Delayed Femoral Nerve Palsy Due to Femoral Artery Pseudo-Aneurysm After a Total Hip Replacement Through an Anterolateral Approach.

We present a rare case of delayed femoral nerve palsy resulting from a pseudo-aneurysm presenting as excruciating anterior thigh pain 2 months after an uneventful total hip arthroplasty through a Watson Jones approach. The large pseudo-aneurysm of the posterior wall of the femoral artery was treated with open exploration and artery repair since the anatomy of the lesion precluded an embolization. Although pain resolved immediately, the recovery of the femoral nerve started after 3 months, while full quadriceps function was restored by the 6th month.

An Early Functional Unsupervised Rehabilitation Protocol Allows Safe Return to Function After Achilles Tendon Repair.

Purpose: Acute Achilles tendon tears in young active individuals are often treated surgically with prolonged rehabilitation, with the leg initially immobilized in plantar flexion in serial non-weight bearing casts and gradually progressing to full weight bearing. This study aimed to evaluate the safety of an early functional unsupervised rehabilitation protocol.

Methods: The medical records of 25 patients treated with open repair were available for follow-up.

In-Flight Medical Events and Cabin Crew First Aid Response.

In-flight medical events (IMEs), although rare, are challenging due to the limited onboard resources and the time needed to reach an airport. Cabin crewmembers (CCMs) are trained to provide first aid, but their effectiveness has not been appropriately studied. IMEs occurring in the biggest airline of Greece were prospectively recorded during a 5-yr period (20142018) and categorized according to a symptom-based taxonomy.

A pilot biomechanical study comparing a novel, intramedullary Nail/Plate construct to standard Dual-Plate fixation of intra-articular C2.3 distal humerus fractures.

Background: The gold-standard treatment for intra-articular distal humerus fractures (DHFs) is dual-plate/dual-column fixation, though optimal orientation is not yet established. With a superior method not yet identified, we propose a load-sharing construct, combining absolute stability (extramedullary plate fixation) for distal articular fragments and relative stability (load-sharing intramedullary nail) for the metaphyseal segment. The purpose of this pilot study was to evaluate the biomechanical performance of a novel implant compared to orthogonal dual-plating.

Topical use of tranexamic acid in primary total knee arthroplasty: a comparative study.

Introduction: Perioperative blood management represents a major issue in knee arthroplasty. The aim of the present observational study is to compare two different methods of topical tranexamic acid (TXA) administration (periarticular and intraarticular) in primary knee arthroplasty.

Patients And Methods: The present is an observational comparative study.

Musculoskeletal injuries among elite artistic and rhythmic Greek gymnasts: A ten-year study of 156 elite athletes.

Data on elite gymnast injuries outside North America is sparse. We report the injuries recorded over a period of 10 years in 156 Greek elite male and female gymnasts. A total of 2390 injuries were reported for a rate of 1,5 new injuries per year per athlete.

The role of cell therapies and hip arthroscopy in the management of osteonecrosis: an update.

The exact pathophysiology of osteonecrosis of the femoral head (ONFH) is still unknown. There is evidence to suggest that in ON there is decreased population and altered function of the mesenchymal stem cells (MSCs) of the femoral head. This could influence both the actual occurrence of ON itself and the repair process that follows.

Neglected patella nonunion successfully treated after 8 years by quadriceps distractive lengthening with a spanning unilateral external fixation system.

Neglected patella non-unions are rare. Contraction of the quadriceps makes late repair extremely difficult. A case of distal patella pole fracture neglected for 8 years is presented.

Prevalence of Knee Osteoarthritis in 100 Athletically Active Veteran Soccer Players Compared With a Matched Group of 100 Military Personnel.

Background: Although knee injuries in professional soccer (football) have been extensively studied, the prevalence of knee osteoarthritis (OA) in veteran players is not well documented.

Purpose: To investigate the prevalence of knee OA in retired professional soccer players in comparison with a group of athletically active military personnel.

Study Design: Cross-sectional study; Level of evidence, 3.

Thoracic Aortic Injury: Embolization of the Tenth Intercostal Artery and Endovascular Treatment in a Young Woman after Posterior Spinal Instrumentation.

Iatrogenic aortic injuries are rare and well-recognized complications of a variety of procedures, including spinal surgery. The placement of pedicle screws is sometimes associated with devastating consequences. Aortic perforation with rapid hematoma formation and delayed aortic trauma leading to pseudoaneurysm formation have been described in the literature.

Neglected lesser tuberosity avulsion in an adolescent elite gymnast.

We report the case of a 16-year-old elite gymnast who presented with recurring pain in the left shoulder after training. The athlete recalled an injury to the shoulder 2 years ago. Clinically a localized tenderness to the anterior shoulder and loss of strength and range of motion was noted.

Evaluation of pullout strength and failure mechanism of posterior instrumentation in normal and osteopenic thoracic vertebrae.

