Original paper
Clinical and Sonographic Assessment of Rotator Cuff Damage During Antegrade Humeral Nailing
Valoración clínico-ecográfica de la agresión al manguito rotador en el abordaje anterógrado del enclavado humeral
R. García-Bógalo
, R. Larrainzar-Garijo, E. Díez-Nicolás, L.F. Llanos-Alcázar
Corresponding author
Department of Orthopedic and Trauma Surgery. 12 de Octubre University Hospital. Madrid
Read
1178
Timeswas read the article
722
Total PDF
456
Total HTML
Share statistics
array:23 [ "pii" => "S1988885608700610" "issn" => "19888856" "doi" => "10.1016/S1988-8856(08)70061-0" "estado" => "S300" "fechaPublicacion" => "2008-01-01" "aid" => "70061" "copyright" => "Sociedad Española de Cirugía Ortopédica y Traumatología (SECOT). All rights reserved" "copyrightAnyo" => "2008" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Rev Esp Cir Ortop Traumatol. 2008;52:2-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 349 "formatos" => array:2 [ "HTML" => 76 "PDF" => 273 ] ] "itemSiguiente" => array:18 [ "pii" => "S1988885608700622" "issn" => "19888856" "doi" => "10.1016/S1988-8856(08)70062-2" "estado" => "S300" "fechaPublicacion" => "2008-01-01" "aid" => "70062" "copyright" => "Sociedad Española de Cirugía Ortopédica y Traumatología (SECOT). All rights reserved" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Rev Esp Cir Ortop Traumatol. 2008;52:9-14" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 291 "formatos" => array:2 [ "HTML" => 69 "PDF" => 222 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original paper</span>" "titulo" => "Anterior Surgical Repair of Distal Ruptures of the Brachial Biceps Tendon" "tienePdf" => "en" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "9" "paginaFinal" => "14" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Reparación quirúrgica por vía anterior de la rotura distal del tendón del bíceps braquial" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "P. Guerra-Vélez, F.J. Sanz-Hospital, J. Cano-Egea, J. Escalera-Alonso, A. Coello-Nogués" "autores" => array:5 [ 0 => array:2 [ "nombre" => "P." "apellidos" => "Guerra-Vélez" ] 1 => array:2 [ "nombre" => "F.J." "apellidos" => "Sanz-Hospital" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Cano-Egea" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Escalera-Alonso" ] 4 => array:2 [ "nombre" => "A." "apellidos" => "Coello-Nogués" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885608700622?idApp=UINPBA00004N" "url" => "/19888856/0000005200000001/v1_201305031652/S1988885608700622/v1_201305031652/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S1988885608700609" "issn" => "19888856" "doi" => "10.1016/S1988-8856(08)70060-9" "estado" => "S300" "fechaPublicacion" => "2008-01-01" "aid" => "70060" "copyright" => "Sociedad Española de Cirugía Ortopédica y Traumatología (SECOT). All rights reserved" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "edi" "cita" => "Rev Esp Cir Ortop Traumatol. 2008;52:1" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 200 "formatos" => array:2 [ "HTML" => 31 "PDF" => 169 ] ] "en" => array:7 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "tienePdf" => "en" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "1" ] ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "E.C. Rodríguez-Merchán" "autores" => array:1 [ 0 => array:2 [ "nombre" => "E.C." "apellidos" => "Rodríguez-Merchán" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885608700609?idApp=UINPBA00004N" "url" => "/19888856/0000005200000001/v1_201305031652/S1988885608700609/v1_201305031652/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original paper</span>" "titulo" => "Clinical and Sonographic Assessment of Rotator Cuff Damage During Antegrade Humeral Nailing" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "2" "paginaFinal" => "8" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "R. García-Bógalo, R. Larrainzar-Garijo, E. Díez-Nicolás, L.F. Llanos-Alcázar" "autores" => array:4 [ 0 => array:4 [ "nombre" => "R." "apellidos" => "García-Bógalo" "email" => array:1 [ 0 => "rgbogalo@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Larrainzar-Garijo" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Díez-Nicolás" ] 3 => array:2 [ "nombre" => "L.F." "apellidos" => "Llanos-Alcázar" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Department of Orthopedic and Trauma Surgery. 12 de Octubre University Hospital. Madrid" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Corresponding author: C/ Carranque, 16, 3.o B. 28025 Madrid." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Valoración clínico-ecográfica de la agresión al manguito rotador en el abordaje anterógrado del enclavado humeral" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2006-07-31" "fechaAceptado" => "2007-01-31" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec101687" "palabras" => array:4 [ 0 => "antegrade humeral nailing" 1 => "rotator cuff" 2 => "humeral shaft" 3 => "fracture" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec101688" "palabras" => array:4 [ 0 => "enclavado humeral anterógrado" 1 => "manguito rotador" 2 => "diáfisis humeral" 3 => "fractura" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Purpose</span><p class="elsevierStyleSimplePara elsevierViewall">One of the most controversial points about antegrade humeral nailing is that of potential iatrogenic injuries to the rotator cuff. The purpose of this paper is to determine the clinical and sonographic impact associated to the use of the anterolateral approach.