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Key Clinical Message: Despite being rare, we have presented a case of osteonecrosis of acetabulum that followed total hip arthroplasty. It's crucial to act appropriately, as it emulates periprosthetic joint infection. The key point is that the osteonecrosis of acetabulum may necessitate revision and can be classified as aseptic loosening. Osteonecrosis of the femoral head is well known and managed with total hip arthroplasty (THA). Acetabulum osteonecrosis can be classified as a cause of painful THA and the cemented acetabular component is a feasible option. However, it seems that the osteonecrosis of acetabulum is sparsely alluded in literature. In this case report sustaining of the right hip pain following THA of 35‐year‐old woman is discussed. [ABSTRACT FROM AUTHOR]

Background: A variety of options including titanium elastic nails (TENs) and locking plates (LPs) are available for the internal fixation of subtrochanteric fractures (STFs). However, the preferred treatment option among children and adolescents is still controversial. Methods: We report four cases of STFs in school-aged pediatric patients, treated with an adult proximal humerus LP. Results: Based on the Flynn scoring system at the last follow-up visit, all patients exhibited excellent clinical outcomes, along with satisfactory radiological outcomes based on the Beaty scoring system. There were no complications. Conclusion: Our findings suggest the efficacy of using adult proximal humerus LPs in treating pediatric STFs. The advantage of these plates lies in their ability to accommodate many screws at appropriate positions and angles without damaging the physis. This approach holds promise for the management of pediatric STFs. [ABSTRACT FROM AUTHOR]

Background: After the spine, the hip is the most common site that can be infected with extrapulmonary tuberculosis (TB). In the early stages, patients present with complaints of pain around the hip, and after a while, they might experience deformities, shortening, and limited movements. Because hip TB mimics the symptoms of other hip diseases like rheumatoid arthritis (RA) and osteoarthritis, diagnosis is difficult. Here, we aimed to report a rare case of hip TB secondary to pulmonary TB and the result of the total hip arthroplasty (THA). Case Report: A 41-year-old man presented to the orthopedic clinic with a complaint of progressive pain in the right hip. After laboratory tests, imaging, and sputum culture, active TB infection and advanced arthritis of the hip joint were detected. A subluxation/dislocation stage of arthritis and an acetabular protrusion were present, leading to the restriction of movements. After receiving medical therapy, we performed THA for the patient. Conclusion: The patient's right hip reached a normal range of motion (ROM) without pain in the 18-month follow-up. Since TB can mimic the symptoms of many common diseases, considering hip TB along with other diagnoses can aid in reducing possible complications and improving patients' lives. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Anterior acetabular wall fractures that extend into the anterior inferior iliac spine are more likely to be unstable, and more likely to require surgical fixation. Conventional acetabular anterior wall fractures originate below the anterior inferior iliac spine (AIIS) level and involve the pelvic brim. Since surgical treatment is preserved for instability and hip incongruency, atypical variation of this fracture usually jeopardizes hip stability. We report on a 33‐year‐old case of an acetabular anterior wall fracture extending to the anterior inferior iliac spine. He was prepared for the stress test and hip stability checked, that was unstable in extension and external rotation. The joint was exposed with the Smith–Peterson approach. Hip congruency was restored, and the AIIS fragment was stabilized by open reduction. Acetabular anterior wall fracture involving AIIS with preservation of pelvic brim is a rare equivalent of anterior wall fracture that jeopardizes hip stability and should be managed surgically. Anterior approaches are preferred in order to visualize the joint. [ABSTRACT FROM AUTHOR]

