The Experts below are selected from a list of 7089 Experts worldwide ranked by ideXlab platform
David Ring - One of the best experts on this subject based on the ideXlab platform.
-
fracture of the distal radius risk factors for complications after locked volar plate fixation
Journal of Hand Surgery (European Volume), 2011Co-Authors: Maximillian Soong, Roderick Van Leerdam, Thierry G Guitton, Julia A Katarincic, David RingAbstract:Purpose To identify risk factors for complications after volar locking plate fixation of distal radius fractures. Methods We assessed early postoperative complications in 594 patients with fracture of the distal radius repaired with a volar locking plate and a minimum 1-month evaluation in the medical record. Later complications were assessed among 321 patients as a subset of the original cohort with a minimum 6 months' evaluation. We compared patient demographics, fracture characteristics, and aspects of management between patients with and without complications in bivariate analysis. Multivariable logistic regression analysis was applied to identify the factors independently associated with complications. Results A total of 47 complications were documented in the medical record. Early complications occurred in 24 of 594, including 8 intra-articular screws and 7 patients with loss of fixation. Late complications occurred in 23 of 321, including 14 patients diagnosed with tendon irritation (one rupture of the flexor pollicis longus tendon) and 5 patients who had subsequent surgery to address dysfunction of the distal radioulnar joint (malunion, synostosis, and arthrofibrosis). Of the 47 complications, 26 were attributed to the plate, of which 9 were considered major (intra-articular screws and tendon rupture; 1.3% (8 out of 594) and less than 1% (1 out of 321) of the early and late groups, respectively). In the logistic regression models, fall from a height and an ipsilateral Elbow Injury were positive independent predictors of early complications, whereas high-volume surgeons and plates other than the most commonly used plate were positive independent predictors of later complications. Conclusions Volar locking plate fixation of distal radius fractures was associated with relatively few plate-related complications in our institutions. Factors indicating higher energy or complexity predicted early complications. The most common late complication was tendon irritation, which is less discrete and perhaps variably diagnosed. Further study is warranted regarding plate design and familiarity, which may help reduce complications. Type of study/level of evidence Prognostic IV.
-
radial head fractures loss of cortical contact is associated with concomitant fracture or dislocation
Journal of Shoulder and Elbow Surgery, 2010Co-Authors: Craig A Rineer, Thierry G Guitton, David RingAbstract:Hypothesis Among radial head fractures displaced greater than 2 mm (Broberg and Morrey modified Mason type 2), separation (complete loss of cortical contact) of at least 1 radial head fracture fragment is associated with a complex Injury pattern, meaning that there are other concomitant Elbow fractures or ligament injuries. Materials and methods We identified 291 consecutive skeletally mature patients with 296 radial head fractures treated during a 6-year period. Of these, 121 consecutive fractures of part of the radial head displaced greater than 2 mm (type 2) were classified according to whether there was complete lack of cortical contact between a fracture fragment and the rest of the proximal radius. Predictors of isolated vs complex Injury pattern were sought in bivariate and multivariable analyses. Results Of 121 fractures, 30 (25%) were classified as having cortical contact, and 91 (75%) were classified as not having cortical contact. Ten (33%) with cortical contact were part of a complex Elbow Injury, and 83 of 91 fractures (91%) without cortical contact were part of a complex Elbow Injury ( P Conclusions Among Mason type 2 fractures, complete loss of cortical contact of at least one fracture fragment is strongly predictive of a complex Injury pattern. Level of evidence 4, Retrospective case series, Treatment study
-
compartment syndrome associated with distal radial fracture and ipsilateral Elbow Injury
Journal of Bone and Joint Surgery American Volume, 2009Co-Authors: Raymond Hwang, Pieter Bas De Witte, David RingAbstract:Background: Forearm compartment syndrome is an uncommon sequela of distal radial fractures. This investigation tested the hypothesis that the risk of forearm compartment syndrome associated with an unstable, operatively treated fracture of the distal end of the radius is higher with a concomitant Injury of the ipsilateral Elbow. Methods: All patients who sustained an unstable fracture of the distal end of the radius and/or Injury to the Elbow (a fracture of the proximal end of the radius and/or ulna, simple Elbow dislocation, Elbow fracture-dislocation, or distal humeral fracture) and were operatively treated at two level-I trauma centers over a five-year period were identified from a comprehensive database. The prevalence of compartment syndrome in a cohort with an isolated distal radial fracture and a cohort with a simultaneous distal radial fracture and Elbow Injury were compared. Results: Nine (15%) of fifty-nine patients who sustained a simultaneous ipsilateral distal radial fracture and Elbow Injury had forearm compartment syndrome develop compared with three (0.3%) of 869 patients with an isolated unstable distal radial fracture (p < 0.001, relative risk = 50). The average time from presentation to the development of compartment syndrome and subsequent fasciotomy was twenty-seven hours. Three of the nine patients with injuries to both the Elbow and the wrist had a compartment syndrome develop after initial operative treatment of the injuries, requiring a return to the operating room for fasciotomy. Conclusions: Forearm compartment syndrome is a frequent complication of simultaneous unstable injuries to the Elbow and the distal end of the radius. Heightened vigilance for compartment syndrome is paramount in patients with this combination of injuries. Level of Evidence: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.