</p> <span class="elsevierStyleSectionTitle">Materials and methods</span><p class="elsevierStyleSimplePara elsevierViewall">Transversal study of a retrospective cohort of 23 patients operated on for humeral diaphyseal fractures at the 12 de Octubre Hospital between 1998 and 2004.</p> <span class="elsevierStyleSectionTitle">Inclusion criteria</span><p class="elsevierStyleSimplePara elsevierViewall">Acute humeral shaft fractures treated by means of antegrade nailing. No age threshold was imposed; minimum follow-up was one year.</p> <span class="elsevierStyleSectionTitle">Exclusion criteria</span><p class="elsevierStyleSimplePara elsevierViewall">Patients with an associated rheumatic pathology were excluded as well as those that had suffered a prior glenohumeral traumatic event or a proximal humeral fracture. Clinical assessment was conducted with Constant's scale and the sonographic study used the contralateral shoulder as control.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Mean score on Contant's scale was 82 points (range: 49-99), with most patients achieving a good result, i.e. 80% obtained more than 65 points. The only sonographic findings described were a few hyperechogenic lines in 4 patients, which were interpreted as partial ruptures of less than 30 mm. These patients had an acceptable functional outcome, with a score of more than 70 points on Constant's scale.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The results of this study suggest that the use of the anterolateral approach for antegrade humeral nailing, provided that there is careful dissection and posterior suturing of the rotator cuff, as well as a sufficiently medialized entry point on the humeral head, ensures a good functional result with no significant clinical-sonographic impact.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Uno de los puntos más controvertidos relacionados con la vía de abordaje en el enclavado anterógrado del húmero es la iatrogenia en el manguito de los rotadores. El objetivo de este trabajo ha sido determinar el impacto clínico-ecográfico asociado a este abordaje.</p> <span class="elsevierStyleSectionTitle">Material y método</span><p class="elsevierStyleSimplePara elsevierViewall">Estudio transversal sobre una cohorte retrospectiva de 23 pacientes intervenidos con fracturas diafisarias de húmero en el Hospital 12 de Octubre entre los años 1998 y 2004.</p> <span class="elsevierStyleSectionTitle">Criterios de inclusión</span><p class="elsevierStyleSimplePara elsevierViewall">Fracturas agudas diafisarias de húmero tratadas mediante osteosíntesis con enclavado por vía anterógrada sin límite de edad y seguimiento mínimo de un año.</p> <span class="elsevierStyleSectionTitle">Criterios de exclusión</span><p class="elsevierStyleSimplePara elsevierViewall">Pacientes con patología reumática asociada, antecedente traumático previo glenohumeral o fracturas del húmero proximal antiguas.</p><p class="elsevierStyleSimplePara elsevierViewall">La valoración clínica se realizó con el test de Constant y el estudio ecográfico utilizó como control el hombro contralateral.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">La puntuación media del test de Constant fue de 82 (49-99), con una agrupación general de resultado de la serie bueno: 80% más de 65. Los únicos hallazgos ecográficos observados fueron líneas hiperecogénicas en 4 pacientes, interpretadas como roturas parciales inferiores a 30 mm. Estos pacientes obtuvieron un resultado funcional aceptablemente bueno, sumando más de 70 puntos en el test de Constant.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Los resultados de este estudio sugieren que la utilización del abordaje anterolateral para el enclavado humeral anterógrado, con una cuidadosa disección y posterior sutura del manguito rotador, así como un punto de entrada en la cabeza humeral suficientemente medial garantizan un buen resultado funcional sin un impacto clínico-ecográfico relevante.