Patella incarceration with associated patella fracture: a rare case of a paediatric patient with no associated femoral fracture.

We describe the case of a 15-year-old girl who presented to the Accident and Emergency Department with right knee pain and a tense effusion following a twist and fall directly onto her right knee. An MRI scan demonstrated that she had an incarcerated dislocated patella with an associated patella avulsion fracture. This required open reduction.

Is It Possible to Overcompress the Syndesmosis?

The case we present suggests that it might be possible to overcompress the syndesmosis, causing subluxation of the talus within the ankle mortise. A 26-year-old female patient had had a Weber Type C ankle fracture internally fixed with a lateral plate and syndesmosis screws. Despite the fibula appearing well reduced and computed tomography imaging showing a well-aligned fibula within the fibular notch, anteromedial subluxation of the talus was present in the ankle mortise.

Migration pattern of a cobalt-chrome monoblock acetabular component after metal-on-metal hip resurfacing.

Objectives: The purpose of this study was to study the initial fixation and migration pattern of a monoblock acetabular component used for a metal on metal hip resurfacing using Einzel Bild Roentgen Analyse (EBRA).

Methods: 99 patients with a mean age of 49.6 years (range 28.

The Bernese peri-acetabular osteotomy through a modified approach. A technical note.

Introduction: A modification of the technique for performing the Bernese periacetabular osteotomy is described.

Materials And Methods: A medial approach to the Ischium and a subtle re-orientation of the pubic osteotomy are detailed.

Conclusion: Surgical morbidity is likely decreased with a concurrent cosmetic advantage without compromise to surgical correction or patient safety.

Custom-made cement-linked mega prostheses: a salvage solution for complex periprosthetic femoral fractures.

Periprosthetic femoral fractures with long stem implants, poor bone stock and loosening pose a considerable surgical challenge. We describe a reconstruction technique using a custom-made mega-prosthesis, cement-linked to the femoral stem of a well-fixed existing implant. Clinical and radiological outcomes were assessed at our tertiary referral centre.

Negligence claims in UK total hip arthroplasty: a series of 167 consecutive cases.

A review of negligence reports, detailing 227 complaints from the practices of two orthopedic surgeons, was undertaken. There were demonstrable differences in the number of complaints over leg-length discrepancy; femoral fracture and cup malposition when cemented versus uncemented implants were compared. Surgeons must appreciate the less forgiving nature of uncemented hip implants and the importance of preoperative planning particularly in the presence of abnormal anatomy.

Total hip arthroplasty in teenagers: an alternative to hip arthrodesis.

Debilitating arthritis in teenage patients is a complex problem with limited surgical options. Hip arthrodesis is unpopular amongst patients, and contemporary total hip arthroplasty (THA) may be a promising alternative. We report on the outcomes of THA in patients less than 20 years of age.

Metal-on-metal bearings, inflammatory pseudotumours and their neurological manifestations.

Metal-on-metal bearings have become more popular for hip arthroplasty in younger patients in the last 15 years. We present a review of the neurological consequences relating to such bearing surfaces illustrated by an appropriate case report. The mechanisms of increased metal ion production and pseudotumour formation are discussed.

The reconstruction of periprosthetic pelvic discontinuity.

The surgical techniques and outcomes of acetabular reconstruction for periprosthetic pelvic discontinuity cases are reported. The mean time to surgery for 9 patients with acute pelvic discontinuity was 16.3 days, with 8 patients (88%) having posterior column plating and a porous metal acetabular cup.

Bilateral symmetrical metachronous myxofibrosarcoma: a case report and review of the literature.

Soft tissue sarcomas (STS) are rare. Affected patients are at increased risk of developing a second primary malignancy, particularly another primary STS. These rarely affect the extremities, tending to occur in the abdomen, head or neck.

Internal fixation after subtrochanteric femoral fracture after hip resurfacing arthroplasty.

Periprosthetic fractures around total hip arthroplasty create surgical challenges with many described techniques of either fixation or revision. The increasing popularity of hip resurfacing arthroplasty poses different problems especially if there is a desire to retain the prosthesis rather than converting to a total hip arthroplasty. We describe a previously unreported technique of fixation for a comminuted, proximal femoral fracture, beneath a hip resurfacing.

Immune responses in patients with metal-on-metal hip articulations: a long-term follow-up.

Metal-on-metal (MoM) hip bearings are being inserted into ever-younger patients. The effects on the immune system of chronic exposure are unknown. We investigated the immune response of patients with MoM hip bearings.

Osteoblastoma crossing the sacro-iliac joint.

Osteoblastoma is a rare primary bone tumour which is well-described in the spine and sacrum. We report a case of histologically confirmed osteoblastoma in a 20-year-old male which crossed the sacroiliac joint. This has not previously been described to our knowledge.