Clinical Documents

To edit the draft, click on the text box below.

×

Draft a comprehensive differential diagnosis for acute substernal chest pain in a 45-year-old male with hypertension and hyperlipidemia, diaphoresis, exertional onset, and normal initial ECG/troponin; include life-threatening causes first, key distinguishing features, and immediate diagnostic next steps.

Draft a detailed differential diagnosis for new-onset unilateral throbbing headache with visual aura and brief monocular vision loss in a 32-year-old female on oral contraceptives; include red-flag symptoms, stroke/TIA considerations, and recommended initial workup.

Draft an assessment and plan for stage-2 hypertension (BP 162/98) in an obese 52-year-old with suspected obstructive sleep apnea; include ASCVD risk estimate, lifestyle prescriptions, first-line pharmacotherapy with drug/dose/targets, baseline labs/monitoring, and 4–6 week follow-up.

Draft an assessment and plan for type 2 diabetes follow-up with A1c 9.2% on metformin 1,000 mg BID and eGFR 65; compare adding a GLP-1 receptor agonist vs an SGLT2 inhibitor, address weight loss goals, hypoglycemia education, vaccinations, and micro/macrovascular screening.

Draft a history and physical for a patient presenting with chest pain, including HPI using OLDCARTS, pertinent ROS, PMH/meds/allergies, FH/SH, focused cardiac/pulmonary exam, initial labs and imaging orders, prioritized differential, HEART score risk stratification, and early management.

Draft a history and physical for a new patient with progressive exertional dyspnea, orthopnea, and bilateral leg edema; include differential (heart failure, COPD, PE, anemia, renal disease), targeted exam maneuvers, and first-line diagnostics and management.

Draft a progress note for COPD follow-up two weeks after an acute exacerbation treated with prednisone and antibiotics; include symptom trajectory, CAT score (if available), inhaler technique/adherence, oxygen needs, spirometry plan, smoking cessation counseling, and return precautions.

Draft a progress note for post-operative day 2 after total knee arthroplasty; include pain control strategy, DVT prophylaxis, PT/OT milestones, wound status, bowel/urinary function, labs/vitals review, complications screening, and discharge readiness.

Draft a discharge summary for community-acquired pneumonia admission; include admission/discharge dates, presenting symptoms, radiology/labs, pathogen if identified, inpatient therapies and response, discharge medications with durations, pending tests, follow-up appointments, and return precautions.

Draft a discharge summary for myocardial infarction managed with PCI and drug-eluting stent placement; include cath findings, complications, inpatient course, discharge medications (DAPT, statin, beta-blocker, ACEi/ARB), cardiac rehab referral, and follow-up plan.

Draft discharge instructions for a patient hospitalized with acute decompensated heart failure; include daily weights, sodium and fluid restriction amounts, medication list with dosing, signs of worsening heart failure, follow-up appointments, and lab monitoring plan.

Draft discharge instructions for an asthma exacerbation; include controller and reliever regimen, steroid taper schedule, spacer technique, trigger avoidance, a written asthma action plan, return precautions, and follow-up timing.

Draft a patient handout on managing high blood pressure in plain language; explain what BP numbers mean, key lifestyle steps (DASH diet, sodium limits, alcohol moderation), home BP monitoring instructions, medication adherence tips, and when to call the doctor.

Draft a patient handout for type 2 diabetes education in plain language; cover A1c goals, the plate method, physical activity targets, self-monitoring of blood glucose, hypoglycemia signs and the 15-15 rule, foot care basics, and a vaccination checklist.

Draft a summary of the latest CDC and WHO guidelines for managing community-acquired pneumonia in adults, including empiric antibiotic choices, duration of therapy, and follow-up recommendations.

Draft a plain-language overview of the ADA and AACE guidelines for diabetes management, focusing on A1c goals, weight management, and the use of GLP-1 receptor agonists and SGLT2 inhibitors.

Draft a summary of the 2024 USPSTF breast cancer screening recommendations, including updated screening intervals, risk-based approaches, and the role of MRI for high-risk patients.

Draft a concise summary of NCCN guidelines for melanoma management, including staging, surgical margins, adjuvant therapy, and checkpoint inhibitor recommendations.

Draft treatment alternatives for community-acquired MRSA skin infections in patients allergic to sulfa drugs; include oral and IV options, dosing, and duration.

Draft treatment alternatives for patients with type 2 diabetes who are unable to tolerate GLP-1 receptor agonists due to nausea; include medication substitutions and lifestyle recommendations.

Draft a summary of options for treating refractory depression, comparing ketamine infusions, transcranial magnetic stimulation (TMS), and electroconvulsive therapy (ECT).

Draft treatment options for advanced prostate cancer, including hormonal therapy, radiopharmaceuticals, and novel androgen receptor pathway inhibitors.

Draft a summary of recent research on mRNA vaccine technology beyond COVID-19, including applications in oncology and autoimmune disease prevention.

Draft an easy-to-understand overview of long COVID research, summarizing major symptoms, hypothesized mechanisms, and emerging treatment approaches.

Draft a summary of current research on Alzheimer’s disease biomarkers, including amyloid and tau imaging, and discuss how they influence diagnosis and trial design.

Draft an explanation of the interaction between warfarin and antibiotics such as ciprofloxacin or TMP-SMX, including INR effects and management recommendations.

Draft a summary evaluating drug interactions for patients taking Paxlovid and common cardiovascular drugs; include mechanism and recommended dose adjustments.

