Osteosynthesis and hemiarthroplasty of fractures of the proximal humerus: outcomes in a consecutive case series

HYPOTHESIS: This study addresses the outcome after osteosynthesis or hemiarthroplasty, using a cohort of patients that was enrolled in a previous prospective study on humeral head perfusion and was consequently treated using a common conceptual approach. MATERIALS AND METHODS: Between 1998 and 2001, 98 patients with 100 fractures of the proximal humerus were treated surgically by a single surgeon with open reduction and internal fixation (ORIF) (51/100, group A, median age 54 years; range, 21-88) or with hemiarthroplasty (49/100, group B, median age 66 years; range, 38-87). Seventy-six of 98 patients were available for re-evaluation at a mean follow-up of five years (3.3-7.3) using the Constant-Murley score (CMS), the Subjective Shoulder Value (SSV), and conventional radiographs. RESULTS: The median total CMS was 77 (range, 37-98) for group A and 70 (range, 39-84) for group B. The median SSV was 92 (range, 40-100) for group A and 90 (range, 40-100) for group B. Avascular necrosis occured in 6/40 fractures treated with ORIF. CONCLUSION: Osteosynthesis and hemiarthroplasty yield similar functional results and comparable patient satisfaction following the applied decision making process in this selected patient cohort. Osteosynthesis with preservation of the humeral head is worth considering when adequate reduction and stable conditions for revascularization can be obtained. In patients with osteopenic bone and/or comminuted fractures, hemiarthroplasty is a viable alternative. LEVEL OF EVIDENCE: Level 2; Prospective non-randomized comparison study.

Why Do We Think Practice Research is a Good Idea? Comments and Musings Inspired by the Salisbury Statement

In this paper I raise some questions about current understandings of practice research and whether they are worth pursuing. In particular, the notion of a gap between practice and research is examined in terms of how it constricts thinking about this issue. I also attempt to explicate some of the less examined assumptions associated with practice research. Finally, I suggest that we embrace multiplicity, not by trying to accommodate all views under the practice research umbrella, but by accepting that there will be many versions of practice research that will have differential appeal.

Editor's Pick

In this new column, which from now on shall appear at regular intervals, the editors of JIPITEC would like to present to their readers monographs that in their mind are either outstanding or are worth being mentioned and recommended to the interested reader. Each individual editor is responsible for his or her own choice and each text reflects personal interests and preferences rather than an editorial policy.

E-Learning Systems, Environments and Approaches

The volume consists of twenty-five chapters selected from among peer-reviewed papers presented at the CELDA (Cognition and Exploratory Learning in the Digital Age) 2013 Conference held in Fort Worth, Texas, USA, in October 2013 and also from world class scholars in e-learning systems, environments and approaches. The following sub-topics are included: Exploratory Learning Technologies (Part I), e-Learning social web design (Part II), Learner communities through e-Learning implementations (Part III), Collaborative and student-centered e-Learning design (Part IV). E-Learning has been, since its initial stages, a synonym for flexibility. While this dynamic nature has mainly been associated with time and space it is safe to argue that currently it embraces other aspects such as the learners’ profile, the scope of subjects that can be taught electronically and the technology it employs. New technologies also widen the range of activities and skills developed in e-Learning. Electronic learning environments have evolved past the exclusive delivery of knowledge. Technology has endowed e-Learning with the possibility of remotely fomenting problem solving skills, critical thinking and team work, by investing in information exchange, collaboration, personalisation and community building.

Vergleich der umweltrelevanten Faktoren von Holzfurnierlagenverbundwerkstoffen (WVC – Wood Veneer Composite) und metallischen Werkstoffen am Praxisbeispiel eines Skidfördersystems

Für eine Beurteilung von Produkten bzw. Produktsystemen im Maschinenbau spielen neben technischen Kennwerten immer mehr die Umweltauswirkungen der Systeme eine wichtige Rolle. Diese Anforderungen haben die Nachfrage für nachhaltige und umweltfreundliche Konstruktionswerkstoffe im Maschinenbau erhöht. Eine Möglichkeit für solche ökologisch vorteilhaften Werkstoffe stellen ausgewählte Holzwerkstoffe dar. Mit diesen Holzwerkstoffen sollen technische Produkte entwickelt werden, welche den Unternehmen die Möglichkeit eröffnet, ihren unternehmerischen Beitrag zur Nachhaltigkeit zu steigern und wirtschaftliche Vorteile zu erzielen. Durch diesen Ansatz ist ein gewisses Maß an Ressourcen- und Energieeffizienz verbunden, dass sich kurzfristig und / oder langfristig wirtschaftlich lohnt. Ein damit verbundener gesellschaftlicher Imagegewinn erzeugt einen zusätzlichen Nutzen. Als sogenannte GLP (Green Logistics Plant) wird diese Art der Holzkonstruktion gegenwärtig im Bereich der Fördertechnik entwickelt und angewendet. Ein Anwendungsbeispiel innerhalb der GLP stellt das Gestellsystem für einen Skidförderer dar. Um die ökologische Wirkung der Konstruktionswerkstoffe transparent und nachvollziehbar zu untersuchen, werden vordergründig die Kategorien des Treibhauspotenzials und des (Primär-) Energieaufwandes genutzt. Weiterhin werden die Wirkungskategorien Versauerung, Eutrophierung, Sommersmog und Ozonabbau analysiert. Ergänzend zu bestehenden Untersuchungen soll die ökologische Vorteilhaftigkeit von Holzfurnierlagenverbundwerkstoffe (Wood Veneer Composite – WVC), Baustahl, verzinktem Stahl und Aluminiumlegierungen in der Lebensphase Produktion untersucht werden. Anschließend werden die Ergebnisse auf das Gestell eines Skid-Fördersystems aus WVC und Baustahl übertragen.

The impact of the achievement motive on athletic performance in adolescent football players

Researchers largely agree that there is a positive relationship between achievement motivation and athletic performance, which is why the achievement motive is viewed as a potential criterion for talent. However, the underlying mechanism behind this relationship remains unclear. In talent and performance models, main effect, mediator and moderator models have been suggested. A longitudinal study was carried out among 140 13-year-old football talents, using structural equation modelling to determine which model best explains how hope for success (HS) and fear of failure (FF), which are the aspects of the achievement motive, motor skills and abilities that affect performance. Over a period of half a year, HS can to some extent explain athletic performance, but this relationship is not mediated by the volume of training, sport-specific skills or abilities, nor is the achievement motive a moderating variable. Contrary to expectations, FF does not explain any part of performance. Aside from HS, however, motor abilities and in particular skills also predict a significant part of performance. The study confirms the widespread assumption that the development of athletic performance in football depends on multiple factors, and in particular that HS is worth watching in the medium term as a predictor of talent.

Iowa State Daily (March 22, 2012)

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