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Acute traumatic proximal tibiofibular joint dislocation is an exceedingly rare injury. This is a case report in a rare horizontal type joint variant, following a long jump injury. The diagnostic approach when this injury is suspected is described.

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European Journal of Trauma Ab stractPurpose: A prospective trial was undertaken to assess if early postoperative mobilization improved functional outcome compared to traditional cast immobilization following open reduction and internal fixation of Weber "B" ankle fractures. Patients and Methods:The immobilized group remained in cast for 6 weeks. The mobilized group was free of plaster casting. Patients were assessed for pain, satisfaction, range of movements according to Lindsjo et al. and Olerud's & Molander's functional outcome and radiologic appearance postoperatively. Results: There was a significantly greater range of motion in the mobilized group at 6 weeks. This advantage diminished at 12 weeks. Patients were also significantly more satisfied in the mobilized group at 1-week follow-up. While satisfaction was insignificantly different at day 2 and week 6, pain scores were the same in both groups throughout. There was no significant difference in functional outcome at 6-and 12-week follow-up. Radiologically, there was no loss of reduction in both groups. Conclusion:The results indicate that earlier mobilization out of cast increases earlier functional outcome and loaded range of motion. These earlier advantages appear to diminish at later follow-up. Importantly, the study does not indicate an increased risk of loss of fracture reduction in the earlier mobilized group.

HighlightsDuplication of appendix with other congenital anomalies is rare.They have clinical and medicolegal significance.Surgeons should be aware of these conditions because of the possible clinical implications.

Our aim was to study the effect of traction on the compartment pressures during intramedullary nailing of closed tibial-shaft fractures. Thirty consecutive patients with Tscherne C1 fractures were randomised into two groups. Sixteen patients underwent intramedullary nailing of the tibia with traction and 14 patients without traction. Compartment pressures were measured before the application of traction or commencement of the procedure and at the end of the procedure. The data collected was analysed using Student's t test. There was no statistically significant difference (p>0.05) in the pre-operative mean compartment pressures for both groups. The mean post-operative measurements were higher in all four compartments in the traction group (p<0.05). None of the pressures reached the critical level. These results show that traction as an aid unnecessarily increases compartment pressures.Résumé Notre but était d'étudier l'effet de la traction sur la tension compartimentale pendant l'enclouage centromé-dullaire des fractures tibiales fermées. Trente malades consécutifs avec des fractures Tscherne C1 ont été randomisés dans deux groupes. Seize malades ont subi un enclouage centromédullaire tibial avec traction et quatorze malades sans traction. Les pressions compartimentales ont été mesurées avant la mise en traction ou au commencement de l'opér-ation et à la fin de l'opération. Les données ont été analysées avec le Student t-test. Il n'y avait aucune différence statistiquement significative (p>0.05) dans les pressions moyennes préopératoires des compartiments pour les deux groupes. Les mesures postopératoires moyennes étaient plus élevées dans les quatre compartiments dans le groupe avec traction (p<0.05). Aucune des pressions n'est arrivée au niveau critique. Ces résultats montrent que la traction augmente les pressions des compartiments.

Thigh infection associated with local emphysematous signs on presentation to the emergency room should alert the medical staff at once of potential complication associated with it. The infection may be associated with underlying bowel pathology and has a high mortality rate. Hence, emergency treatment should be instituted. We discuss a case with this uncommon presentation, treatment administered and relevant literature.