How many knots are necessary to achieve knot security of two high strength suture tapes? A biomechanical comparative analysis.

Introduction: According to current clinical practice, a minimum of 7 knots are required to provide secure hold in high-strength sutures. A new technology featuring a suture tape with a salt-infused silicon core has been recently developed, potentially reducing the number of needed knots.

Aims: to (1) assess the influence of number of knots on tape security, (2) evaluate the effect of different ambient conditions on knot security, and (3) compare the biomechanical competence of the novel versus a conventional suture tape.

Transgluteal approach for excision of pelvic lipoma causing sciatic pain.

Sciatic nerve pain, affecting 12%-27% of the general population, often arises from a myriad of etiologies due to the complex anatomy of the sciatic region. The intricate relationship between the sciatic nerve and surrounding structures in the pelvis poses significant challenges in both diagnosis and surgical management. We report two cases of adult female patients presenting with chronic sciatic pain, refractory to conservative treatment.

Open reduction and internal fixation versus minimally invasive plate osteosynthesis of unstable proximal humerus fractures treated with locking plate and intramedullary allograft: A retrospective study.

Background: This retrospective clinical study aims to compare the functional and radiological outcomes after open reduction and internal fixation versus minimally invasive plate osteosynthesis of unstable proximal humerus fractures treated with both locking plate and intramedullary graft.

Methods: Forty-seven patients with proximal humerus fractures were treated with either open reduction and internal fixation (25 cases) or minimally invasive plate osteosynthesis (22 cases) and evaluated retrospectively with a minimum follow-up of 12 months. Thirty-one fresh-frozen fibulae and 16 lyophilized tibia allografts were used for augmentation.

The Presence of Bilateral Dilated Pupils is Not a Death Sentence in a Stroke Patient: A Case Report.

Bilateral dilated pupils are an ominous clinical sign of brainstem dysfunction, which uniformly leads to a bad prognosis for the patient. In some rare instances in adult patients, it could be reversible. We present a clinical case of an elderly stroke patient with bilateral dilated pupils with a surprisingly favorable clinical outcome.

Restoration of the anterior compartment after robotic total knee arthroplasty significantly improves functional outcome and range of motion at 1 year.

Purpose: This study aims to assess the functional outcomes based on restoring the anterior compartment after total knee arthroplasty (TKA).

Methods: This retrospective study included 96 primary TKAs performed between 2021 and 2022. Functional positioning principles were applied using an image-based robotic-assisted system.

The Impact of a Robotic Digital Microscope on the Ergonomics in a Neurosurgical Operating Theatre (A Single-Centre Experience).

Ergonomics is an emerging concept in the neurosurgical operating theatre, where neurosurgeons work under great concentration and frequently neglect their uncomfortable body posture. Work-related musculoskeletal disorders (WMSD) are becoming a widespread burden in the neurosurgical community. WMSD have a negative impact on surgical performance and decrease the surgeons' quality of life.

Functional positioning principles for image-based robotic-assisted TKA achieved a higher Forgotten Joint Score at 1 year compared to conventional TKA with restricted kinematic alignment.

Purpose: Few comparative studies assessed the current concept of individualised alignment for total knee arthroplasty (TKA) and their outcomes at mid-term. This study aimed to evaluate the functional outcomes at 1 year of primary TKA performed with a functional positioning technique based on an image-based robotic-assisted system, compared to conventional TKA performed with a restricted kinematic alignment technique.

Methods: This retrospective comparative study included 100 primary TKAs performed with functional positioning principles using an image-based robotic-assisted system.

New measurement technique for restoration of the trochlear offset after image-based robotic-assisted total knee arthroplasty: a reliability study.

Introduction: The new concepts in total knee arthroplasty (TKA) tend to improve the alignment and ligament balancing after TKA. Nevertheless, the assessment of the anterior compartment is difficult. The purpose of this study was to describe a new measurement technique of trochlear offset restoration on CT-scan after primary robotic-assisted TKA and assess its reliability and repeatability.

Treatment of Metaphyseal Defects in Plated Proximal Humerus Fractures with a New Augmentation Technique-A Biomechanical Cadaveric Study.

: Unstable proximal humerus fractures (PHFs) with metaphyseal defects-weakening the osteosynthesis construct-are challenging to treat. A new augmentation technique of plated complex PHFs with metaphyseal defects was recently introduced in the clinical practice. This biomechanical study aimed to analyze the stability of plated unstable PHFs augmented via implementation of this technique versus no augmentation.

Ceftobiprole for Treatment of Complicated Bacteremia.

Background: Ceftobiprole is a cephalosporin that may be effective for treating complicated bacteremia, including methicillin-resistant .

Methods: In this phase 3, double-blind, double-dummy, noninferiority trial, adults with complicated bacteremia were randomly assigned in a 1:1 ratio to receive ceftobiprole at a dose of 500 mg intravenously every 6 hours for 8 days and every 8 hours thereafter, or daptomycin at a dose of 6 to 10 mg per kilogram of body weight intravenously every 24 hours plus optional aztreonam (at the discretion of the trial-site investigators). The primary outcome, overall treatment success 70 days after randomization (defined as survival, bacteremia clearance, symptom improvement, no new bacteremia-related complications, and no receipt of other potentially effective antibiotics), with a noninferiority margin of 15%, was adjudicated by a data review committee whose members were unaware of the trial-group assignments.

Surgical Treatment of Lung Abscess Due to an Awn Aspiration in a 9-Year-Old Child: A Case Report.

Introduction: Foreign body aspiration is a common condition in the child population and is one of the leading causes of accidental deaths in children. The aspiration of an awn (grass inflorescences) is extremely rare.

