Evidence map›Paper›PMID 35971598›Full record

ArticleClinics in shoulder and elbow2022

Biomechanical investigation of arm position on deforming muscular forces in proximal humerus fractures.

Christen E Chalmers, David J Wright, Nilay A Patel, Hunter Hitchens, Michelle McGarry, Thay Q Lee, John A Scolaro

Open access · diamondAbstract read
In one paragraph

Article in Clinics in shoulder and elbow, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.9field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Christen E ChalmersDepartment of Orthopedic Surgery, University of California Irvine, Irvine, CA, USA.
David J WrightDepartment of Orthopedic Surgery, University of California Irvine, Irvine, CA, USA.
Nilay A PatelDepartment of Orthopedic Surgery, University of California Irvine, Irvine, CA, USA.
Hunter HitchensCornell University, Ithaca, NY, USA.
Michelle McGarryOrthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, USA.
Thay Q LeeOrthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, USA.
John A ScolaroDepartment of Orthopedic Surgery, University of California Irvine, Irvine, CA, USA.
University of California, Irvine · USOrthopaedic Research Foundation · USCornell University · US

Funding

Foundation for Orthopedic Trauma
6 · The paper itself

Abstract

backgroundMuscular forces drive proximal humeral fracture deformity, yet it is unknown if arm position can help mitigate such forces. Our hypothesis was that glenohumeral abduction and humeral internal rotation decrease the pull of the supraspinatus and subscapularis muscles, minimizing varus fracture deformity.

methodsA medial wedge osteotomy was performed in eight cadaveric shoulders to simulate a two-part fracture. The specimens were tested on a custom shoulder testing system. Humeral head varus was measured following physiologic muscle loading at neutral and 20° humeral internal rotation at both 0° and 20° glenohumeral abduction.

resultsThere was a significant decrease in varus deformity caused by the subscapularis (p<0.05) at 20° abduction. Significantly increasing humeral internal rotation decreased varus deformity caused by the subscapularis (p<0.05) at both abduction angles and that caused by the supraspinatus (p<0.05) and infraspinatus (p<0.05) at 0° abduction only.

conclusionsPostoperative shoulder abduction and internal rotation can be protective against varus failure following proximal humeral fracture fixation as these positions decrease tension on the supraspinatus and subscapularis muscles. Use of a resting sling that places the shoulder in this position should be considered.

Indexed as

BiomechanicsProximal humeral fractureRotator cuffShoulder joint

Identifiers

PMID35971598
PMCPMC9727481
OpenAlexW4292188623

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.