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Objective: Intertrochanteric femur fractures (ITFF), more so reverse oblique fractures (AO/OTA 31-A3), are the most challenging clinically, with significant morbidity and mortality. Early stable fixation should be achieved to allow early mobilization and reduce complications. This study evaluates the functional and radiological outcomes of three Proximal Femoral Nail (PFN) techniques – PFN alone, Cable + PFN, and Monocortical reconstruction plate (MRP) + PFN– in managing reverse oblique ITFF, to determine the most ideal of them. Methods: A retrospective analysis was performed on 106 patients treated from 2015 to 2022. The patients were classified by the surgical intervention: Cable + PFN (n = 37), MRP + PFN (n = 29), and PFN (n = 40). The critical parameters analyzed included healing time, quality of reduction, rates of complications, and functional outcomes of Trendelenburg gait. Results: The bone healing time was significantly faster in the Cable + PFN group and MRP + PFN group as compared to the PFN group, 4.43 ± 0.92 and 4.44 ± 0.90 months versus 6.40 ± 2.41 months, respectively (p

Objective: Diagnosing subscapularis tendon rupture in preoperative MRI slices can be challenging. This study investigated whether subcoracoid effusion (SE) is more common in subscapularis tendon injuries and whether it can serve as a marker. Methods: Patients with subscapularis tendon rupture were categorized as Group 1, consisting of 26 patients, while patients with intact subscapularis tendon but other cuff pathologies were classified as Group 2, consisting of 116 patients. We evaluated the presence of effusion in the subcoracoid bursa, effusion in the subscapular bursa, acromiohumeral distance, and coracohumeral distance. We examined retrospectively 208 patients who underwent shoulder arthroscopy in the same clinic between January 2021 and August 2023. We included 142 patients in the study who underwent surgery due to rotator cuff rupture. cuff rupture. We reviewed preoperative MRI images and surgical notes of the patients. Patients with subscapularis rupture were categorized as Group 1, consisting of 26 patients, while patients with intact subscapularis but other cuff pathologies were classified as Group 2, consisting of 116 patients. Results: No statistically significant differences were observed between the groups regarding sex, age, and gender. Of 142 patients, 26 (18%) had arthroscopically confirmed Ssc tears. Among these, 22 were repaired, and 4 underwent debridement. There was no significant difference between the groups regarding acromiohumeral distance (p=0.253) and coracohumeral distance (p=0.12). No significant difference was found in subscapular bursa effusion between the groups (p=0.81). The difference in SE between the groups was statistically significant (p=0.0003). Conclusion: In our study, we showed the relationship between the sub finding and Ssc tears. We found no relationship between coracohumeral and acromiohumeral distance and subscapularis tears. [ABSTRACT FROM AUTHOR]

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Lisfranc injuries are rare, often missed, and may cause permanent structural deterioration of tarsometatarsal joint, despite optimal management. Consequently, a Lisfranc injury may lead to disruption of the biomechanics of the normal foot during walking and may alter the plantar pressure distribution, which is essential for proper gait mechanics. Therefore, the main purpose of the study was to specify the dynamic plantar pressure, radiographic and clinical features, after surgically managed Lisfranc injuries. This study was carried out over a period of 10 years and included 62 patients who were surgically treated for Lisfranc injury, with mean 57-month follow-up. Radiological (intermetatarsal, Kite's, first metatarsophalangeal, Meary's, Hibbs' and calcaneal pitch angles, and medial cuneiform–fifth metatarsal distance), pedobarographical, and clinical results with the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score assessments for both feet were assessed. In the radiological assessment, the mean first intermetatarsal (p = 0.006) and Meary's angle (p = 0.000) were decreased on the injured feet compared to the uninjured feet on the anteroposterior and lateral radiographs. In the pedobarographic assessment, the injured feet midfoot contact time increased (p = 0.03), and maximum force (p = 0.001), total peak pressure (p = 0.008), and contact area (p = 0.017) decreased, compared to the uninjured feet. The mean AOFAS score was 75/100 at the final follow-up visit. There was seen to be reduced both contact surface area and time of the midfoot. Despite surgical management of Lisfranc injuries, the injured foot does not regain functional, radiological, or pedobarographical levels as compared to the uninjured foot for ≥ 57 months. [ABSTRACT FROM AUTHOR]

