{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T19:30:24Z","timestamp":1773603024327,"version":"3.50.1"},"reference-count":25,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,1,12]],"date-time":"2022-01-12T00:00:00Z","timestamp":1641945600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"publisher","award":["CZ.02.1.01\/0.0\/0.0\/17_049\/0008441"],"award-info":[{"award-number":["CZ.02.1.01\/0.0\/0.0\/17_049\/0008441"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Data on the effectiveness of arthroscopic arthrolysis and extraction of osteosynthetic material after osteosynthesis of the proximal humerus in patients with persisting problems are rare and insufficient. In this study, we performed arthroscopic arthrolysis and extraction of fixation screws, and, where protruding, extraction of the nail in 34 patients with problems persisting 12 months after osteosynthesis of the proximal humerus using an intramedullary nail. The effectiveness of the treatment was assessed using the Constant\u2013Murley shoulder score and forward flexion difference between the treated arm and the contralateral one. A median increase of 16 points in CMS score and 30 degrees reduction in the arm forward flexion difference was recorded 12 months after the arthroscopy. The improvement was significantly higher in the patient group with intramedullary nail extraction (however, this group had worse pre-operative values and the screw was only extracted where likely to cause problems). The median time to heal was 11 weeks; no serious peri- or post-procedural complications occurred. Mini-invasive arthroscopic arthrolysis combined with extraction of osteosynthetic material proved to be a safe and effective method for treatment of patients after osteosynthesis of the proximal humerus using an intramedullary nail with persisting pain and\/or mobility limitation.<\/jats:p>","DOI":"10.3390\/jcm11020362","type":"journal-article","created":{"date-parts":[[2022,1,12]],"date-time":"2022-01-12T09:10:36Z","timestamp":1641978636000},"page":"362","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Outcomes of Mini-Invasive Arthroscopic Arthrolysis Combined with Locking Screw and\/or Intramedullary Nail Extraction after Osteosynthesis of the Proximal Humerus Fracture"],"prefix":"10.3390","volume":"11","author":[{"given":"Roman","family":"Madeja","sequence":"first","affiliation":[{"name":"Department of Trauma Surgery, University Hospital Ostrava, 17. Listopadu 1790, 708 52 Ostrava, Czech Republic"},{"name":"Faculty of Medicine, Institute of Emergency Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0733-915X","authenticated-orcid":false,"given":"Jana","family":"Pometlov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, University Hospital Ostrava, 17. Listopadu 1790, 708 52 Ostrava, Czech Republic"},{"name":"Faculty of Medicine, Institute of Emergency Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8514-9079","authenticated-orcid":false,"given":"Roman","family":"Brz\u00f3ska","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, St. Luke\u2019s Hospital, Bielsko-Bia\u0142a, Bystrza\u0144ska 94b str., 43-300 Bielsko-Bia\u0142a, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji\u0159\u00ed","family":"Voves","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, University Hospital Ostrava, 17. Listopadu 1790, 708 52 Ostrava, Czech Republic"},{"name":"Faculty of Medicine, Institute of Emergency Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lubor","family":"Bialy","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, University Hospital Ostrava, 17. Listopadu 1790, 708 52 Ostrava, Czech Republic"},{"name":"Faculty of Medicine, Institute of Emergency Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leopold","family":"Pleva","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, University Hospital Ostrava, 17. Listopadu 1790, 708 52 Ostrava, Czech Republic"},{"name":"Faculty of Medicine, Institute of Emergency Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Str\u00e1nsk\u00fd","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, University Hospital Ostrava, 17. Listopadu 1790, 708 52 Ostrava, Czech Republic"},{"name":"Faculty of Medicine, Institute of Emergency Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0511-0749","authenticated-orcid":false,"given":"Ad\u00e9la","family":"Vrtkov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Applied