Christopher Chuinard

The incidence of proximal humerus fractures is increasing; most are treated non-operatively, but sequelae of these fractures remain a treatment challenge whether surgery has been performed or not. A common classification system can assist treating physicians with diagnosis and treatment options based upon expected outcomes. Reverse shoulder arthrop...

Neuropathies of the elbow are a common cause of pain and disability. When conservative treatment fails, surgical treatments have been designed to alleviate compression, decrease tension, or both. Traditional surgical approaches provide extensile exposure to provide access to constricting anatomy, while preventing injury to vulnerable anatomy. Minim...

Neuropathies of the elbow are a common cause of pain and disability. When conservative treatment fails, surgical treatments have been designed to alleviate compression, decrease tension, or both. Traditional surgical approaches provide extensile exposure to provide access to constricting anatomy, while preventing injury to vulnerable anatomy. Minim...

Where Are We Now?Care of patients with proximal humerus fractures and shoulder arthritis has advanced tremendously in the last half-century. What began as simple fracture management and palliative care for the patient with arthritis, was transformed in the 1970s by Neer’s seminal work [1], and now offers surgeons and their patients advanced surgica...

In some patients nonoperative treatment of a rotator cuff tear is sufficient, while in others it is only the first stage of treatment prior to surgery. Fatty infiltration progresses throughout the nonoperative treatment although it is not known at what point fatty infiltration contributes to poor functional outcomes, absence of healing, or increase...

To evaluate long-term clinical outcome of proximal carpectomy. Our assumption was that this intervention should result in long-term benefit, making a wrist painless, mobile, and functional, compatible with social and professional life, whatever the initial etiology of the degenerative wrist. We report a continuous single centre retrospective series...

The purpose of this study was to evaluate the results of revision arthroscopic stabilization after failed open anterior shoulder stabilization. We studied a retrospective series of 22 consecutive patients with recurrent anterior shoulder instability after open surgical stabilization (12 Latarjet procedures, 4 Eden-Hybinette procedures, 3 open Banka...

The purpose of this study is to specifically evaluate the implications of unlinked and linked designs on the survivorship of revision surgery. Between 1972 and 1990, 352 linked and 151 unlinked prostheses were inserted at our institution. One-hundred and twenty-two elbows (24%) underwent subsequent revision: 55 linked (16%) and 67 unlinked (44%). S...

The purpose is to report the results of reverse shoulder arthroplasty (RSA) after previous failed rotator cuff surgery. A retrospective multicenter study of 42 RSA in 40 patients (mean age, 71 years) with a mean follow-up of 50 months. Thirty shoulders presented with a pseudoparalytic shoulder and 12 with a painful shoulder with maintained active a...

The "terrible triad" of the elbow is the combination of an elbow dislocation, radial head and a coronoid process fracture. Because of a combined sagittal, frontal and transverse instability, these injuries are notoriously difficult to treat. We report our results with a technique for reconstruction of "terrible triad" injuries with either no factur...

Overhead athletes report an inconsistent return to their previous level of sport and satisfaction after arthroscopic SLAP lesion repair. Arthroscopic biceps tenodesis offers a viable alternative to the repair of an isolated type II SLAP lesion. Cohort study; Level of evidence, 3. Twenty-five consecutive patients operated for an isolated type II SLA...

Although a reverse shoulder arthroplasty (RSA) can restore active elevation in the cuff deficient shoulder, it cannot restore active external rotation when both the infraspinatus and teres minor muscles are absent or atrophied. We hypothesized that a latissimus dorsi and teres major (LD/TM) transfer with a concomitant RSA would restore shoulder fun...

Introduction La perte définitive de l’élévation active et de la rotation externe active observée dans quelques épaules avec une arthrose combinée à un déficit de coiffe des rotateurs constitue un handicap très pénalisant. Des gestes aussi simples que manger, boire, faire sa toilette, se coiffer ou tendre la main deviennent impossibles. Le problème...

Definitive loss of active external rotation of the shoulder impacts an individual's ability to perform ADL's, creating severe disability. To restore active external rotation, we modified the L'Episcopo procedure by transferring both the latissimus dorsi and teres major (LD/TM) through a single delto-pectoral approach. The two tendons were rerouted...

We report the results of a new technique consisting of a combined arthroscopic Bankart repair associated with a transfer of the coraco-biceps tendon to reinforce the deficient anterior capsule by lowering the subscapularis. The procedure combines 2 parts: an arthroscopic Bankart repair, which recreates the glenoid concavity and retensions the infer...

Lesions of the long head of the biceps tendon are often associated with massive rotator cuff tears and may be responsible for shoulder pain and dysfunction. The purpose of this study was to evaluate the clinical and radiographic outcomes of isolated arthroscopic biceps tenotomy or tenodesis as treatment for persistent shoulder pain and dysfunction...

Loss of active external rotation of the shoulder, related to absent or fatty infiltrated rotator cuff muscles, results in a patient's inability to move the hand to the mouth or to the top of the head. When this condition is combined with pseudoparalysis of the shoulder (active flexion <90 degrees), the patient has a limb that is only functional at...

New suture methods and "double-row" fixation are advocated as means to improve the contact surface area and pressure at the tendon-bone interface, thereby increasing the success rate of arthroscopic cuff repair. By combining a medially placed inverted horizontal mattress suture with a laterally placed anchor, the "tension-band suture" offers the sa...

The indications and techniques for surgical management of fractures of the proximal humerus remain controversial, and the results of treatment are often disappointing, with a relatively high complication rate. Anatomic reduction can be difficult, and loss of fixation because of poor bone quality may lead to fracture displacement and malunion. Hemia...

The tendon of the long head of the biceps (LHB) is a frequent source of pain in the shoulder as the result of numerous pathologies, ranging from tendonitis, delamination, subluxation, to dislocation or hypertrophy with joint entrapment, affecting both the tendon and its pulley system. The treatment of pathology of the LHB tendon involves resection...

BACKGROUND: The purpose is to report the results of reverse shoulder arthroplasty (RSA) after previous failed rotator cuff surgery. MATERIALS AND METHODS: A retrospective multicenter study of 42 RSA in 40 patients (mean age, 71 years) with a mean follow-up of 50 months. Thirty shoulders presented with a pseudoparalytic shoulder and 12 with a painfu...

Although the first shoulder arthroplasty was implanted in 1893 by the French surgeon Jules-Emile Pean,[1][1] the development of the procedure came in the 1950s when Neer[2][2] described the results using a vitallium prosthesis to treat comminuted fractures of the head of the humerus. About 20

Unlabelled: Our goal was to analyze the results of unconstrained shoulder replacement in a large series of sequelae of proximal humeral fractures in order to validate a previously described surgical classification. In a multicenter study, we retrospectively evaluated 203 patients with sequelae of proximal humeral fractures who were treated with a...

A patient-entered computerized history, can be used as a means of medical data collection in a large inner city population. We evaluated whether a patient presenting to the Charity Hospital campus of the Medical Center of Louisiana in New Orleans would use a computer to provide medical information. To determine whether patients would self-administe...

OBJECTIVE: To determine the responses of the medial and lateral collateral ligaments (MCL, LCL) of the human knee to externally applied stresses. DESIGN: Differential variable reluctance transducers were used to measure length changes along the long posterior parallel fibers of the MCL and the middle third of the LCL through a flexion range of 15-1...

Repair of defective knee ligaments requires knowledge of their normal function to achieve optimal surgical results and to prevent joint arthropathy. Many investigations have been conducted detailing the mechanics of the collateral ligaments of the human knee. A review of this literature, however, reveals a bewildering array of results, making it di...