Aim Of The Study: This study aims to describe the symptoms, diagnosis, therapeutic difficulties, and results of the aspiration of grass inflorescence.

Statistical Morphology and Fragment Mapping of Complex Proximal Humeral Fractures.

: Proximal humerus fractures (PHFs) are common in the elderly, but the treatment results are often poor. A clear understanding of fracture morphology and distribution of cortical bone loss is important for improved surgical decision making, operative considerations, and new implant designs. The aim of this study was to develop a 3D segmentation fracture mapping technique to create a statistical description of the spatial pattern and cortical bone loss of complex PHFs.

Intraosseous Epidermoid Cyst: a Case Report.

Background: Epidermoid cysts are benign lesions that occur throughout the body. Their development in the oral cavity is extremely rare. Intraosseous epidermoid cysts of the jaw are even rarer and difficult to distinguish from other lesions.

Superior fixation strength of coronoid process replacement using individually designed 3D printed prosthesis with curved cemented intramedullary stem.

Background: Coronoid fractures frequently occur as part of complex elbow injuries and account for 2%-15% of the cases with dislocations. Comminuted fractures and nonunions necessitate surgical treatment. Considering the latest technological advancements, the aim of this study was to investigate the fixation strength of coronoid replacement using an individualized 3D printed prosthesis with curved cemented intramedullary (IM) stem vs.

A Novel Technique for Treatment of Metaphyseal Voids in Proximal Humerus Fractures in Elderly Patients.

: The treatment of proximal humerus fractures in elderly patients is challenging, with reported high complication rates mostly related to implant failure involving screw cut-out and penetration. Metaphyseal defects are common in osteoporotic bone and weaken the osteosynthesis construct. A novel technique for augmentation with polymethylmethacrylate (PMMA) bone cement was developed for the treatment of patients in advanced age with complex proximal humerus fractures and metaphyseal voids, whereby the cement was allowed to partially cure for 5-7 min after mixing to achieve medium viscosity, and then it was manually placed into the defect through the traumatic lateral window with a volume of 4-6 mL per patient.

Subjective workload measurement of the transition from a conventional operative microscope to a Robotic Digital Microscope. A pilot study.

•Evaluate the subjective workload for transition of an experienced neurosurgeon from a conventional operative microscope /OPMI/ to a Robotic Digital Microscope /RDM/.•Show a single center initial experience of the use an exoscope.•The exoscope improves ergonomics.

Comminuted intraarticular calcaneal fractures: Multiplanar VA locked plating and interlocked nailing incorporate longitudinal strut and provide superior stability - a biomechanical cadaveric study.

Treatment of comminuted intraarticular calcaneal fractures remains controversial and challenging. The aim of this study was to investigate the biomechanical performance of three different methods for fixation of such fractures. Comminuted calcaneal fractures, including Sanders III AB fracture of the posterior facet and Kinner II B fracture of the calcaneocuboid joint (CCJ) articular calcaneal surface, were created in 18 human cadaveric lower legs by osteotomizing.

Percutaneous fixation of intraarticular joint-depression calcaneal fractures with different screw configurations - a biomechanical human cadaveric analysis.

Purpose: The aim of this study was to assess the biomechanical performance of different screw configurations for fixation of Sanders type II B joint-depression calcaneal fractures.

Methods: Fifteen human cadaveric lower limbs were amputated and Sanders II B fractures were simulated. The specimens were randomized to three groups for fixation with different screw configurations.

Volar versus combined dorsal and volar plate fixation of complex intraarticular distal radius fractures with small dorsoulnar fragment - a biomechanical study.

Complex intraarticular distal radius fractures (DRFs), commonly managed with volar locking plates, are challenging. Combined volar and dorsal plating is frequently applied for treatment, however, biomechanical investigations are scant. The aim of this biomechanical study was to investigate volar plating versus double plating in DRFs with different degrees of lunate facet comminution.

A Case of Tracheal Stenosis as an Isolated Form of Immunoproliferative Hyper-IgG4 Disease in a 17-Year-Old Girl.

Immunoglobulin G4-related disease (IgG4-RD) is a lymphoproliferative disease which is described almost exclusively in adults. There are only a few pediatric patients who have been observed with this disorder. Here, we describe a rare case of IgG4-RD in a 17-year-old girl with a single manifestation-tracheal stenosis without previous intubation or other inciting event.

A rare case of congenital anterior urethral diverticulum in a two-year-old boy.

Congenital diverticulum is a very rare disease of the urethra in which there is a sacculus enlargement on its ventral surface. We present a Case of a 2-year-old boy with symptoms of urinary hesitancy and swelling in the penoscrotal angle that appears during micturition. The diagnosis of urethral diverticulum is confirmed by retrograde urethrography and voiding cystogram.

Two reconstruction plates provide superior stability of displaced midshaft clavicle fractures in comparison to single plating - A biomechanical study.

Background: Displaced midshaft fractures are the most common surgically treated clavicle fractures. However, they are associated with high complication rates following plating due to fixation failure in terms of plate breakage, screw breakage and/or screw loosening. The aim of this study was to compare the biomechanical competence of three different plating techniques for fixation of displaced midshaft clavicle fractures.

Does Supplemental Intramedullary Grafting Increase Stability of Plated Proximal Humerus Fractures?

Objectives: To investigate the biomechanical competence of locked plating augmented with supplemental intramedullary graft in comparison to conventional locked plate fixation in proximal humerus fractures (PHF).

Methods: Complex four-part PHFs were set in 30 artificial humeri assigned to 3 study groups (n = 10 in each group). Group 1 was characterized by loss of medial support, group 2 by simulated severe cancellous bone damage due to osteoporosis, and group 3 by combination of the 2 features.