Gregory K. Berry

Percutaneous humeral plating of fractures of the proximal humerus: results of a prospective multicenter clinical trial.

Objectives: To evaluate the safety and functional outcome of a recently described surgical technique of percutaneous plating for proximal humerus fractures. Design: Prospective clinical trial. Setting: Two urban Level 1 university trauma centers. Patients: From February 2002 to December 2003, 34 consecutive patients underwent surgery by 5 trauma surgeons from 2 teaching hospitals. Twenty-seven patients had 1-year follow-up. Intervention: The technique involved 2 minimal incisions with a lateral deltoid split and a more distal shaft incision. A proximal humerus-specific locking plate was implemented. Main Outcome Measurements: DASH (disabilities of the arm, shoulder, and hand) and Constant-Murley evaluation scores were used for functional evaluation. The presence of complications was noted. Results: Specifically, there were no axillary nerve injury injuries and no loss of reduction. The average Constant score at 1 year was 82 and the DASH score was 26. Conclusion: This study demonstrated that the functional outcome results correspond to a normal age-adjusted score signifying an acceptable result.

Circumferential Casting of Distal Radius Fractures.

Objectives: To determine the prevalence and predictive factors for the early cast alteration (splitting, trimming, and complete replacement) in patients with distal radius fractures (DRFs) treated in circumferential cast. To determine whether performing early cast alterations affects the fracture alignment. Design: Retrospective Cohort Study. Setting: Level 1 Trauma Center. Patients: All adult patients who presented with a DRF to a tertiary care hospital over a 3-year period. Intervention: All DRFs without immediate surgical indications are initially treated with circumferential casts at this center. Outcome Measurements: The following variables were analyzed: patient demographics, polytrauma at the time of injury, physician subspecialty performing reduction, and type of cast alteration. Radiographs were used to assess initial fracture characteristics and secondary displacement of reduction over time. Analysis was performed primarily to identify predictive variables for the early cast alteration and secondarily to determine the effect of these alterations on fracture alignment. Results: 296 patients were included in the study. One of every 4–5 patients had their cast altered within the first 10 days of treatment. One of 3 polytrauma patients had their cast altered. No type of cast alteration was found to be significantly predictive of loss of fracture alignment at 2 or 6 weeks. Conclusions: Cast alteration is commonplace after casting of DRFs but is not associated with the loss of alignment. Patients with polytrauma may benefit from immediate cast splitting. Level of Evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Retraction notice to Proximal humerus fractures treated by percutaneous locking plate internal fixation. [ OTSR 95/1 (2009) 56–62]

1 d vailable online: 20 February 2009. This article has been retracted at the request of the uthors and the editor-in-chief. Reason: The editors of Orthopaedics & Traumatology: urgery & Research (OTSR; editors-in-chief: J.M. Thomine nd P. Beaufils), and Dr Julien Girard, corresponding author, ave decided to retract the article: Proximal humerus ractures treated by percutaneous locking plate internal xation, by D.M. Rouleau, G.Y. Laflamme, G.K. Berry, .J. Harvey, J. Delisle, J. Girard, published in OTSR 009;95(1):56—62. Alerted by the university authorities of Montreal, the ditors of OTSR have observed that this work had been he object of a previous publication in the Journal of rthopaedic Trauma (editor-in-chief: Roy Sanders): Percutaeous plating of fractures of the proximal humerus: Results f a prospective multicenter clinical trial, by G.Y. Laflamme, .M. Rouleau, G.K. Berry, P.H. Beaumont, R. Reindl, E.J. arvey, J Orthop Trauma 2008;22(3):153—8.