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Awake neuraxial anesthesia techniques such as spinal anesthesia (SA) have been recently popularized and successfully used in infants for infraumbilical procedures. Application of an infant spinal anesthesia protocol in infants presenting for inguinal herniorrhaphy improves operating room and postanesthesia recovery unit utilization. [Extracted from the article]

The article discusses glenohumeral bone loss and anterior instability. A history of trauma is typically being reported by patients with shoulder dislocation. Axial computed tomography is recommended as its is helpful in quantifying the degree of head involvement to aid in treatment planning. Associated soft tissue injuries to the shoulder can also be evaluated by magnetic resonance imaging.

Cada vez es mayor el número de adultos de mediana edad y ancianos que participan en actividades deportivas, y el de atletas que desean continuar en activo a pesar de su envejecimiento. El conocimiento de las diferencias anatómicas, fisiológicas y psicosociales entre atletas jóvenes y mayores puede ayudar a los atletas de edad avanzada a mantener su función. La capacidad atlética puede conservarse en edades avanzadas, de forma que muchas de las consecuencias fisiológicas del envejecimiento queden mitigadas o revertidas con la práctica regular del ejercicio. La mayoría de las lesiones en atletas de edad avanzada son crónicas o por excesivo uso, pudiendo producir una disminución de su flexibilidad y resistencia. Además, muchos atletas de edad avanzada tienen problemas médicos y musculoesqueléticos que obligan a programar la actividad atlética según su salud general y sus requerimientos funcionales. [ABSTRACT FROM AUTHOR]

Blood loss, operative time, and rate of complications were compared in 606 patients undergoing primary unilateral total hip arthroplasty with either spinal anesthesia (SA) or general anesthesia (GA). Patients were followed for 2 years after surgery. Compared with GA, SA resulted in mean reductions of 12% in operative time, 25% in estimated intraoperative blood loss, 38% in rate of operative blood loss, and 50% in intraoperative transfusion requirements. Compared with patients receiving GA, patients receiving SA had higher hemoglobin levels on postoperative days 1 and 2 and a 20% lower total transfusion requirement. SA appears superior to GA for this procedure.

Os acromiale is a developmental aberration in which the distal acromion fails to fuse. This aberration is often discovered incidentally but may present with a clinical picture similar to that of subacromial impingement syndrome. Treatment for symptomatic os acromiale is initially nonoperative-activity modification, physical therapy, corticosteroid injection, use of nonsteroidal anti-inflammatory medication. Nonoperative management of clinically significant, radiographically confirmed os acromiale should be pursued for at least 6 months before consideration of surgical intervention. Subacromial decompression is often necessary to address symptoms of impingement. Excision of the os fragment may provide definitive treatment for smaller fragments (<3 cm). Removal of larger fragments remains controversial and should be approached with caution. Surgical fixation of larger fragments with or without supplemental autograft in conjunction with a structured postoperative program of physical therapy can reliably provide relief for symptomatic os acromiale.

Although the etiology of the discoid lateral meniscus (DLM) has been the subject of debate, the entity is now believed to result from abnormal development secondary to a deficiency in normal attachments. In children younger than 10 years, snapping knee syndrome is pathognomonic for an unstable DLM. In adolescents, clinical presentation varies and often includes symptoms typically found with meniscal tears. The asymptomatic DLM does not require surgery. Treatment for the symptomatic stable DLM is directed toward arthroscopic saucerization with preservation of enough meniscus to maintain some biomechanical function. Recent reports of meniscal repair for the unstable Wrisberg meniscus have been encouraging. Optimal treatment for DLM requires a high index of suspicion in the appropriate clinical setting and up-to-date knowledge of available therapeutic modalities.