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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]

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: Determining the exact details of complex traumatic injuries such as knee ligament rupture will be a crucial point in planning the surgical approach, which is determined through accurate imaging techniques such as magnetic resonance imaging (MRI). We aimed to evaluate the pattern of medial collateral ligament (MCL) rupture in patients who presented with simultaneous rupture of the anterior cruciate ligament (ACL) and MCL. Methods: We evaluated knee MRI in 44 patients (25 women and 19 men, mean age: 38.6 ± 5.4 years) who suffered from clinically acute simultaneous ACL and MCL injuries. Meniscus status, MCL rupture patterns, and pivot bone bruise were analyzed. Results: Concerning ACL rupture, 38.6% had a partial ACL rupture, and 61.4% had a complete rupture. The meniscus ruptured in 61.4%. The most common site of the meniscus rupture was related to the medial posterior horn (37.0%). The vertical type rupture was the most common (37.0%), followed by the horizontal rupture (29.6%). MCL rupture was present in all patients with grade 2 rupture revealed in 52.3%. Regarding the location of MCL ligament rupture, the highest ratio was found in the femoral site (65.9%). Semimembranosus rupture was observed in 2.3%. Pivot bone bruise was positive in 34.1%. Medial patellofemoral ligament (MPFL) rupture was also revealed in 68.2%. There was a significant relationship between the grade of rupture in the MCL and the presence of pivot bone bruise (P < 0.001). Conclusion: Femoral detachment of MCL and posterior horn of medial meniscus (PHMM) are the most common sites of MCL injury and meniscus rupture in the context of ACL rupture. Besides, our results show a relevant influence of the extent of bone bruise on the grade of MCL rupture. [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]

This study aimed to investigate the effectiveness of the sliding double flexible intramedullary nail technique (SDFIN) in managing lower extremity long bone fractures and deformities in patients with osteogenesis imperfecta (OI) based on radiographic measurements. This study was conducted involving type III or IV Silence OI patients who underwent treatment with SDFIN for fractures, deformity correction, or previous device failure. The surgical technique involved the insertion of two straight flexible intramedullary nails in each bone segment, with one inserted from the caudal epiphysis and the other from the proximal region. Clinical and radiological outcomes were evaluated with a mean follow-up of 62.8 ± 20.3 months. Among the 33 lower extremity long bone segments treated with SDFIN, revision was required in 12 segments, resulting in an overall complication rate of 51.5%. Complications included nail migrations observed in 10 cases, decreased joint range of motion in seven, refractures and malrotations in five, nail fracture, and nail extrusion in one case were observed. The femur group had a complication rate of 50%, while the tibia group had a rate of 53.3%. The SDFIN technique demonstrated satisfactory outcomes in managing leg fractures and deformities in OI patients. The technique showed comparable results to newly designed Faisser-Duval rods at a lower cost. Further research and refinement of the technique are necessary to reduce complications and improve patient outcomes., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)