Background: The talus bone is the second-largest bone in the tarsal region. Talar fractures are rare injuries that occur due to highenergy traumas. Open reduction and internal fixation (ORIF) is the treatment of choice in the talar body fracture-dislocation. Avascular necrosis (AVN), osteoarthritis (OA), malunion, non-union, skin infections, and ankylosis of the subtalar joint are complications that can happen following the talar body fracture. Case Report: We reported a rare open fracture-dislocation of the talar body concomitant with the anterior talofibular ligament (ATFL) rupture in a 24-year-old motorcyclist man. ORIF with two 4.5 mm cancellous screws and ATFL repair were performed. After 6 months of follow-up, the radiographic bone union was achieved, and the patient had no complaints of pain, disability, and discomfort. Conclusion: According to the blood supply of the talus bone, appropriate management and follow-up should be considered to prevent severe consequences. Due to the lack of literature on this lesion, in this report, we tried to provide more comprehensive information regarding the diagnosis, treatment, and follow-up of this group of patients. To the best of our knowledge, our case will probably be the second case of the talar body fracture concomitant with rupture of the ATFL. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Combined fractures of the femoral head and acetabulum due to hip gunshot injuries (GSI) are rare, and there is no preferred treatment option. We present a 35‐year‐old male patient who sustained a right hip GSI. Delayed THA with a two‐step sequential approach is a feasible management in this situation to manage soft tissue and decrease infection rate. At a 1‐year follow‐up visit, the pain was relieved, and the function improved significantly, and he had no complaints. [ABSTRACT FROM AUTHOR]

Septic arthritis (SA) is a joint inflammation that develops secondary to infectious causes. SA in children is associated with a high rate of morbidity and mortality; therefore, it is regarded as an orthopedic emergency. Because SA of the hip joint usually mimics other musculoskeletal diseases, diagnosis remains challenging. Although this lesion usually shows a good outcome, treatment at an inappropriate time, neglect, or inadequate treatment could lead to poor outcomes. We report on the case of a healthy adolescent who complained of episodes of fever and chills, weight loss, pain in his left hip, and limping. After performing necessary workups, two differential diagnoses of tumor and SA were made. The results of Gram stain and culture of the synovial fluid after surgical excision showed Klebsiella pneumoniae and Enterobacter cloacae complex. To the best of our knowledge, this is the first report of SA due to co-infection with K. pneumoniae and E. cloacae in a healthy patient. [ABSTRACT FROM AUTHOR]

Traumatic rupture of the posterior tibialis tendon is an extremely infrequent condition, which mostly occurred due to a traumatic mechanism of pronation and external rotation, less commonly in direct trauma on the medial side of the ankle. This lesion is overlooked preoperatively most of the time because of the limitation of physical examination owing to acute pain and swelling secondary to a medial malleolar fracture. Early diagnosis and treatment of this injury are very important to prevent the complications like acquired flatfoot deformity. Few cases have been described in the literature for the posterior tibialis tendon rupture associated with a closed ankle fracture. Here we report an acute rupture of the posterior tibialis tendon associated with a closed medial malleolar fracture after a high-energy trauma in a healthy 33-year-old man. We fixed the medial malleolar fracture with two screws and repaired the tendon with a direct end-to-end suture. We hope that our study can be helpful for other colleagues to consider this lesion in similar circumstances. [ABSTRACT FROM AUTHOR]

Background/Objectives Isotretinoin is commonly used in the treatment of acne vulgaris. While one of the more common side-effects is cheilitis, we have observed an increased incidence of cheilitis prior to the commencement of systemic isotretinoin. The aim of this study was to assess the prevalence of cheilitis among acne vulgaris patients. Methods A non-interventional cross-sectional study of patients with acne vulgaris. Patients with previous use of systemic retinoids were excluded. The patients were examined for signs and symptoms of cheilitis. Results Of a total of 400 patients, 134 (34%) had evidence of cheilitis at initial presentation. Two-thirds (63%) were female ( P < 0.001). The distribution of the cheilitis was as follows; 55% on the lower lip, 30% on both lips, and 16% on the upper lip. Over a quarter (27%) of patients with cheilitis had acne excorie, compared with only 8% of patients with no signs of cheilitis. Conclusion Our findings suggest that cheilitis is quite common among acne vulgaris patients even before treatment with isotretinoin. [ABSTRACT FROM AUTHOR]