journal cme questions

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19. Dushuttle RP, Coyle MP, Zawadsky JP, Bloom H. Fractures of the capitellum. J Trauma 1985;25:317–321. 20. Morrey BF, Tanaka S, An KN. Valgus stability of the elbow. A definition of primary and secondary constraints. Clin Orthop Relat Res 1991;265:187–195. 21. Mancini GB, Fiacca C, Picuti G. Resection of the radial capitellum. Long-term results. Ital J Orthop Traumatol 1989;15:295–302. 22. Deutch SR, Jensen SL, Tyrdal S, Olsen BS, Sneppen O. Elbow joint stability following experimental osteoligamentous injury and recon- struction. J Shoulder Elbow Surg 2003;12:466 – 471. 23. Fowles JV, Kassab MT. Fracture of the capitulum humeri. Treatment by excision. J Bone Joint Surg 1974;56A:794 –798. 24. Sabo MT, Fay K, McDonald CP, Ferreira LM, Johnson JA, King GJ. Effect of coronal shear fractures of the distal humerus on elbow kinematics and stability. J Shoulder Elbow Surg 2010;19:670 – 680. 25. Sano S, Rokkaku T, Saito S, Tokunaga S, Abe Y, Moriya H. Herbert screw fixation of capitellar fractures. J Shoulder Elbow Surg 2005; 14:307–311. 26. Mahirogullari M, Kiral A, Solakoglu C, Pehlivan O, Akmaz I, Rodop O. Treatment of fractures of the humeral capitellum using herbert screws. J Hand Surg 2006;31B:320 –325. 27. Kamineni S, Morrey BF. Distal humeral fractures treated with non- custom total elbow replacement. J Bone Joint Surg 2004;86A:940 – 947. 28. Garcia JA, Mykula R, Stanley D. Complex fractures of the distal humerus in the elderly. The role of total elbow replacement as primary treatment. J Bone Joint Surg 2002;84B:812– 816. 29. Frankle MA, Herscovici D Jr, DiPasquale TG, Vasey MB, Sanders RW. A comparison of open reduction and internal fixation and primary total elbow arthroplasty in the treatment of intraarticular distal humerus fractures in women older than age 65. J Orthop Trauma 2003;17:473– 480. 30. McKee MD, Veillette CJ, Hall JA, Schemitsch EH, Wild LM, McCormack R, et al. A multicenter, prospective, randomized, con- trolled trial of open reduction—internal fixation versus total elbow arthroplasty for displaced intra-articular distal humeral fractures in elderly patients. J Shoulder Elbow Surg 2009;18:3–12. 31. Cobb TK, Morrey BF. Total elbow arthroplasty as primary treatment for distal humeral fractures in elderly patients. J Bone Joint Surg 1997;79A:826 – 832. 32. Adolfsson L, Nestorson J. The Kudo humeral component as primary hemiarthroplasty in distal humeral fractures. J Shoulder Elbow Surg 2011;21:451– 455. 33. Adolfsson L, Hammer R. Elbow hemiarthroplasty for acute recon- struction of intraarticular distal humerus fractures: a preliminary report involving 4 patients. Acta Orthop 2006;77:785–787. 34. Parsons M, O’Brien R, Hughes J. Elbow hemiarthroplasty for acute and salvage reconstructions of intra-articular distal humerus frac- tures. Tech Shoulder Elbow Surg 2005;6:87–97. 35. Hardy P, Menguy F, Guillot S. Arthroscopic treatment of capitellum fracture of the humerus. Arthroscopy 2002;18:422– 426. 36. Feldman MD. Arthroscopic excision of type II capitellar fractures. Arthroscopy 1997;13:743–748. 37. Kuriyama K, Kawanishi Y, Yamamoto K. Arthroscopic-assisted reduc- tion and percutaneous fixation for coronal shear fractures of the distal humerus: report of two cases. J Hand Surg 2010;35A:1506 –1509. 38. Mitani M, Nabeshima Y, Ozaki A, Mori H, Issei N, Fujii H, et al. Arthroscopic reduction and percutaneous cannulated screw fixation of a capitellar fracture of the humerus: a case report. J Shoulder Elbow Surg 2009;18:e6 –9. 39. Ring D. Open reduction and internal fixation of an apparent capitel- lar fracture using an extended lateral exposure. J Hand Surg 2009; 34A:739 –744. 40. Malki AA, Salloom FM, Wong-Chung J, Ekri AI. Cannulated screw fixation of fractured capitellum: surgical technique through a limited approach. Injury 2000;31:204 –206. 41. Elkowitz SJ, Polatsch DB, Egol KA, Kummer FJ, Koval KJ. Capi- tellum fractures: a biomechanical evaluation of three fixation meth- ods. J Orthop Trauma 2002;16:503–506. 42. Mehdian H, McKee MD. Fractures of capitellum and trochlea. Orthop Clin North Am 2000;31:115–127. 43. Sen MK, Sama N, Helfet DL. Open reduction and internal fixation of coronal fractures of the capitellum. J Hand Surg 2007;32A:1462–1465. 44. Brouwer KM, Jupiter JB, Ring D. Nonunion of operatively treated capitellum and trochlear fractures. J Hand Surg 2011;36A:804 – 807. JOURNAL CME QUESTIONS Coronal Shear Fractures of the Distal Humerus What imaging study is best to guide surgical planning for a coronal shear fracture of the distal humerus? a. AP, lateral, internal oblique, and external oblique x-rays b. Intraoperative arthrogam c. CT scan d. MRI scan e. Transpiral tomography In an elderly patient, what treatment is preferable for a coronal shear fracture of the distal humerus with moderate comminution? a. Excision of the fracture fragment b. Arthroscopic reduction and internal fixation c. Open reduction internal fixation d. Hemiarthroplasty e. Total elbow arthroplasty To take the online test and receive CME credit, go to http://www.jhandsurg.org/CME/home. CORONAL SHEAR FRACTURES OF THE DISTAL HUMERUS 2417 Current Concepts JHS Vol A, November

