In a prospective study, the diagnostic accuracy of three-dimensional magnetic resonance imaging in the evaluation of ruptures of the lateral ligaments of the ankle was determined by comparing three-dimensional magnetic resonance findings with operative findings. In a series of 18 consecutive cases of acute significant inversion trauma to the ankle, a three-dimensional fast imaging with steady-state precession pulse sequence (3D FISP) was performed. The study included only those cases in which views showed a difference in talar tilt of 15 degrees or more, and a difference in anteroposterior drawer of 10 mm or more between the imaged and the normal ankle. All ankles were scheduled for surgical exploration. Compared with operative findings, the sensitivity, specificity, and accuracy of 3D FISP imaging were, respectively, 100%, 50%, and 94.4% for ruptures of the anterior talofibular ligament and 91.7%, 100%, and 94.4% for ruptures of the calcaneofibular ligament. We believe that 3D FISP magnetic resonance imaging is a noninvasive, fast, and very accurate diagnostic aid to operative planning for double ligament tears in younger competitive athletes.

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Purpose of Review This review focuses on the evolution of minimally invasive techniques in orthopedic surgery and provides an overview of the evidence-based knowledge of the last decade. Recent Findings Implants and surgical techniques for minimally invasive osteosynthesis in periarticular, spinal and pelvic fractures underwent rapid improvement. They show adequate healing along with low complication rates and satisfactory outcome. Computer-assisted insertion of implants and navigation offer new possibilities and are particularly advantageous in difficult anatomical regions, such as the pelvis or spine. Summary The treatment purpose in minimally invasive orthopedic surgery consists of anatomic reconstruction and stabilization of the articular surface, length, axis and rotation with minimal soft-tissue trauma. This review article highlights the surgical evolution and discusses recent advances in techniques and technology implementing minimally invasive approaches as the gold standard of treatment in the near future.

A man, aged 55, presented with a spontaneous haemarthrosis of his right knee, 1 year after an unicompartmental knee replacement. This case showed an atraumatic rupture of the metal marker wire of an all-polyethylene inlay tibial implant which caused a destruction of the polyethylene surface and a disseminated synovitis of the right knee. This is a rare but destructive complication following an unicompartmental knee arthroplasty.

Both the operative treatment of fractures in a middle-aged (SP) and a geriatric group (PF) lead to significant increasing of IL-6 levels. In view of a comparative surgical burden, these data suggest that age may be a confounding factor for a surgery induced pro-inflammatory response in the early postoperative stage.

Nonunion is a very rare complication of a comminuted intra-articular wrist fracture treated by external fixation. The authors describe the likely reasons and the after-care, in order to avoid this complication.

A boy, age 9, presented with deformation and pain of the left distal forearm, 1 year after a plate osteosynthesis for a distal radial metaphyseal fracture. This case showed a pediatric nonunion of a distal radial metaphyseal fracture which caused strong deformation of the left distal forearm. This is an extremely rare complication in children following an open reduction and internal fixation for a displaced distal forearm fracture. Key points of pediatric fracture healing are discussed and a review of the literature is given.

Non-union of the ulnar diaphysis after isolated ulnar shaft fracture is uncommon. Complications due to non-union of the ulna must therefore be very rare. A case of a stress fracture of the radius in a postmenopausal woman following an isolated ulnar shaft fracture and non-union is presented. The mechanism of the stress fracture and propositions for preventing non-union of the ulnar shaft after an isolated fracture in the osteoporotic patient are discussed.