-
apparently isolated partial articular fractures of the radial head prevalence and reliability of radiographically diagnosed displacement
Journal of Shoulder and Elbow Surgery, 2007Co-Authors: Peter Kloen, Job N Doornberg, Andreas Elsner, Rene K Marti, Niek C Van Dijk, David RingAbstract:The purpose of this study was to measure the prevalence and reliability of the radiographic diagnosis of displacement of apparently isolated partial articular radial head fractures and use these factors to assess treatment considerations. Among 119 radiographically visible partial fractures of the radial head not associated with other wrist, forearm, or Elbow Injury, 101 were classified as Mason type 1 (85%), 11 as borderline between Mason type 1 and Mason type 2 fractures (9%), and 7 as Mason type 2 fractures (6%) according to Broberg and Morrey’s modification of the Mason classification. The intraobserver reliability of the classification of Mason type 1 and type 2 fractures was excellent (mean κ, 0.85), but the interobserver reliability was only moderate (multirater κ, 0.45). Because apparently isolated, stable partial fractures of the radial head are infrequently displaced and observers have moderate disagreement regarding the diagnosis of displacement, it is likely that displacement is overdiagnosed.
-
the ulnar nerve in Elbow trauma
Journal of Bone and Joint Surgery American Volume, 2007Co-Authors: Robert Shin, David RingAbstract:>The prevalence of ulnar nerve dysfunction after Elbow Injury is unknown because authors of published investigations have inadequately differentiated among acute Injury-related, acute surgery-related, and delayed (sub-acute or chronic) ulnar neuropathies and these retrospective case series have not included careful evaluation of ulnar nerve function. > Ulnan neuropathy is well documented after distal humeral fracture, but it can also develop following any complex Elbow trauma. > The ulnar nerve should be identified and protected during the treatment of a bicolumnar fracture of the distal part of the humerus, but current data are inconclusive regarding the value of routine anterior transposition of the nerve. > Although most delayed ulnar neuropathies present at a relatively late stage with weakness, with or without muscle atrophy, improved motor strength may be observed in some patients many years after ulnar nerve decompression. > Ulnar nerve decompression and transposition are becoming an integral part of many posttraumatic reconstructive Elbow procedures, but most recommendations for management of the ulnar nerve are based on retrospective reviews, anecdotal reports, and expert opinion.
Ellen Shanley - One of the best experts on this subject based on the ideXlab platform.
-
humeral torsion as a risk factor for shoulder and Elbow Injury in professional baseball pitchers
American Journal of Sports Medicine, 2015Co-Authors: Thomas J Noonan, Richard J Hawkins, Charles A Thigpen, Lane Bailey, Douglas J Wyland, Michael J Kissenberth, Ellen ShanleyAbstract:Background:Numerous studies have demonstrated that humeral retrotorsion is increased in the dominant arms of throwing athletes. No study has clearly defined the relationship between humeral retrotorsion and shoulder and Elbow Injury.Hypothesis:Uninjured professional pitchers will display more dominant humeral torsion (HT) than professional pitchers who sustain shoulder injuries but less than pitchers who sustain Elbow injuries.Study Design:Case-control study; Level of evidence, 3.Methods:Pitchers from the Colorado Rockies professional baseball organization were recruited for participation for this prospective Injury study from 2009 to 2013. HT was assessed using indirect ultrasonographic techniques and was measured prospectively in 255 pitchers before each spring training (average of 2 trials). From the beginning of the preseason to the end of the postseason, overuse upper extremity injuries (shoulder or Elbow) were tracked for each participating athlete. All athletes who reported pain or Injury to their ...