Mathematics, Faculty of Electrical Engineering and Computer Science, VSB\u2014Technical University of Ostrava, 708 00 Ostrava, Czech Republic"},{"name":"Department of the Deputy Director for Science and Research, University Hospital Ostrava, 17. Listopadu 1790, 708 52 Ostrava, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0682-4521","authenticated-orcid":false,"given":"Jaroslav","family":"Jano\u0161ek","sequence":"additional","affiliation":[{"name":"Center for Health Research, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1622-8961","authenticated-orcid":false,"given":"Krist\u00fdna","family":"\u010cabanov\u00e1","sequence":"additional","affiliation":[{"name":"Centre for Advanced Innovation Technologies, V\u0160B\u2014Technical University of Ostrava, 708 33 Ostrava, Czech Republic"},{"name":"Faculty of Mining and Geology, V\u0160B\u2014Technical University of Ostrava, 708 33 Ostrava, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.1007\/s00402-019-03252-1","article-title":"Trends in surgical management of proximal humeral fractures in adults: A nationwide study of records in Germany from 2007 to 2016","volume":"139","author":"Klug","year":"2019","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1007\/s11999-011-2056-y","article-title":"Similar outcomes for nail versus plate fixation of three-part proximal humeral fractures","volume":"470","author":"Konrad","year":"2012","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1186\/s13018-019-1345-0","article-title":"Effect of intramedullary nail and locking plate in the treatment of proximal humerus fracture: An update systematic review and meta-analysis","volume":"14","author":"Shi","year":"2019","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e130","DOI":"10.1016\/j.jse.2015.11.016","article-title":"Intramedullary nailing of the proximal humerus: Evolution, technique, and results","volume":"25","author":"Dilisio","year":"2016","journal-title":"J. Shoulder Elb. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1016\/j.jse.2012.06.008","article-title":"Locking plate fixation of fractures of the proximal humerus: Analysis of complications, revision strategies and outcome","volume":"22","author":"Jost","year":"2013","journal-title":"J. Shoulder Elb. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.5114\/aoms.2020.97714","article-title":"Medium- to long-term clinical and functional outcomes of isolated and combined subscapularis tears repaired arthroscopically","volume":"17","author":"Cigolotti","year":"2020","journal-title":"Arch. Med. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1186\/s13018-018-0783-4","article-title":"A novel implant removal technique by endoscopy","volume":"13","author":"Liu","year":"2018","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1742","DOI":"10.1007\/s00167-010-1093-5","article-title":"A meta-analysis of open versus arthroscopic Bankart repair using suture anchors","volume":"18","author":"Petrera","year":"2010","journal-title":"Knee Surg. Sports Traumatol. Arthrosc. Off. J. ESSKA"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1007\/s00167-006-0229-0","article-title":"Arthroscopic removal of an intramedullary nail in the humerus","volume":"15","author":"Kim","year":"2007","journal-title":"Knee Surg. Sports Traumatol. Arthrosc. Off. J. ESSKA"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1007\/s00590-017-1938-4","article-title":"Shoulder arthroscopy combined to hardware removal in proximal humeral fractures: A series of 58 cases with a mean follow-up of 2 years","volume":"27","author":"Maroun","year":"2017","journal-title":"Eur. J. Orthop. Surg. Traumatol. Orthop. Traumatol. Orthop. Traumatol."},{"key":"ref_11","unstructured":"Jaeger, M., Leung, F., Li, W., and Trafton, P. (2021, December 20). AO Surgery Reference: Nailing (Straight Nail); Extraarticular 2-Part, Surgical Neck, Impaction. Available online: https:\/\/surgeryreference.aofoundation.org\/orthopedic-trauma\/adult-trauma\/proximal-humerus\/extraarticular-2-part-surgical-neck-impaction\/nailing-straight-nail#determination-of-entry-point-and-opening-of-the-canal fig 1.2.3.4."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1978","DOI":"10.1016\/j.injury.2019.06.029","article-title":"Intramedullary nailing of displaced four-part fractures of the proximal humerus","volume":"50","author":"Kloub","year":"2019","journal-title":"Injury"},{"key":"ref_13","unstructured":"AO\/OTA (2021, December 20). AO\/OTA Fracture and Dislocation Classification Compendium\u20142018. Available online: https:\/\/classification.aoeducation.org\/?