Unusual insidious spinal accessory nerve palsy: a case report.

Introduction: Isolated spinal accessory nerve dysfunction has a major detrimental impact on the functional performance of the shoulder girdle, and is a well-documented complication of surgical procedures in the posterior triangle of the neck. To the best of our knowledge, the natural course and the most effective way of handling spontaneous spinal accessory nerve palsy has been described in only a few instances in the literature.

Case Presentation: We report the case of a 36-year-old Caucasian, Greek man with spontaneous unilateral trapezius palsy with an insidious course.

Maisonneuve fracture without deltoid ligament disruption: a rare pattern of injury.

The Maisonneuve fracture is considered by many to be one of the most unstable ankle injuries. We report a rare injury involving fracture of the proximal fibula in association with a posterior malleolar fracture and disruption of the anterior-inferior tibiofibular ligament, without disruption of the deltoid ligament or fracture of the medial malleolus. This report of a diagnostically challenging case highlights the importance of timely clinical and radiographic reassessment of a patient who fails to improve with initial therapy, and describes the clinical and diagnostic imaging findings of an unusual ankle injury.

Correlation of pQCT bone strength index with mechanical testing in distraction osteogenesis.

Distraction osteogenesis is an established method of treatment of non-unions and limb length discrepancies. Despite improvements in surgical techniques and fixation devices there is still a considerable possibility of failure of the regenerate bone after frame removal. The hypothesis of the present experimental study was that a noninvasive bone strength marker, the strength-strain index (SSI) measured by peripheral quantitative computerized tomography (pQCT), could be significantly correlated with a biomechanical bone strength index, the maximum load at bone failure (F(max)), assessed in a three-point bending test.