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Page 1: Journal CME Questions

CORONAL SHEAR FRACTURES OF THE DISTAL HUMERUS 2417

19. Dushuttle RP, Coyle MP, Zawadsky JP, Bloom H. Fractures of thecapitellum. J Trauma 1985;25:317–321.

20. Morrey BF, Tanaka S, An KN. Valgus stability of the elbow. Adefinition of primary and secondary constraints. Clin Orthop RelatRes 1991;265:187–195.

21. Mancini GB, Fiacca C, Picuti G. Resection of the radial capitellum.Long-term results. Ital J Orthop Traumatol 1989;15:295–302.

22. Deutch SR, Jensen SL, Tyrdal S, Olsen BS, Sneppen O. Elbow jointstability following experimental osteoligamentous injury and recon-struction. J Shoulder Elbow Surg 2003;12:466–471.

23. Fowles JV, Kassab MT. Fracture of the capitulum humeri. Treatmentby excision. J Bone Joint Surg 1974;56A:794–798.

24. Sabo MT, Fay K, McDonald CP, Ferreira LM, Johnson JA, King GJ.Effect of coronal shear fractures of the distal humerus on elbowkinematics and stability. J Shoulder Elbow Surg 2010;19:670–680.

25. Sano S, Rokkaku T, Saito S, Tokunaga S, Abe Y, Moriya H. Herbertscrew fixation of capitellar fractures. J Shoulder Elbow Surg 2005;14:307–311.

26. Mahirogullari M, Kiral A, Solakoglu C, Pehlivan O, Akmaz I, RodopO. Treatment of fractures of the humeral capitellum using herbertscrews. J Hand Surg 2006;31B:320–325.

27. Kamineni S, Morrey BF. Distal humeral fractures treated with non-custom total elbow replacement. J Bone Joint Surg 2004;86A:940–947.

28. Garcia JA, Mykula R, Stanley D. Complex fractures of the distalhumerus in the elderly. The role of total elbow replacement asprimary treatment. J Bone Joint Surg 2002;84B:812–816.

