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Calcaneal fractures are difficult to treat because of their often-related sequelae. The authors present a simple, rapid, economic, and easy-to-perform technique that uses percutaneously positioned Kirschner wires plus a plaster cast for the reduction and stabilization of certain calcaneal fractures. A review of the relevant literature is also provided. [ABSTRACT FROM AUTHOR]

Abstract: Colles’ fracture is a distal radius injury, with dorsal tilt of the distal radial fracture fragment. Its typical treatment involves reduction and plaster cast immobilization to restore its anatomical position. Sometimes, reduction maneuver may be difficult with poor outcomes, requiring repeated reduction maneuvers or eventual surgical treatment. The author proposes a simple, easy, and reliable manual reduction technique. [ABSTRACT FROM AUTHOR]

Gleich-Koutsogiannis is a widely known extra-articular closing calcaneal osteotomic technique for correction of the adult flatfoot. Absolute care must be observed during each procedural step to avoid undesirable drawbacks, such as nerves and tendons lesions, incorrect fixation, and hardware painful prominence. It is the purpose of this report to introduce tricks to critical steps in order to improve the technique and minimize potential surgical complications.

Distal tibia fractures are one of the most demanding injuries in orthopaedic traumatology, due mainly to frequent coexistence of covering tissue problems and poor blood supply. Smoking exerts a detrimental effect on fracture healing, increasing the time to union. We report the case of a 60-year-old heavy-smoker (about 20 cigarettes a day) with a distal tibia fracture that necessitated synthesis with an external fixator to maximize the healing process, which nevertheless required more than one and half year to heal. We consider this case as a "take-home message" against tobacco use during the treatment of any orthopaedic issue.

Multifragmentary fractures of the radial head (Mason type 3) are challenging for the surgeon. They are usually treated by means of complete removal of the injured head and sometimes by implantation of a metal prosthesis. Indeed, the bone fragments are often too small to allow stabilization through screws or even wires. The Author proposes an alternative technique, tested on a sawbone model, in which bioabsorbable thread is used, introduced in a figure-of-eight fashion. A review of the literature is provided.

Complete absence of 1 or more pedal rays is a rare condition. In the present report, the case of an adult male with complete congenital absence of his right fourth and fifth pedal rays is described. The condition had been asymptomatic until he had sustained an acute third metatarsal fracture and was satisfactorily treated with cast immobilization., (Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)

Plantar fasciitis is often a difficult condition to treat. It is related to repetitive strain of the fascia at its attachment to the heel bone. This condition quite often appears with the concomitant presence of a plantar calcaneal heel spur. Corticosteroid injection is a popular treatment choice for plantar fasciitis, and accurate localization of the injected medication is essential for successful resolution of symptoms after the injection. In the present brief technical communication, a method for targeting the attachment of the plantar fascia to the medial tubercle of the tuberosity of the calcaneus is described. The targeting method uses the lateral radiograph of the foot to aid in localization of the proximal attachment of the plantar fascia to the calcaneus., (Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)

Traumatic inferior dislocation of the shoulder (also termed "luxatio erecta") is a very rare injury. The correct diagnosis may be overlooked and results after reduction can often result in significant morbidity of the affected joint. It is described in a clinical case in which a male adult reported a luxatio erecta that was correctly diagnosed and reduced with uneventful recovery. Since it is a quite rare event in the emergency room, a careful review of the literature warned us about potential pitfalls in diagnosis and treatment of this peculiar injury. Our brief case report is intended to furnish educational images and stress the importance of a correct clinical and radiographic evaluation.

Unicompartmental knee arthroplasty (UKA) has evolved into a suitable option for diseased knees that cannot be managed with arthroscopic treatment and at the same time are not good candidates for total knee replacement. Since meticulous execution of the surgical technique is essential to optimizing UKA outcome, some procedural key-points are mandatory. Templates (phantoms) are then used to size the required prosthetic component (using these radiographs. Arthritic varus (or valgus) knees with an asymptomatic patello-femoral joint are typically ideal for UKA. Metal-backed tibial components should be favourite instead of all-polyethylene tibial components to avoid polyethylene creep that may occur in fixed bearings. Moreover, a proper thickness of the polyethylene layer is mandatory, in order to avoid early failure.

A peculiar clinical presentation of post-traumatic complex left foot fracture deformity is presented in this report as the result of a motorbike accident. Notwithstanding the significant deformity following forefoot fractures, the patient complained only of the recent onset of metatarsalgia. Of particular interest, is that this severe foot injury as well following deformity was overlooked, probably because patient had sustained head injury that was the main problem to treat due to life risk.

Acute compartment syndrome is both a life and limb threatening surgical emergency, caused by an increase in compartment contents due to either trauma or surgery. We illustrate a foot compartment syndrome, clinically diagnosed, that took place after direct injury during a football match. Compartments release through fasciotomies promptly relieved symptoms. Educational images are furnished.