_ga=2.153667836.572291093.1640888057-1166149626.1640888057."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.jse.2007.06.022","article-title":"A review of the Constant score: Modifications and guidelines for its use","volume":"17","author":"Constant","year":"2008","journal-title":"J. Shoulder Elb. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e375","DOI":"10.1016\/j.eats.2016.10.014","article-title":"Arthroscopic Removal of Proximal Humerus Plates in Chronic Post-traumatic Shoulder Stiffness","volume":"6","author":"Bhatia","year":"2017","journal-title":"Arthrosc. Tech."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e343","DOI":"10.1016\/j.eats.2016.01.009","article-title":"Arthroscopic Removal of Symptomatic Proximal Humerus Locking Plates With Bone-Void Filler Augmentation","volume":"5","author":"Voleti","year":"2016","journal-title":"Arthrosc. Tech."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1007\/s00167-009-0991-x","article-title":"Arthroscopic removal of proximal humerus locking plates","volume":"18","author":"Dines","year":"2010","journal-title":"Knee Surg. Sports Traumatol. Arthrosc. Off. J. ESSKA"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1007\/s00402-009-0882-0","article-title":"Arthroscopic locking plate removal after proximal humeral fractures","volume":"130","author":"Voigt","year":"2010","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1016\/j.arthro.2014.04.092","article-title":"Arthroscopy after locked plating of proximal humeral fractures: Implant removal, capsular release, and intra-articular findings","volume":"30","author":"Katthagen","year":"2014","journal-title":"Arthrosc. J. Arthrosc. Relat. Surg. Off. Publ. Arthrosc. Assoc. North Am. Int. Arthrosc. Assoc."},{"key":"ref_20","first-page":"47","article-title":"Arthroscopic implant removal after fixed-angle plate osteosynthesis of the proximal humerus. Technique and initial results in comparison to open implant removal","volume":"115","author":"Katthagen","year":"2012","journal-title":"Der Unf."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1007\/s00167-013-2437-8","article-title":"The feasibility and results of an arthroscopic removal of humeral locking plates and glenohumeral arthrolysis after proximal humeral fractures","volume":"22","author":"Maqdes","year":"2014","journal-title":"Knee Surg. Sports Traumatol. Arthrosc. Off. J. ESSKA"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"83","DOI":"10.4055\/cios.2017.9.1.83","article-title":"Comparison of Clinical and Radiological Results according to Glenosphere Position in Reverse Total Shoulder Arthroplasty: A Short-term Follow-up Study","volume":"9","author":"Choi","year":"2017","journal-title":"Clin. Orthop. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1016\/j.jse.2016.11.046","article-title":"Clavicle hook plate fixation for distal-third clavicle fracture (Neer type II): Comparison of clinical and radiologic outcomes between Neer types IIA and IIB","volume":"26","author":"Lee","year":"2017","journal-title":"J. Shoulder Elb. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1016\/j.jse.2016.02.006","article-title":"Surgical treatment of lesions of the long head of the biceps brachii tendon with rotator cuff tear: A prospective randomized clinical trial comparing the clinical results of tenotomy and tenodesis","volume":"25","author":"Lee","year":"2016","journal-title":"J. Shoulder Elb. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1016\/j.arthro.2017.10.027","article-title":"Comparison of Short-term Complications After Rotator Cuff Repair: Open Versus Arthroscopic","volume":"34","author":"Day","year":"2018","journal-title":"Arthrosc. J. Arthrosc. Relat. Surg. Off. Publ. Arthrosc. Assoc. North Am. Int. Arthrosc. Assoc."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/2\/362\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:27:25Z","timestamp":1760362045000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/2\/362"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,12]]},"references-count":25,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,1]]}},"alternative-id":["jcm11020362"],"URL":"https:\/\/doi.org\/10.3390\/jcm11020362","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,12]]}}}