2008.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
16
|
Martínez-Díaz S, Torrens C, Corrales M, Melendo E, Cáceres E. Concordance and reproducibility in the assessment of humeral radiolucencies in cemented shoulder hemiarthroplasties. Rev Esp Cir Ortop Traumatol (Engl Ed) 2009. [DOI: 10.1016/s1988-8856(09)70133-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
17
|
Ginés A, Torrens C, Solano A, Ruiz A, Martínez S, Cáceres E. Prosthetic Version and Healing of the Greater Tuberosity: Their Influence on Functional Outcome in Implanted Hemiarthroplasties due to Fractures of the Proximal Humerus. Rev Esp Cir Ortop Traumatol (Engl Ed) 2007. [DOI: 10.1016/s1988-8856(07)70003-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
18
|
Brawley L, Torrens C, Anthony FW, Itoh S, Wheeler T, Jackson AA, Clough GF, Poston L, Hanson MA. Glycine rectifies vascular dysfunction induced by dietary protein imbalance during pregnancy. J Physiol 2003; 554:497-504. [PMID: 14578485 PMCID: PMC1664758 DOI: 10.1113/jphysiol.2003.052068] [Citation(s) in RCA: 98] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Protein restriction in rat pregnancy programmes the development of elevated systolic blood pressure and vascular dysfunction in the offspring. A recent study has shown that hypertension is reversed by maternal glycine supplementation. Whether this protective effect is exerted directly on the embryo and fetus, or indirectly via effects on the mother, is unknown although we have previously shown abnormalities in the maternal vasculature. We tested the hypothesis that dietary glycine repletion would reverse endothelial dysfunction in protein-restricted pregnant rat dams using wire myography. Impaired acetylcholine- (P < 0.01) and isoprenaline-induced (P < 0.05) vasodilatation in isolated mesenteric arteries (MA) from protein-restricted pregnant dams was accompanied by reduced vascular nitric oxide (NO) release (P < 0.05). Dietary glycine supplementation reversed vascular dysfunction in MA (P < 0.05) and improved NO release thus potentially protecting the maternal circulation. The impaired NO release in the MA of low protein diet dams was not accompanied by reduced eNOS mRNA expression, suggesting that eNOS activity was altered. Protein restriction did not alter the vascular function of a conduit artery, the thoracic aorta. These results provide evidence that adequate provision of glycine, a conditionally essential amino acid in pregnancy, may play a role in the vascular adaptations to pregnancy, protecting the fetus from abnormal programming of the cardiovascular system.
Collapse
Affiliation(s)
- L Brawley
- Centre for Developmental Origins of Health and Disease, Princess Anne Hospital, Coxford Road, Southampton SO16 5YA, UK
| | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Abstract
Tarsal coalitions are uncommon entities. Talocalcaneal and calcaneonavicular synostosis are present in most of the reported cases. Cubonavicular coalition represents only 1% of all the cases in the literature reviewed. The current authors report on a new case of bilateral cubonavicular coalition and present a literature review. The authors also report on the etiology, clinical and radiologic findings, and the treatment to be used. Tarsal coalitions are uncommon entities that must be suspected in an adolescent with painful feet who also has decreased mobility and deformity of the feet.
Collapse
Affiliation(s)
- X Piqueres
- Orthopaedic Department, Hospital de l'Esperança, Barcelona, Spain
| | | | | | | |
Collapse
|
20
|
Bisbe E, Escolano F, Castillo J, Torrens C. [Possible air embolism during shoulder arthroplasty]. Rev Esp Anestesiol Reanim 1999; 46:273. [PMID: 10439651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
|
21
|
López JM, Torrens C, León V, Marín M. Unusual fracture of distal third of the clavicle in a hockey player: case report and a new approach to treatment. Knee Surg Sports Traumatol Arthrosc 1999; 7:132-4. [PMID: 10223537 DOI: 10.1007/s001670050135] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Clavicle fractures represent 5% of all skeletal injuries, and the distal third of the clavicle is involved in approximately 10%-15% of all these fractures. The incidence of delayed union or non-union in Neer type II fractures of the distal third of the clavicle is high. The ideal treatment for Neer type II fractures of the distal third of the clavicle is still open to controversy. Several treatments have been proposed, but there is no consensus about the treatment of choice. The case reported here presents a unique type of fracture of the lateral end of the clavicle that, since a medial fragment is involved, is a Neer type II fracture, but because of the nature of the fracture line the coracoclavicular ligaments remained intact. Trans-bony suture between the two fracture fragments was performed as the only treatment. This treatment has not been previously described and, although it has just been used in a single case, it appears to be an effective, efficient and simple alternative for the treatment of Neer type II fractures of the distal third of the clavicle.
Collapse
Affiliation(s)
- J M López
- Department of Orthopaedics and Traumatology, Hospital de l'Esperança, Barcelona, Spain
| | | | | | | |
Collapse
|
22
|
Torrens C, Mestre C, Pérez P, Marin M. Subcoracoid dislocation of the distal end of the clavicle. A case report. Clin Orthop Relat Res 1998:121-3. [PMID: 9553543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Subcoracoid dislocation of the outer end of the clavicle in association with an acromial fracture is a rare injury usually produced by high energy trauma that moves the clavicle posterior to the conjoined tendon and inferior to the coracoid process. To restore the acromioclavicular joint, open reduction is needed. After the reduction is accomplished, the clavicle has to be stabilized with a coracoclavicular screw. The acromial fracture can be reduced and held with nonabsorbable sutures placed through the bone. To avoid osteolysis of the distal end of the clavicle and to be able to repair the torn ligaments, treatment should not be delayed.
Collapse
Affiliation(s)
- C Torrens
- Hospital de l'Esperança de Barcelona, Spain
| | | | | | | |
Collapse
|
23
|
Nogués X, Guelar A, Mestres C, Torrens C. [Gluteal compartment syndrome with normal interstitial pressure in a drug addict]. Med Clin (Barc) 1990; 94:316-7. [PMID: 2342395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|