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The aim of the study was to find out if ulnar shortening is effective to treat ulnar wrist pain and which factors influence outcome. Thirty-seven patients were evalua- ted with a mean follow-up of 4.5 years. Thirty patients (81%) would undergo the same operation again although 21 (57%) had residual ulnar wrist pain. Mean disabilities of arm, shoulder and hand (DASH) score was 22 and mean patient rated wrist evaluation score (PRWE) was 33. DASH and PRWE scores were better in smokers, in patients operated on the non- dominant side and when follow-up was longer. PRWE score was worse in posttraumatic cases. Age, gender and type of osteotomy did not influence outcome. Three patients (8%) needed an additional operation for nonunion and in 17 (46%) plate and screws had to be removed. It can be concluded that ulnar shortening can be proposed to treat ulnocarpal wrist pain, but complete pain relief cannot be guaranteed and additional surgery may be required.This study presents a series of cases with surgically treated partial distal biceps tendon ruptures. The results of full distal biceps tendon rupture repair are also presented and a comparison is made between the two groups. Between 2001 and 2015, patients with partial and full ruptures of the distal biceps tendon were surgically repaired. At follow-up, the elbow function of the patients was assessed using the Oxford Elbow Score and maximum flexion and supination forces were measured. Forty-eight elbows in 43 patients returned to the follow-up visit. There was no statistically significant difference between the two groups in terms of function and strength. In this study, there were no statistical differences in outcome between the partial and the full distal biceps tendon groups. Surgical repair seems to be a valuable treatment option for partial distal biceps tendon ruptures.The objectives of this study were to determine the clinical and radiologic outcome after headless compression screw fixation through the transolecranon approach in patients who had sustained Dubberley type 2 and 3 articular surface fractures of the distal humerus. Twenty-seven patients were included in the study. There were 23 Dubberley type 2 and 4 type 3 fractures. All patients were available for a minimum of 24 months of follow-up. The evaluation was performed using the VAS, the DASH score, and the MEPS. The outcome was excellent in 18 patients, and 9 patients had a good result by the MEPS. The average range of flexion was 132° (range 110°-140°). The mean extensor lag was 7.9° (range 0°-30°). The main advantages of the transolecranon approach are direct fracture visualization, ease of joint inspection, help in reduction, and ease of correct perpendicular fracture fixation.Radial head replacement or ORIF are established treatment options for Mason type-III and type-IV fractures. The aim of this study was to provide results for reconstruction of these complex fractures using fine-threaded K-wires. We present results after reconstruction of 15 Mason type-III and 8 Mason type-IV fractures. Parameters used to describe the functional outcome were pain level, range of motion, and clinical scores. To estimate the elbow stability we performed ultrasound examinations under valgus/varus stress. All radial heads could be reconstructed. The average resting pain level was 0.9 of 10. The average ROM for extension/flexion was 134°, average forearm rotation was 159°. For the whole patient collective the mean MEPS was 86.5 points and the mean QuickDASH was 16.8 points with no significant difference for both groups. We can recommend ORIF with fine-threaded K-wires for Mason type-III and type-IV fractures of the radial head. Ligamentous injuries can be addressed successfully with external fixation.The purpose of this study is to evaluate radiological, clinical results and complication rates of dual plate fixation for severe metaphyseal comminuted fracture of proximal humerus. 21 patients who have proximal humerus fractures with impaired posteromedial buttress were enrolled. Fractures were treated with dual plate technique using Proximal Humeral Locking plate and Variable Angle Plate. Radiographic results were analyzed based on duration of union. For evaluation of the degree of anatomical reduction, neck shaft angle on the anteroposterior view was measured by simple plain radiography using the Paavolainen method, while anterior-posterior angulation was measured on the axial view. Degree of anatomic reduction was good in 17 patients (80.95%), fair in 3 patients (14.28%), and poor in 1 patient (4.77%). One case of impingement, and one case of avascular necrosis were noted. The dual plate technique provides stable fixation and satisfactory clinical and radiological results for severely comminuted metaphyseal fracture of the proximal humerus.The axilla is a region of clinical and surgical importance with plenty of anatomical variations. One of these is the presence of accessory muscles. The literature was reviewed in order to identify the different supernumerary muscles that are described in the axilla. Variant muscle slips arising from the pectoral muscle or latissimus dorsi muscle have been described. There still remains controversy regarding the phylogenetic origin of these different muscles. We described the most frequently reported muscles, their origin, and course. Further research is required regarding the innervation and influence on glenohumeral and scapulothoracic kinematics.This retrospective study evaluated the outcome after intramedullary nailing with the Rockwood Clavicle Pin (RCP) for acute displaced middle third clavicle fractures in adults. Of 84 included patients treated for this fracture 2003-2009, 66 (79%) were evaluated. Of these, 52 (79%) were re-examined, including fluoroscopy, while 14 patients (21%) were evaluated by mailed questionnaire. Primary