Object: There is limited data on the pullout strength of spinal fixation devices in the thoracic spine among individuals with different bone quality. An in vitro biomechanical study on the thoracic spine was performed to compare the pullout strength and the mechanism of failure of 4 posterior fixation thoracic constructs in relation to bone mineral density (BMD).

Methods: A total of 80 vertebrae from 11 fresh-frozen thoracic spines (T2-12) were used.

Anterior cervical discectomy and fusion with a locked plate and wedged graft effectively stabilizes flexion-distraction stage-3 injury in the lower cervical spine: a biomechanical study.

Study Design: An in vitro three-dimensional (3D) flexibility test of human C3-C7 cervical spine specimens.

Objective: To test the hypothesis that anterior cervical fusion with a wedged graft and a locked plate can effectively stabilize the cervical spine after complete anterior and posterior segmental ligamentous release.

Summary Of Background Data: Distraction-flexion Stage 3 injuries of the lower cervical spine (bilateral facet dislocations) are usually reduced under awake cranial traction.

Tibiotalocalcaneal arthrodesis with a retrograde intramedullary nail: a biomechanical analysis of the effect of nail length.

Background: Fatigue fractures of the tibia have been observed at the level of the proximal end of the nail after successful tibiocalcaneal arthrodesis with a retrograde intramedullary device.

Materials: To study the effect of nail length, five matched pairs of cadaver tibiae were instrumented with strain gauges and potted in methylmethacrylate from a level 3 cm proximal to the distal medial malleolus to simulate a successful tibiocalcaneal arthrodesis. A standard length (15 cm) ankle arthrodesis nail and an identical longer device terminating in the proximal tibial metaphysis were inserted in each paired tibia using appropriate technique.

Flexion-extension response of the thoracolumbar spine under compressive follower preload.

Study Design: The authors conducted an in vitro biomechanical flexibility study of T2-S1 specimens in flexion-extension under compressive follower preloads of physiological magnitudes.

Objectives: The objectives of this study were to test the hypotheses that 1) the thoracolumbar spine will support compressive preloads of in vivo magnitudes and 2) allow physiological mobility under flexion-extension moments if the preload is applied along an optimized follower load path that approximates the kypholordotic curve of the thoracolumbar spine.

Summary Of Background Data: In the absence of muscle forces, the ligamentous thoracolumbar spine specimens cannot support the compressive loads expected in vivo.

An experimental model of adult-onset slip progression in isthmic spondylolistesis.

Progressive spondylolisthesis may occur in adults with isthmic spondylolysis with an estimated incidence of 20%. This biomechanical study showed that in adult spines with bilateral L5 pars fractures, an anterior slip of L5 depends on the extent of the load-bearing deficiency of the disc and the presence of shear force across L5-S1. A combination of disc degeneration and muscle dysfunction may be responsible for converting a stable isthmic spondylolysis into an unstable progressive spondylolisthesis.

New insights into the development of popliteal cysts.

Background: This prospective study was designed to investigate the aetiology of popliteal (Baker's) cysts.

Methods: Some 426 legs in 312 individuals were investigated with ultrasonography for the presence of a popliteal cyst. Participants included healthy volunteers, patients with a painful knee, and a group of patients with signs and symptoms of deep vein thrombosis (DVT).

Effect of compressive follower preload on the flexion-extension response of the human lumbar spine.

Traditional experimental methods are unable to study the kinematics of whole lumbar spine specimens under physiologic compressive preloads because the spine without active musculature buckles under just 120 N of vertical load. However, the lumbar spine can support a compressive load of physiologic magnitude (up to 1200 N) without collapsing if the load is applied along a follower load path. This study tested the hypothesis that the load-displacement response of the lumbar spine in flexion-extension is affected by the magnitude of the follower preload and the follower preload path.

The treatment and functional outcome of type IV coronal shear fractures of the distal humerus: a retrospective review of five cases.

Objective: To present the treatment method and outcome of 5 cases of type IV coronal shear fractures of the distal end of the humerus.

Design: Retrospective study.

Patients: Five patients with an isolated type IV coronal shear fracture of the distal end of the humerus.

Solid variant of aneurysmal bone cyst: a case report with bilateral involvement of the distal femoral metaphyses.

An extremely rare case of bilateral, symmetrical involvement of distal femoral metaphyses by the solid variant of aneurysmal bone cyst (ABC) in a boy aged 13 years is described. Although there is no difference between the conventional ABC and the solid variant in terms of clinical and radiological presentation, the lesion is solid, composed of fibrohistiocytic cells with abundant giant cells and/or areas of florid, heterotopic ossification, while aneurysmal channels are sparse or absent. The lesion needs to be differentiated from giant cell tumour of bone, when the osteoclastic component predominates, while fibrous dysplasia, osteoblastoma and even osteosarcoma need to be excluded any time ossification is prominent.