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Clinical Management of Elbow and Shoulder Surgery
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Clinical Management of Elbow and Shoulder Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: closed (25 April 2025) | Viewed by 2634

Special Issue Editors

Dr. Hugo C. Rodriguez

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Guest Editor
Department of Orthopedic Surgery, Larkin Community Hospital, South Miami, FL, USA
Interests: orthopedic surgery; regenerative medicine; shoulder arthroplasty; shoulder arthroscopy; artificial intelligence
Dr. Ashim Gupta

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Guest Editor
South Texas Orthopaedic Research Institute, Laredo, TX, USA
Interests: orthopedic surgery; regenerative medicine; shoulder arthroplasty; shoulder arthroscopy; artificial intelligence
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The treatment and management of Shoulder and Elbow pathology involves deep knowledge of the intricate interplay between anatomy, biomechanics and biology. Topics such as fracture care, ligaments and tendon repair, and the management of osteoarthritis are just the tip of the iceberg. Traditionally, the management of these injuries involves activity modification, physical therapy, a variety of surgical procedures, and pharmacological agents, including non-steroidal anti-inflammatory drugs, corticosteroids viscosupplementation, narcotics and biologics.

In the last decade, there significant advances have been made in the treatment and management of routine Shoulder and Elbow pathologies; these have returned function to patients and alleviated chronic pain. This collection highlights the current status, challenges, and emerging trends in the treatment and management of shoulder and elbow pathologies. We welcome both basic and translational original research and review articles covering, but not limited to, the treatment and management of the following:

  • fractures of the shoulder and elbow;
  • rotator cuff pathology;
  • shoulder osteoarthritis;
  • elbow osteoarthritis;
  • ligament and tendon pathology of the shoulder and elbow;
  • advances in regenerative medicine.

Dr. Hugo C. Rodriguez
Dr. Ashim Gupta
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • shoulder arthroplasty
  • rotator cuff
  • shoulder instability
  • elbow arthroplasty
  • arthroscopy
  • fracture management
  • regenerative medicine

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Published Papers (3 papers)

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11 pages, 222 KiB  
Article
Post-Surgical Ulnar Nerve Neuropathy in Distal Humerus Fractures: Comparison Between In Situ Decompression and Anterior Subcutaneous Transposition
by Ignacio García-Cepeda, Ana-Elena Sanz-Peñas, Inés de Blas-Sanz, Clarisa Simón-Pérez, Emilio-Javier Frutos-Reoyo and Ignacio Aguado-Maestro
J. Clin. Med. 2025, 14(7), 2490; https://doi.org/10.3390/jcm14072490 - 5 Apr 2025
Viewed by 289
Abstract
Postoperative ulnar neuropathy is a common complication in patients undergoing surgery for distal humerus fractures, particularly when open reduction and internal fixation (ORIF) is performed. Objectives: This study aims to compare the rates of ulnar nerve neuropathy following classic in situ decompression [...] Read more.
Postoperative ulnar neuropathy is a common complication in patients undergoing surgery for distal humerus fractures, particularly when open reduction and internal fixation (ORIF) is performed. Objectives: This study aims to compare the rates of ulnar nerve neuropathy following classic in situ decompression versus ulnar nerve subcutaneous anterior transposition. Methods: A retrospective study was conducted, including 51 patients treated for distal humerus fractures with precontoured locking plates in our institution between 2009 and 2023, according to specific inclusion and exclusion criteria. Age, sex, ulnar neuropathy, range of motion (ROM), complications, surgical approach, and Mayo Elbow Performance Score (MEPS) were evaluated. Ulnar nerve function was graded according to modified McGowan classification. Results: Ulnar neuropathy was observed in 17 (33.3%) patients, with a higher risk in those who underwent anterior ulnar nerve transposition compared to in situ decompression (58% vs. 26%, p = 0.042). In the modified McGowan classification, 14 patients had grade 1 and 3 had grade 2 neuropathy. The overall complication rate was 49%, and the functional outcomes according to the MEPS scale showed a mean score of 81.6 (SD 17.29). The mean flexion–extension was 100.56°, and 94% of patients retained complete pronosupination. Conclusions: Our results demonstrate that routine intraoperative ulnar nerve transposition should not be performed for these fractures. Full article
(This article belongs to the Special Issue Clinical Management of Elbow and Shoulder Surgery)
8 pages, 197 KiB  
Article
Reverse Shoulder Arthroplasty in Patients with Rheumatoid Arthritis: A Nationwide Analysis
by Andrew G. Beauperthuy, Nadia F. Linton, Peter A. Falgiano, Kevin L. Mekkawy, Hugo C. Rodriguez and Ashim Gupta
J. Clin. Med. 2025, 14(3), 994; https://doi.org/10.3390/jcm14030994 - 4 Feb 2025
Viewed by 884
Abstract
Introduction: Reverse shoulder arthroplasty (RSA) was originally developed for treating rotator cuff arthropathy but is now commonly used for rheumatoid arthritis (RA)-related shoulder degeneration. While previous studies have identified RA to be a risk factor for complications following total shoulder arthroplasty, its specific [...] Read more.
Introduction: Reverse shoulder arthroplasty (RSA) was originally developed for treating rotator cuff arthropathy but is now commonly used for rheumatoid arthritis (RA)-related shoulder degeneration. While previous studies have identified RA to be a risk factor for complications following total shoulder arthroplasty, its specific impact on RSA outcomes remains unclear. This study aims to evaluate the post-operative medical and implant-related complications, and healthcare utilization, among RA patients undergoing RSA. Methods: A retrospective analysis of patients undergoing RSA was conducted using a national administrative claims database from 2010 to 2023. Patients who underwent RSA with and without RA were identified using corresponding diagnoses and procedural codes. Patients with RA who underwent RSA had propensity score matched to a control on a 1:5 basis. The control group consisted of patients who did not have RA and underwent RSA for any other indication. Results: A total of 7232 of RSA patients with RA were matched to 36,054 control patients. The RA cohort had significantly higher rates of 90-day medical complications when compared to the control (p < 0.001), with the highest rates in urinary tract infections (OR: 9.69), pulmonary embolisms (OR: 9.69), and the need for blood transfusions (OR:9.41). Patients with RA had significantly greater odds of developing all implant-related complications within 2 years compared to the control group (p < 0.001). This cohort also had significantly higher fall rates (p < 0.001) and mean lengths of stay (3.42 vs. 2.0 days, p < 0.0001). Conclusions: RSA patients with prior diagnoses of RA face a higher risk of implant-related and medical complications, falls, and prolonged hospital stays compared to the control. These findings suggest that RA is an independent risk factor for reverse total shoulder arthroplasty. Therefore, these patients should be closely monitored post-operatively to reduce complications, cost of care, and length of stay. Level of Evidence: III, retrospective case–control study Full article
(This article belongs to the Special Issue Clinical Management of Elbow and Shoulder Surgery)