-
shoulder range of motion deficits in baseball players with an ulnar collateral ligament tear
American Journal of Sports Medicine, 2012Co-Authors: Craig J Garrison, Charles A Thigpen, Mollie A Cole, John E Conway, Michael J Macko, Ellen ShanleyAbstract:Background:Shoulder range of motion (ROM) deficits are associated with Elbow Injury in baseball players.Purpose:To compare the ROM characteristics of baseball players with a diagnosed ulnar collateral ligament (UCL) tear with those of a group of age-, activity-, and position-matched healthy controls.Study Design:Cross-sectional study; Level of evidence, 3.Methods:Sixty male competitive high school and collegiate baseball players participated. Thirty athletes (age [mean ± standard deviation], 18.20 ± 1.56 years) with a diagnosed UCL tear were compared with 30 (age, 18.57 ± 0.86 years) age-, activity-, and position-matched players without a UCL Injury. Of the 60 participants, there were 44 pitchers, 4 catchers, 5 infielders, and 7 outfielders. Participants were measured for shoulder internal rotation (IR), external rotation (ER), and horizontal adduction (HA) at 90° of shoulder elevation. Participants were also measured for Elbow extension in a seated position. Group comparisons were made between participan...
Richard J Hawkins - One of the best experts on this subject based on the ideXlab platform.
-
humeral torsion as a risk factor for shoulder and Elbow Injury in professional baseball pitchers
American Journal of Sports Medicine, 2015Co-Authors: Thomas J Noonan, Richard J Hawkins, Charles A Thigpen, Lane Bailey, Douglas J Wyland, Michael J Kissenberth, Ellen ShanleyAbstract:Background:Numerous studies have demonstrated that humeral retrotorsion is increased in the dominant arms of throwing athletes. No study has clearly defined the relationship between humeral retrotorsion and shoulder and Elbow Injury.Hypothesis:Uninjured professional pitchers will display more dominant humeral torsion (HT) than professional pitchers who sustain shoulder injuries but less than pitchers who sustain Elbow injuries.Study Design:Case-control study; Level of evidence, 3.Methods:Pitchers from the Colorado Rockies professional baseball organization were recruited for participation for this prospective Injury study from 2009 to 2013. HT was assessed using indirect ultrasonographic techniques and was measured prospectively in 255 pitchers before each spring training (average of 2 trials). From the beginning of the preseason to the end of the postseason, overuse upper extremity injuries (shoulder or Elbow) were tracked for each participating athlete. All athletes who reported pain or Injury to their ...
-
correlation of torque and Elbow Injury in professional baseball pitchers
American Journal of Sports Medicine, 2010Co-Authors: Adam W Anz, Brandon D Bushnell, Leah Griffin, Thomas J Noonan, Michael R Torry, Richard J HawkinsAbstract:Background: During the pitching motion, velocity is generated by the upper extremity kinetic chain on internal rotation of the shoulder and trunk translational/rotational motion. This generation of power places significant forces and torques on the Elbow and shoulder. Elbow valgus torque and shoulder rotational torque are theoretically linked to Elbow Injury.Hypothesis: Pitchers experiencing higher levels of Elbow valgus torque and shoulder external rotation torque throughout the pitching motion are more likely to suffer Elbow Injury than pitchers with lower levels of torque.Study Design: Cohort study; Level of evidence, 3.Methods: With an established biomechanical analysis model, 23 professional baseball pitchers were videotaped during spring training games and followed prospectively for the next 3 seasons for Elbow Injury. A mixed statistical model using differences of least squares means and analysis of variance was used to analyze the association between Elbow Injury and torque levels throughout the p...
-
association of maximum pitch velocity and Elbow Injury in professional baseball pitchers
American Journal of Sports Medicine, 2010Co-Authors: Brandon D Bushnell, Adam W Anz, Thomas J Noonan, Michael R Torry, Richard J HawkinsAbstract:BackgroundRecent literature has explored the association of upper extremity Injury in baseball players with various aspects of the pitching motion. To our knowledge, no study has directly evaluated the connection between maximum pitch velocity and Elbow Injury in professional baseball pitchers.HypothesisProfessional pitchers throwing at higher maximum ball velocity will have a higher risk of Elbow Injury.Study DesignCohort study; Level of evidence, 3.MethodsTwenty-three professional pitchers were analyzed during spring training games and the ball velocity of the fastest pitch thrown for a strike (maximum pitch velocity) was recorded. This group was then followed prospectively over the following 3 seasons for Elbow Injury significant enough to warrant inclusion on the disabled list and/or require surgery. The association between maximum pitch velocity and Elbow Injury was then analyzed using an unpaired Student t test.ResultsThere were 9 players with Elbow injuries in the group of pitchers studied, includi...
Lewis A. Yocum - One of the best experts on this subject based on the ideXlab platform.