Abstract Introduction Pyomyositis is a disease in which an abscess is formed deep within large striated muscles. Case presentation We report the case of a 10-year-old boy who presented with fever and a painful hip and was subsequently diagnosed with pyomyositis of the tensor fascia lata. In children with clinical and laboratory findings of inflammation in the vicinity of the hip joint, the differential diagnosis includes transient synovitis, an early stage of Legg-Calvé-Perthes disease, infectious arthritis of the hip, rheumatologic diseases and extracapsular infection such as osteomyelitis. Conclusion To the best of the authors' knowledge, this is the first report of pyomyositis of the tensor fascia lata. Although pyomyositis is a rare disease and the differential diagnosis includes a variety of other commonly observed diseases, pyomyositis should be considered in cases where children present with fever, leukocytosis and localized pain.

Objective: Most of the previous studies have shown good functional outcomes for most patients after in situ pinning or pinning with anatomical reduction of slipped capital femoral epiphyses (SCFE). We undertook a retrospective study to document comparative outcomes of both treated groups of 25 SCFE patients. Methods: Between 2005 and 2013, 21 patients (26 hips) with SCFE underwent in situ pinning or pinning with anatomical reduction at a tertiary referral center. Medical records and radiographs were reviewed for slip characteristics. Magnetic resonance imaging (MRI) was performed to all patients at final visits. Mean follow-up was 139 months (range, 64 to 179). Results: There was no significant difference between in situ group and reduction group regarding range of motion (ROM), Visual Analog Scale (VAS), and Harris Hip Score (HHS) of hip (p>0.05). Mean outcome scores were; HHS 80.4, and VAS 2.9 respectively. Conclusion: Especially in the anatomic reduction group, a decrease in hip ROM was observed (not statistically significant) compared to the in situ group. MRI revealed atrophy of the peri-hip musculature in the reduction group. This present study may suggest that patients with SCFE whether anatomically reduced or in situ pinned may not contribute to clinical outcomes. [ABSTRACT FROM AUTHOR]

Objective: Polio survivors have common sequelae of lower extremity paralysis characterized by flaccid muscle tone, limited ambulation, asymmetric involvement, retarded growth, and disuse osteoporosis. Such patients at risk of disuse osteoporosis are also at risk of sustaining osteoporotic fractures. This study aims to evaluate the effectiveness of extramedullary internal fixation devices in achieving better results in osteoporotic poliorelated femoral fractures. Methods: Retrospective evaluation was made of a total of 13 adult polio patients treated with extramedullary internal fixation devices for unilateral proximal and diaphyseal femoral fractures. The functional status of all patients was evaluated with the Vignos grade of disability. Results: All patients (mean age 62 years; range 47-88 years) were treated with extramedullary internal fixation devices (locked plate in eight diaphyseal fractures; dynamic condylar screw (DCS) and plate in three, and dynamic hip screw (DHS) and plate in two proximal femoral fractures). The mean follow-up period was 48.6 months (range 26-62 months). Bony union was confirmed at a mean of 3.7 months (range, 3-5 months) in all patients. Massive pulmonary embolism was seen in one patient. No cases of non-union, implant cutout or any other complications developed. Conclusion: Post-polio patients are at high risk of fractures. Extramedullary internal fixation devices provide effective stability for bony union and good functional results in poliorelated femoral fractures. [ABSTRACT FROM AUTHOR]

Glomus tumors are rare, slow-growing vascular tumors that are uncommon in the foot or ankle. This case series describes 2 glomus tumors located in the hallux, 1 in the foot, and 3 in the ankle. One case was misdiagnosed and initially mistreated at another facility, radiographs were not diagnostic in any of the cases, and magnetic resonance imaging was diagnostic in only 2 cases. Surgical treatment was ultimately successful in all cases. It is hoped that this series may help to raise awareness of glomus tumors among foot and ankle surgeons. [ABSTRACT FROM AUTHOR]