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:18 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intramedullary mailing of humeral shaft fractures with a locking flexible nail" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.P. Stannard" 1 => "H.W. Harris" 2 => "G. McGwin Jr." 3 => "D.A. Volgas" 4 => "J.E. Alonso" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Bone Joint Surg" "fecha" => "2003" "volumen" => "85" "paginaInicial" => "2103" "paginaFinal" => "2110" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14630838" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fixation of fractures of tehe shaft of the humerus by dynamic compression plate or intramedullary nail. A prospective randomised trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R.G. McConmark" 1 => "D. Brien" 2 => "R.E. Buckley" 3 => "M.D. McKee" 4 => "J. Powell" 5 => "E.H. Schemitsch" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Bone Joint Surg Br" "fecha" => "2000" "volumen" => "82" "paginaInicial" => "336" "paginaFinal" => "339" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10813165" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intramedullary nailing of humeral shaft fractures. A retrospective study of 126 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "T. Flinkkilä" 1 => "P. Hyvönen" 2 => "M. Lakovaara" 3 => "T. Linden" 4 => "J. Ristiniemi" 5 => "M. Hämäläinen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Orthop Scand" "fecha" => "1999" "volumen" => "70" "paginaInicial" => "133" "paginaFinal" => "136" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10366912" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Complications of locked nailing in humeral shaft fractures" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Lin" 1 => "P.W. Shen" 2 => "S.M. Hou" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.TA.0000032252.57947.47" "Revista" => array:7 [ "tituloSerie" => "J Trauma" "fecha" => "2003" "volumen" => "54" "paginaInicial" => "943" "paginaFinal" => "949" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12777908" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0016508597003934" "estado" => "S300" "issn" => "00165085" ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A clinical method of functional assessment of the shoulder" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.R. Constant" 1 => "A.H.G. Murley" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Orthop" "fecha" => "1987" "volumen" => "214" "paginaInicial" => "160" "paginaFinal" => "164" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3791738" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Assesment of shoulder function" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C.R. Constant" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "The cuff" "paginaInicial" => "39" "paginaFinal" => "44" "serieFecha" => "1997" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Randomised prospective study of humeral shaft fracture fixation: intramedullary nails versus plates" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.R. Chapman" 1 => "M.B. Henley" 2 => "J. Agel" 3 => "P.J. Benca" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Orthop Trauma" "fecha" => "2000" "volumen" => "14" "paginaInicial" => "162" "paginaFinal" => "166" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10791665" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Complications associated with the Seidel nail" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.E. Barnes" 1 => "T.E. Shuler" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Orthop Rev" "fecha" => "1993" "volumen" => "22" "paginaInicial" => "699" "paginaFinal" => "706" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8351173" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antegrade locked intramedullary nailing in humeral shaft fractures" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Ajmal" 1 => "M. O'Sullivan" 2 => "J. McCabe" 3 => "W. Curtin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Injury" "fecha" => "2001" "volumen" => "32" "paginaInicial" => "692" "paginaFinal" => "694" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11600115" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of humeral shaft fractures with the Seidel Nail. A study of 23 cases with rotator cuff evaluation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "O. Gaullier" 1 => "L. Rebaï" 2 => "J.L. Dumaud" 3 => "M. Moughabghab" 4 => "S. Benaissa" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Chir Orthop" "fecha" => "1999" "volumen" => "85" "paginaInicial" => "349" "paginaFinal" => "361" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10457553" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Cox MA, Dolan M, Synnott K, McElwain JP. Closed inter-locking nailing of humeral shaft fractures with the Russel-Taylor Nail. J Orthop Trauma. 14:349-53." ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Farragos AB, Schemitsch EH, McKee MD. Complications of intramedullary mailing for fractures of the humeral shaft: a review. J Orthop Trauma; 13:258-67." ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intramedullary nailing of humeral shaft fractures" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "T.A. Russel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:3 [ "titulo" => "Presented at the AAOOs Annual Meeting" "conferencia" => "Washington, DC" "serieFecha" => "February 1992" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Surgical exposures in orthopaedics: the anatomic approach" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Hoppenfeld" 1 => "P. deBoer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:4 [ "edicion" => "3<span class="elsevierStyleSup">th</span> ed." "fecha" => "2005" "editorial" => "Marbán" "editorialLocalizacion" => "Madrid" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Humeral locking nail: a preliminary report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H. Seidel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Orthopedics" "fecha" => "1989" "volumen" => "12" "paginaInicial" => "219" "paginaFinal" => "226" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2922359" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Locked nailing of humeral shaft fractures" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C.M. Robinson" 1 => "K.M. Bell" 2 => "Court-Brown" 3 => "M.M. McQueen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Bone Joint Surg" "fecha" => "1992" "volumen" => "74B" "paginaInicial" => "558" "paginaFinal" => "562" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Modified extra-rotator cuff entry point in antegrade humeral nailing" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P. Dimakopoulos" 1 => "A.X. Papadopoulus" 2 => "M. Papas" 3 => "A. Panagopoulos" 4 => "E. Lambiris" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00402-004-0757-3" "Revista" => array:6 [ "tituloSerie" => "Arch Orthop Trauma Surg" "fecha" => "2005" "volumen" => "125" "paginaInicial" => "27" "paginaFinal" => "32" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15723245" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The anatomy and biomechanics of locked humeral nails" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "J. Kellam" 1 => "D. Beverland" 2 => "H. Brockhuyse" 3 => "A. Cuncins" 4 => "T. Hearn" 5 => "A. Patel" 6 => "S. MacKinnon" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "J Orthop Trauma" "fecha" => "1991" "volumen" => "5" "paginaInicial" => "217" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/19888856/0000005200000001/v1_201305031652/S1988885608700610/v1_201305031652/en/main.assets" "Apartado" => array:4 [ "identificador" => "7604" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original papers" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/19888856/0000005200000001/v1_201305031652/S1988885608700610/v1_201305031652/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885608700610?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 4 | 2 | 6 |
| 2024 September | 8 | 5 | 13 |
| 2024 August | 15 | 3 | 18 |
| 2024 July | 5 | 4 | 9 |
| 2024 June | 4 | 0 | 4 |
| 2024 May | 9 | 3 | 12 |
| 2024 April | 16 | 16 | 32 |
| 2024 March | 8 | 15 | 23 |
| 2024 February | 11 | 8 | 19 |
| 2024 January | 10 | 6 | 16 |
| 2023 December | 11 | 9 | 20 |
| 2023 November | 5 | 7 | 12 |
| 2023 October | 23 | 19 | 42 |
| 2023 September | 8 | 4 | 12 |
| 2023 August | 10 | 17 | 27 |
| 2023 July | 20 | 28 | 48 |
| 2023 June | 4 | 6 | 10 |
| 2023 May | 13 | 14 | 27 |
| 2023 April | 2 | 2 | 4 |
| 2023 March | 3 | 1 | 4 |
| 2023 February | 5 | 3 | 8 |
| 2023 January | 3 | 9 | 12 |
| 2022 December | 6 | 4 | 10 |
| 2022 November | 7 | 14 | 21 |
| 2022 October | 8 | 4 | 12 |
| 2022 September | 15 | 14 | 29 |
| 2022 August | 10 | 16 | 26 |
| 2022 July | 10 | 7 | 17 |
| 2022 June | 7 | 14 | 21 |
| 2022 May | 5 | 3 | 8 |
| 2022 April | 11 | 10 | 21 |
| 2022 March | 10 | 7 | 17 |
| 2022 February | 10 | 5 | 15 |
| 2022 January | 10 | 7 | 17 |
| 2021 December | 6 | 9 | 15 |
| 2021 November | 4 | 11 | 15 |
| 2021 October | 3 | 16 | 19 |
| 2021 September | 3 | 8 | 11 |
| 2021 August | 7 | 7 | 14 |
| 2021 July | 5 | 5 | 10 |
| 2021 June | 7 | 6 | 13 |
| 2021 May | 4 | 10 | 14 |
| 2021 April | 15 | 28 | 43 |
| 2021 March | 10 | 9 | 19 |
| 2021 February | 6 | 9 | 15 |
| 2021 January | 4 | 6 | 10 |
| 2020 December | 0 | 2 | 2 |
| 2020 November | 0 | 7 | 7 |
| 2020 October | 0 | 2 | 2 |
| 2020 September | 0 | 1 | 1 |
| 2020 August | 0 | 4 | 4 |
| 2020 July | 0 | 5 | 5 |
| 2020 June | 0 | 2 | 2 |
| 2020 May | 0 | 8 | 8 |
| 2020 April | 0 | 2 | 2 |
| 2020 March | 0 | 4 | 4 |
| 2020 February | 0 | 3 | 3 |
| 2020 January | 0 | 6 | 6 |
| 2019 December | 0 | 10 | 10 |
| 2019 November | 0 | 13 | 13 |
| 2019 October | 0 | 3 | 3 |
| 2019 September | 0 | 10 | 10 |
| 2019 August | 0 | 8 | 8 |
| 2019 July | 0 | 7 | 7 |
| 2019 June | 0 | 32 | 32 |
| 2019 May | 0 | 38 | 38 |
| 2019 April | 0 | 17 | 17 |
| 2019 February | 0 | 6 | 6 |
| 2018 December | 0 | 9 | 9 |
| 2018 October | 0 | 15 | 15 |
| 2018 September | 0 | 1 | 1 |
| 2018 August | 0 | 1 | 1 |
| 2018 July | 0 | 3 | 3 |
| 2018 June | 0 | 1 | 1 |
| 2018 February | 1 | 0 | 1 |
| 2017 December | 2 | 2 | 4 |
| 2017 November | 1 | 2 | 3 |
| 2017 October | 3 | 0 | 3 |
| 2017 September | 2 | 8 | 10 |
| 2017 August | 5 | 3 | 8 |
| 2017 July | 8 | 0 | 8 |
| 2017 June | 9 | 2 | 11 |
| 2017 May | 3 | 7 | 10 |
| 2017 April | 7 | 13 | 20 |
| 2017 March | 5 | 49 | 54 |
| 2017 February | 4 | 1 | 5 |
| 2017 January | 5 | 0 | 5 |
| 2016 December | 7 | 1 | 8 |
| 2016 November | 7 | 2 | 9 |
| 2016 October | 3 | 0 | 3 |
| 2016 September | 4 | 2 | 6 |
Show all