-
glenohumeral internal rotation deficits in baseball players with ulnar collateral ligament insufficiency
American Journal of Sports Medicine, 2009Co-Authors: Joshua S. Dines, Meredith Akerman, Joshua B Frank, Lewis A. YocumAbstract:BackgroundThe kinetic chain of the throwing motion functions to optimize efficiency of proximal segments to decrease force loads seen at smaller, distal segments such as the ulnar collateral ligament. Several studies have shown that shoulder internal rotation forms the physiologic counter to the valgus torque generated during the late cocking phase of throwing. Previous studies have implicated decreased glenohumeral internal rotation as a cause of shoulder internal impingement. To date, an association between pathologic glenohumeral internal rotation deficit and Elbow Injury has not been exhibited.HypothesisThrowers with ulnar collateral ligament insufficiency will exhibit significantly increased glenohumeral internal rotation deficit.Study DesignCase control study; Level of evidence, 3.MethodsTwenty-nine baseball players with ulnar collateral ligament insufficiency were demographically matched with 29 control baseball players who had no history of shoulder, Elbow, or cervical spine Injury. The investigat...
Thomas J Noonan - One of the best experts on this subject based on the ideXlab platform.
-
humeral torsion as a risk factor for shoulder and Elbow Injury in professional baseball pitchers
American Journal of Sports Medicine, 2015Co-Authors: Thomas J Noonan, Richard J Hawkins, Charles A Thigpen, Lane Bailey, Douglas J Wyland, Michael J Kissenberth, Ellen ShanleyAbstract:Background:Numerous studies have demonstrated that humeral retrotorsion is increased in the dominant arms of throwing athletes. No study has clearly defined the relationship between humeral retrotorsion and shoulder and Elbow Injury.Hypothesis:Uninjured professional pitchers will display more dominant humeral torsion (HT) than professional pitchers who sustain shoulder injuries but less than pitchers who sustain Elbow injuries.Study Design:Case-control study; Level of evidence, 3.Methods:Pitchers from the Colorado Rockies professional baseball organization were recruited for participation for this prospective Injury study from 2009 to 2013. HT was assessed using indirect ultrasonographic techniques and was measured prospectively in 255 pitchers before each spring training (average of 2 trials). From the beginning of the preseason to the end of the postseason, overuse upper extremity injuries (shoulder or Elbow) were tracked for each participating athlete. All athletes who reported pain or Injury to their ...
-
correlation of torque and Elbow Injury in professional baseball pitchers
American Journal of Sports Medicine, 2010Co-Authors: Adam W Anz, Brandon D Bushnell, Leah Griffin, Thomas J Noonan, Michael R Torry, Richard J HawkinsAbstract:Background: During the pitching motion, velocity is generated by the upper extremity kinetic chain on internal rotation of the shoulder and trunk translational/rotational motion. This generation of power places significant forces and torques on the Elbow and shoulder. Elbow valgus torque and shoulder rotational torque are theoretically linked to Elbow Injury.Hypothesis: Pitchers experiencing higher levels of Elbow valgus torque and shoulder external rotation torque throughout the pitching motion are more likely to suffer Elbow Injury than pitchers with lower levels of torque.Study Design: Cohort study; Level of evidence, 3.Methods: With an established biomechanical analysis model, 23 professional baseball pitchers were videotaped during spring training games and followed prospectively for the next 3 seasons for Elbow Injury. A mixed statistical model using differences of least squares means and analysis of variance was used to analyze the association between Elbow Injury and torque levels throughout the p...
-
association of maximum pitch velocity and Elbow Injury in professional baseball pitchers
American Journal of Sports Medicine, 2010Co-Authors: Brandon D Bushnell, Adam W Anz, Thomas J Noonan, Michael R Torry, Richard J HawkinsAbstract:BackgroundRecent literature has explored the association of upper extremity Injury in baseball players with various aspects of the pitching motion. To our knowledge, no study has directly evaluated the connection between maximum pitch velocity and Elbow Injury in professional baseball pitchers.HypothesisProfessional pitchers throwing at higher maximum ball velocity will have a higher risk of Elbow Injury.Study DesignCohort study; Level of evidence, 3.MethodsTwenty-three professional pitchers were analyzed during spring training games and the ball velocity of the fastest pitch thrown for a strike (maximum pitch velocity) was recorded. This group was then followed prospectively over the following 3 seasons for Elbow Injury significant enough to warrant inclusion on the disabled list and/or require surgery. The association between maximum pitch velocity and Elbow Injury was then analyzed using an unpaired Student t test.ResultsThere were 9 players with Elbow injuries in the group of pitchers studied, includi...