outcome was Constant score (CS), secondary outcomes included Subjective Shoulder Value (SSV), healing rate at follow up, complications, and cosmetic appearance. Patients were re-evaluated with a mean follow-up of 39 months (range 13-96). Mean CS at follow up was 90 (range 55-100) and mean shoulder function measured with the SSV was 93 (range 36-100). Three (6%) of the re-examined patients had a non-union at follow up. Twelve (18%) had wound problems, with exposure of the lateral part of the pin in five patients (8%). There were no deep infections but seven patients (11%) were treated for superficial wound infections. Breakage of the implant occurred in one case (2%). Treatment of displaced midshaft clavicle fractures with the RCP results in good clinical outcome and a high patient satisfaction with a high healing rate. However, the technique is associated with postoperative complications. Level of evidence Level IV, Case series with no comparison group. Treatment study.The purpose of this study was to compare prospecti- vely the radiographic and clinical results of patients treated with tightrope through either mini-open or percutaneous stabilization for acute AC joint injuries. Eighty patients were included in this study and were randomly divided into two groups. Group A included 40 injuries treated with mini-open repair. Group B consisted of 40 injuries treated with percutaneous stabilization. Demographic and clinical data were comparable between the two groups before surgery (P>0.05). Peri-operative data, complications and clinical outcomes between the two groups were compared. The average follow-up time of Group A, was 26.5±4.3 months and Group B, was 25.2±5.6 months (P>0.05). The mean operative time was 63.2±9.6 minutes and 45.6±7.1 minutes, and the mean incision length was 6.0±1.5 cm and 4.0±0.8 cm, respectively. The operative time and incision length were significantly longer in Group A (both P0.05). Both methods were efficient methods for acute AC joint dislocation. However, percutaneous fixation had the advantages of a shorter surgical time and smaller incision length.MUA, manipulation under anesthesia ; FS, frozen shoulder ; SPADI, Shoulder Pain and Disability Score ; OSS, Oxford Shoulder Score ; NPRS, Numeric Paind Rating Scale. Manipulation under anesthesia is a well-established, but controversial, treatment for frozen shoulders. check details We will evaluate our results of manipulation and physiotherapy in stage two frozen shoulders. Questionnaires were sent to 65 patients with stage 2 frozen shoulders, treated with manipulation under anaesthesia between January 2012 and January 2014. Outcome parameters consisted of SPADI, OSS, EQ-5D, pain and satisfaction. A response rate of 75% was obtained. Mean follow up was 21 months (range 11-36). The median SPADI score was 11.2 (IQR 0.8-25.2) and median OSS was 39.0 (IQR 30-43). Only 72% of patients reported that they reached their pre injury level of functioning. A satisfaction rate of 92% was reported. Manipulation is a relatively easy intervention with a high satisfaction rate. We assume that manipulation could shorten the duration of symptoms. However, this needs to be confirmed in a randomized trial with a control group.Factors associated with tendon degeneration have not been fully investigated. The purpose of this study was to identify factors associated with tendon degeneration in patients with rotator cuff tear. A total of 93 patients with a full-thickness rotator cuff tear (fRCT) were included in the study. A full-thickness supraspinatus tendon sample was harvested from the middle portion between the lateral edge and the musculotendinous junction, and assessed histologically. Association between the degree of tendon degeneration and factors in demographic, clinical, radiologic, and arthroscopic categories were investigated. The mean of the total degeneration score was significantly lower in patients with symptom duration of 6 months or less than longer than 6 months (13.1 ± 2.6 vs 14.4 ± 2.3, p = 0.010). This study showed that tendon degeneration significantly progressed 6 months after the onset of symptoms, and suggested early intervention to avoid further deterioration of tendon degeneration.One of the most powerful excitatory synapses in the brain is formed by cerebellar climbing fibers, originating from neurons in the inferior olive, that wrap around the proximal dendrites of cerebellar Purkinje cells. The activation of a single olivary neuron is capable of generating a large electrical event, called “complex spike”, at the level of the postsynaptic Purkinje cell, comprising of an initial large-amplitude spike followed by a long polyphasic tail of small-amplitude spikelets. Several ideas discussing the role of the cerebellum in motor control are centered on these complex spike events. However, these events, only occurring 1-2 times per second, are extremely rare relative to Purkinje cell “simple spikes” (standard sodium-potassium action potentials). As a result, drawing conclusions about their functional role has been very challenging. In fact, because standard spike sorting approaches cannot fully handle the polyphasic shape of complex spike waveforms, the only safe way to avoid omissions and false detections has been to rely on visual inspection by experts, which is both tedious and, because of attentional fluctuations, error prone. Here we present a deep learning algorithm for rapidly and reliably detecting complex spikes. Our algorithm, utilizing both action potential and local field potential signals, not only detects complex spikes much faster than human experts, but it also reliably provides complex spike duration measures similar to that of the experts. A quantitative comparison of our algorithm’s performance to both classic and novel published approaches addressing the same problem reveals that it clearly outperforms these approaches.