Draft a summary of the common and serious side effects of semaglutide, including GI intolerance, gallbladder disease, and thyroid-related warnings.

Draft an overview of potential side effects associated with long-term corticosteroid use, including osteoporosis, glucose intolerance, and adrenal suppression.

Draft a summary of essential lab tests to order in suspected acute pancreatitis, including amylase, lipase, liver enzymes, and metabolic panels, with interpretation guidance.

Draft laboratory workup recommendations for suspected hypothyroidism, including TSH, free T4, thyroid antibodies, and when to consider secondary causes.

Draft an explanation of which labs should be monitored in patients receiving methotrexate therapy, including CBC, LFTs, renal function, and frequency of monitoring.

why choose us

Edit Geo

×

300×250 Ad Slot

Research Article: Comparison of three reconstruction techniques for medial column support loss in elderly patients with proximal humeral fractures

Date Published: 2026-05-08

Abstract:
To compare the therapeutic outcomes of lateral locking plate combined with anterior medial support plate, locking plate combined with autogenous iliac bone graft, and simple lateral locking plate in the reconstruction of medial column support loss in elderly patients with proximal humeral fractures. A retrospective cohort study was conducted to analyze the data of 51 elderly patients with proximal humeral fractures who were admitted to the Orthopedics Department of Zhongshan Hospital affiliated with Dalian University from February 2016 to May 2020 and suffered from medial column support deficiency. 16 males and 35 females; Age (62.4 ± 10.2) years old. 17 cases were treated with lateral locking steel plate combined with anterior medial support steel plate (double plate group), 17 cases were treated with locking steel plate combined with autogenous iliac bone graft (bone graft group), and 17 cases were treated with lateral PHILOS steel plate alone (steel plate group). Compare the hospitalization time, intraoperative blood loss, fracture healing time, neck shaft angle, humeral head loss height, and shoulder joint range of motion (flexion, abduction, external rotation, extension) among three groups of patients at the last follow-up. At the last follow-up, use pain visual analog scale (VAS), American Society of Shoulder and Elbow Surgeons (ASES), disability of the arm, shoulder, and hand (DASH) score, and shoulder joint function Constant Murley score to observe the incidence of complications. All 51 patients were followed up for 12–26 months (mean 16.8 ± 2.6 months). There was no statistically significant difference in preoperative general information among the three groups of patients ( P > 0.05), indicating comparability. The bleeding volume of the three groups was 450.6 ± 13.7 ml, 380.5 ± 15.3 ml, and 280.2 ± 10.3 ml, respectively, and the differences between the two groups were statistically significant ( P < 0.05). There was no statistically significant difference in hospitalization time and fracture healing time among the three groups of patients ( P > 0.05); at the last follow-up, the neck shaft angles were 132.1° ± 9.8°, 125.3° ± 5.4°, and 120.1° ± 7.5°, respectively, with statistically significant differences between the two groups ( P < 0.05). At the last follow-up, the height of humeral head loss was 1.32 mm ± 0.33 mm, 2.04 mm ± 0.56 mm, and 3.12 mm ± 0.85 mm, respectively, with statistically significant differences between the two groups ( P < 0.05). At the last follow-up, the range of motion for shoulder flexion was 158.6° ± 12.8°, 149.3° ± 10.5°, and 140.2° ± 11.3°, respectively, with statistically significant differences between the two groups ( P < 0.05); The outreach activity degrees were 148.2° ± 10.4°, 140.3° ± 11.5°, and 134.3° ± 12.6°, respectively, and the differences between the two groups were statistically significant ( P < 0.05); the external rotation range of motion was 41.2° ± 7.8°, 40.5° ± 6.1°, 39.8° ± 7.4°, and the backward extension range of motion was 36.6° ± 1.2°, 35.8° ± 1.0°, 35.2° ± 1.4°, respectively. There was no statistically significant difference in the comparison between the three groups ( P > 0.05). At the last follow-up, there was no statistically significant difference in VAS score, ASES score, DASH score, and Constant Murley score among the three groups ( P > 0.05). There were 1, 2, and 3 patients with complications in each of the three groups, respectively, with no statistically significant difference observed among the groups ( P > 0.05). For complex fractures of the proximal humerus in elderly patients with missing medial column support, all three reconstruction techniques can effectively reconstruct the stability of the medial column. However, the combination of a lateral locking plate and an anteromedial support plate (dual plating, Group A) demonstrated superior outcomes in maintaining the postoperative neck shaft angle, prevent loss of humeral head height, improve shoulder joint mobility, promote functional recovery, and have the advantage of fewer complications. However, this technique is also associated with disadvantages such as extensive soft tissue dissection and a relatively complex surgical procedure. Treatment selection should be individualized based on patient factors and surgeon experience.

Introduction:
Proximal humeral fracture is a common orthopedic injury. It is the third most common fracture among the elderly, following hip fractures and distal radius fractures, with an increasing incidence rate ( 1 ). Proximal humeral fractures account for about 5%?9% of all fractures in adults, and are more common in elderly patients with osteoporosis, especially women. In this age group where osteoporosis is common, even simple injuries from falls can lead to serious fractures. The incidence rate of proximal humeral…

Read more

300×250 Ad Slot

×
Chat & Ask Questions Career Openings Medical Doctors Check on Drug
Interactions Latest Health News
by WebHealthNetwork Get CME Credits Latest Clinical Trials Latest Research Articles Clinical Documents Update Profile

News

Chat

HCP Tools

Careers

Update Profile