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Jane Fitzpatrick,1,2 Christen Richardson,3 Ianiv Klaber,4 Martin D Richardson1 1Centre for Health and Exercise Sports Medicine, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; 2Joint Health Institute, Melbourne, VIC, Australia; 3Medical School, College of Health and Medicine, Australian National University, Acton, ACT, Australia; 4Orthopaedic Surgery Department, School of Medicine, Pontifical Catholic University of Chile, Santiago, ChileCorrespondence: Jane FitzpatrickCentre for Health and Exercise Sports Medicine, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Level 7, Allan Gilbert Building, 161 Barry Street, Melbourne, VIC, AustraliaEmail jane.fitzpatrick@unimelb.edu.auBackground/Hypothesis: Adhesive capsulitis of the shoulder results in pain and restricted movement of the glenohumeral joint. Hypothesis: There would be a difference in active range of movement in the affected shoulder of patients with adhesive capsulitis after receiving a series of injections of collagenase Clostridium histolyticum (CCH) compared to placebo.Methods: This study reports the results from a single site that was part of a 321-participant, multicenter, double-blind, prospective parallel-group, randomized controlled clinical trial. Inclusion criteria: over 18 years of age, unilateral idiopathic adhesive capsulitis for > 3 months, but < 12 months. Exclusion criteria: recent physical therapy, injections, subacromial impingement, calcific tendonitis or glenohumeral joint arthritis in the affected shoulder. Subjects were randomized 3:1 to receive CCH 0.58 mg or placebo under ultrasound guidance. Injections were on days 1, 22, and 43. The primary outcome measure was a functional assessment of active range of movement.Results: Overall, 37 patients were screened, 26 subjects were excluded, and 11 subjects were randomly assigned to the treatmen

BACKGROUND:The classification of proximal humeral fractures remains challenging. The two main classification systems used, the Neer and the AO classification, have both been shown to have less than ideal interobserver agreement. Agreement in classification is required, however, to guide fracture management. METHOD:Data from the Victorian Orthopaedic Trauma Outcomes Registry were collected and the X-rays of 104 proximal humeral fractures were reviewed by three orthopaedic consultants. They classified the fractures according to the Neer and AO classifications, as well as their simplified versions. Interobserver agreement was then assessed using kappa statistics. RESULTS:Interobserver agreement was better overall in the Neer classification, which was moderate (kappa = 0.40-0.58), than the AO classification, which was fair to moderate (kappa = 0.31-0.54). When simplified, the Neer and AO classification interobserver agreement remained similar. CONCLUSION:The classification of proximal humeral fractures with both the Neer and the AO systems remains difficult with minimal improvements seen when reducing the number of categories in each classification system. From these results, the Neer classification system would appear slightly more useful in clinical practice to guide treatment.

The Fairchild Republic Company A-10 aircraft was subjected to a complete static structural test program covering all the critical flight, landing, and ground handling conditions. There were 79 separate test conditionsin this test program. Four of these conditions were selected to be run as failing loads tests at the conclusion of the test program. There were no major structural failures of the primary structure. There were some failures and design deficiencies in secondary structure. (Author)