Other

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9 pages, 6922 KiB  
Technical Note
Intuitive and Minimally Invasive Surgical Technique for Comminuted Mid-Shaft Clavicle Fractures: Fixation with an Anterior Mini Plate and Superior Locking Compression Plate
by Seungwoo Ok, Seong-Meen Yoon and Sungwook Choi
J. Clin. Med. 2025, 14(3), 999; https://doi.org/10.3390/jcm14030999 - 4 Feb 2025
Viewed by 847
Abstract
Background: We have applied an anterior locking compression mini plate in addition to a conventional superior locking compression plate for the treatment of wedge or multifragmentary clavicular fractures. Methods: Medical and radiologic data were retrospectively reviewed for patients who underwent surgical [...] Read more.
Background: We have applied an anterior locking compression mini plate in addition to a conventional superior locking compression plate for the treatment of wedge or multifragmentary clavicular fractures. Methods: Medical and radiologic data were retrospectively reviewed for patients who underwent surgical fixation with an anterior locking compression mini plate and conventional anatomical locking compression plate in a clavicle fracture of AO/OTA 15.2 B and 15.2 C. The primary outcome was bone union, and the secondary outcome was postoperative complications associated with the procedure. The functional outcomes included the Visual Analog Scale (VAS), University of California at Los Angeles Shoulder Scale (UCLASS), and Constant Shoulder Scale (CSS). Results: Nineteen patients with AO/OTA 15.2 B and 2 C clavicular fractures were followed for an average of 16 months (range: 12–30). The average patient age was 41 (range: 21–76) years, and 17 male and 2 female patients were included. The most common cause of clavicle fractures was sports activity (36.8%). A total of 10 patients had AO/OTA classification 15.2 C, and 9 patients had AO/OTA classification 15.2 B clavicular fractures. Primary fracture union healing was observed in all 19 (100%) patients, and the average time to bone union was 11 weeks (range: 7~21). There was no fixation failure or postoperative infection. The mean VAS, UCLASS, and CSS scores at the final follow-up were 0.6, 33.4, and 65 on a 75-point scale (87 on a 100-point scale), respectively. Conclusions: Dual plating using an anterior mini plate with a superior LCP could be considered as an option to minimize soft-tissue injury in comminuted mid-shaft clavicle fractures. Full article
(This article belongs to the Special Issue Clinical Management of Elbow and Shoulder Surgery)
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