Epicondilites are pathologies poorly understood from the aetiopathogenetic point of view. In this regard, many hypotheses have been considered and numerous anatomical structures are involved. Current therapeutic options are either conservative or surgical. Conservative treatments are: immobilization of the elbow flexed at 90-degrees, stretching the forearm muscles, manipulating the wrist, the application of low-energy extracorporeal shock waves, acupuncture, autologous blood injection under the extensor carpi radialis brevis, laser therapy and pulsed electromagnetic field therapy. Surgical treatments are: fasciotomy, excision of angiofibroblastic hyperplasias located at the origin of extensor carpi radialis brevis, partial release of the orbicular ligament, release of the extensor muscles, elongation of the tendon of extensor carpi radialis brevis and arthroscopic treatment. Advantages and disadvantages are described for each treatment according to the international literature.

A case of an isolated astragalo-scaphoid dislocation following a fall from a motorbike is reported. Due to the diagnostic obscurity of the full extent of the injury, computed tomography (CT) with 3D reconstruction was utilized to precisely visualize the articular condition and revealed the presence of small intra-articular bone fragments and calcaneo-cuboid subluxation. Furthermore, the detailed imaging offered valuable information for preoperative planning. Patient has healed without sequelae. In light of the good outcome in this case, we suggest utilizing CT with 3D reconstruction when there is a risk to overlook foot dislocation and potential associated lesions.

An unusual picture of polyarticular tophaceous gout is reported. It concerns a 61-year-old patient with tophaceous deposits for 30 years. Descriptive clinical and radiographic images are furnished.

Traditional treatment of complex ankle fracture consists of open reduction and internal fixation. Nevertheless, this treatment can delay fracture healing and cause prolonged oedema. The surgeon should consider necessity of early recovery when treating athletes, especially football players. In this light, it was decided to perform an arthroscopy-assisted percutaneous minimal osteosynthesis of a fibular fracture together with a syndesmotic disruption in order to permit the patient, a 24-year-old male, to resume quicker and easier full sport activities. The outcome was good and allowed patient to play soccer since 6 months following surgery. The complete and detailed articular evaluation provided by the arthroscope permitted to manage carefully a complex articular traumatism, avoiding the necessity of plating the fracture and improving a rapid full recovery of the joint function.

Prosthetic socket revisions are always difficult and affected by problems such as possible bone-stock losses, leading to an increase in morbidity associated with surgery. These aspects are more important in elderly patients due to their frequently poor health. The bone deficit may be filled in different ways, with techniques that are nevertheless technically demanding and at risk of complications. In the opinion of the Author it is possible to leave a migrated but well-fixed cup/shell in place, simply by loading through the insertion of a second cemented cup alongside. We considered two cases of verticalized sockets: a cemented socket and a non-cemented one which, by demonstrating stability in removal attempts, forced the surgeon to leave them in place and to place a second cemented polyethylene cup alongside. This cheap surgical choice allows to shorten surgical times, to diminish blood losses and to achieve an immediate rigid fixation, aspect of utmost importance in elderly patients, allowing them to walk with a 100% load by the second post-operative day. The unremoved prosthetic cup, that is even better stabilized by the new cement, works as a "support wall" in DeLee and Charnley's zone 3, an acetabular X-ray sector notoriously subordinated to damaging tensile forces which may cause loosening of the original prosthetic cup. Because of the positive clinical and radiographic results demonstrated over time by this "enforced" revision solution, the author proposes to name it as the "Wall-Socket" technique.

Distal locking is considered a difficult stage of the endomedullary tibial nailing procedure. A new rapid, simple, and inexpensive freehand aiming technique is presented that uses a galvanized metal grid. The grid is positioned to overlay the skin of the medial cutaneous face of the tibia, giving to the underlying bone under fluoroscopy a pattern that resembles a chessboard. The squares of the grid permit a rapid and accurate localization of the corresponding distal holes of the endomedullary nail, requiring only a single fluoroscopy image, which can be important relative to radiation exposure.

A case of bilateral rupture of the Achilles tendon in a patient treated with levofloxacin for cystitis is reported. A 76-year-old woman suddenly developed painful ankles one day after levofloxacin treatment. Drug therapy was switched to amoxicillin/clavulanate on the fourth day. Sonography revealed a serious condition of tendinosis with complete bilateral full-thickness rupture on day 6. Tendons were both repaired in the same surgical session. Pathological anatomy of the specimens reported fatty tissue lobules with panniculitis and histiocytosis. Ankles were immobilized postoperatively with a plaster cast. Achilles tendon rupture may occur as an adverse side effect of short-term use of levofloxacin, a fluoroquinolone antibiotic. This adverse effect is a rare and poorly understood complication of this antibiotic therapy. A review of the literature is provided.

The authors report the case of intraoperative fracture of the patellar bone plug during an operation to reconstruct an anterior cruciate ligament using bone-patellar tendon-bone. This complication, known among the problems of reconstructing the anterior cruciate ligament, is usually reported when using interference screws to block the plug at the femoral level. In the case, we describe the fracture event occurred using cross-pins. The post-operative 3D radiographic reconstruction permitted precise localisation of the position of the detached bone fragment.