29. Frankle MA, Herscovici D Jr, DiPasquale TG, Vasey MB, SandersRW. A comparison of open reduction and internal fixation andprimary total elbow arthroplasty in the treatment of intraarticulardistal humerus fractures in women older than age 65. J OrthopTrauma 2003;17:473–480.

30. McKee MD, Veillette CJ, Hall JA, Schemitsch EH, Wild LM,McCormack R, et al. A multicenter, prospective, randomized, con-trolled trial of open reduction—internal fixation versus total elbowarthroplasty for displaced intra-articular distal humeral fractures inelderly patients. J Shoulder Elbow Surg 2009;18:3–12.

JOURNAL CME QUESTIONS

JHS �Vol A, No

for distal humeral fractures in elderly patients. J Bone Joint Surg1997;79A:826–832.

32. Adolfsson L, Nestorson J. The Kudo humeral component as primaryhemiarthroplasty in distal humeral fractures. J Shoulder Elbow Surg2011;21:451–455.

33. Adolfsson L, Hammer R. Elbow hemiarthroplasty for acute recon-struction of intraarticular distal humerus fractures: a preliminaryreport involving 4 patients. Acta Orthop 2006;77:785–787.

34. Parsons M, O’Brien R, Hughes J. Elbow hemiarthroplasty for acuteand salvage reconstructions of intra-articular distal humerus frac-tures. Tech Shoulder Elbow Surg 2005;6:87–97.

35. Hardy P, Menguy F, Guillot S. Arthroscopic treatment of capitellumfracture of the humerus. Arthroscopy 2002;18:422–426.

36. Feldman MD. Arthroscopic excision of type II capitellar fractures.Arthroscopy 1997;13:743–748.

37. Kuriyama K, Kawanishi Y, Yamamoto K. Arthroscopic-assisted reduc-tion and percutaneous fixation for coronal shear fractures of the distalhumerus: report of two cases. J Hand Surg 2010;35A:1506–1509.

38. Mitani M, Nabeshima Y, Ozaki A, Mori H, Issei N, Fujii H, et al.Arthroscopic reduction and percutaneous cannulated screw fixationof a capitellar fracture of the humerus: a case report. J ShoulderElbow Surg 2009;18:e6–9.

39. Ring D. Open reduction and internal fixation of an apparent capitel-lar fracture using an extended lateral exposure. J Hand Surg 2009;34A:739–744.

40. Malki AA, Salloom FM, Wong-Chung J, Ekri AI. Cannulated screwfixation of fractured capitellum: surgical technique through a limitedapproach. Injury 2000;31:204–206.

41. Elkowitz SJ, Polatsch DB, Egol KA, Kummer FJ, Koval KJ. Capi-tellum fractures: a biomechanical evaluation of three fixation meth-ods. J Orthop Trauma 2002;16:503–506.

42. Mehdian H, McKee MD. Fractures of capitellum and trochlea.Orthop Clin North Am 2000;31:115–127.

43. Sen MK, Sama N, Helfet DL. Open reduction and internal fixation ofcoronal fractures of the capitellum. J Hand Surg 2007;32A:1462–1465.

44. Brouwer KM, Jupiter JB, Ring D. Nonunion of operatively treated

31. Cobb TK, Morrey BF. Total elbow arthroplasty as primary treatment capitellum and trochlear fractures. J Hand Surg 2011;36A:804–807.

ncepts

Coronal Shear Fractures of the DistalHumerus

What imaging study is best to guide surgicalplanning for a coronal shear fracture of the distalhumerus?

a. AP, lateral, internal oblique, and external oblique x-rays

b. Intraoperative arthrogam

c. CT scan

d. MRI scan

In an elderly patient, what treatment ispreferable for a coronal shear fracture of thedistal humerus with moderate comminution?

a. Excision of the fracture fragment

b. Arthroscopic reduction and internal fixation

c. Open reduction internal fixation

d. Hemiarthroplasty

e. Total elbow arthroplasty

CurrentCo

e. Transpiral tomography

To take the online test and receive CME credit, go to http://www.jhandsurg.org/CME/home.

vember