Internal fixation with cannulated screws for UFNF in the elderly is a valuable option, although it has substantial reoperation and mortality rates. Further prospective high-quality, randomised controlled trials are required to establish the optimal approach for the treatment of UFNF.

Background:The high demands to the glenohumeral joint and the violent shoulder blows experienced during martial arts (MA) could compromise return to sports and increase the recurrence rate after arthroscopic stabilization for anterior shoulder instability in these athletes.Purpose:To report the functional outcomes, return to sports, and recurrences in a series of MA athletes with anterior shoulder instability treated with arthroscopic stabilization with suture anchors.Study Design:Case series; Level of evidence, 4.Methods:A total of 20 consecutive MA athletes were treated for anterior shoulder instability at a single institution between January 2008 and December 2013. Range of motion (ROM), the Rowe score, a visual analog scale (VAS), and the Athletic Shoulder Outcome Scoring System (ASOSS) were used to assess functional outcomes. Return-to-sport and recurrence rates were also evaluated.Results:The mean age at the time of surgery was 25.4 years (range, 18-35 years), and the mean follow-up was 71 months (range, 36-96 months). No significant difference in preoperative and postoperative shoulder ROM was found. The Rowe, VAS, and ASOSS scores showed statistical improvement after surgery (P < .001). In all, 19 athletes (95%) returned to sports. However, only 60% achieved ≥90% recovery after surgery. The recurrence rate was 20%.Conclusion:In this retrospective study of a consecutive cohort of MA athletes, arthroscopic anterior shoulder stabilization significantly improved functional scores. However, only 60% of the athletes achieved the same level of competition, and there was a 20% recurrence rate.

In these series of cases including patients with pre-collapse osteonecrosis, we observed non-significant results regarding rate of conversion to THA with CD, CDBG or CDSC at an average of 5.5 years.

Gluteal compartment syndrome (GCS) is extremely rare when compared to compartment syndrome in other anatomical regions, such as the forearm or the lower leg. It usually occurs in drug users following prolonged immobilization due to loss of consciousness. Another possible cause is trauma, which is rare and has only few reports in the literature. Physical examination may show tense and swollen buttocks and severe pain caused by passive range of motion. We present the case of a 70-year-old man who developed GCS after prolonged anterior-posterior pelvis compression. The physical examination revealed swelling, scrotal hematoma, and left ankle extension weakness. An unstable pelvic ring injury was diagnosed and the patient was taken to surgery. Measurement of the intracompartmental pressure was measured in the operating room, thereby confirming the diagnosis. Emergent fasciotomy was performed to decompress the three affected compartments. Trauma surgeons must be aware of the possibility of gluteal compartment syndrome in patients who have an acute pelvic trauma with buttock swelling and excessive pain of the gluteal region. Any delay in diagnosis or treatment can be devastating, causing permanent disability, irreversible loss of gluteal muscles, sciatic nerve palsy, kidney failure, or even death.

Background: The goals of intertrochanteric hip fracture (IHF) treatment are stable fixation, early mobilisation and function restoration. If the attempt to reduce, stabilise and fracture healing utilising a femoral cephalomedullar nail (CMN) fails, options for subsequent attempts are limited. Purpose: Evaluate the clinical and radiographic outcomes of conversion total hip arthroplasty (THA) using a modular stem following a CMN failure. Materials and methods: We retrospectively reviewed a consecutive series of patients with an IHF between 2012 and 2014 to identify CMN patients that went on to the subsequent failure and conversion to THA utilising a modular femoral stem (MFS). In all cases, MP Reconstruction Prosthesis (Waldemar Link, Hamburg, Germany) was implanted. Primary clinical outcomes were assessed using Harris Hip Score (HSS) before conversion procedure, 3 months, 6 months and recent office visit post-conversion THA thereafter. The secondary outcome was to analyse intra and postoperative complications. Serial radiographs at each follow-up interval were assessed for clinical success or to confirm adverse events. Results: 28 patients were included in the study; 17 were females. The average age was 72.7 years (SD ± 10.5); the average time from the index procedure to conversion THA was 12.6 months (SD ± 3.5). At baseline, average HHS was 42.1 (SD ± 3.6), improved to 80.7 (SD ± 5.1) at 3 months, 86.0 (SD ± 3.9) at 6-months which levelled off to 86.1 (SD ± 4.0) at final follow-up. There were 4 (14%) post-conversion complications: 2 dislocations, 1 superficial wound infection, 1 patient with symptomatic abductor deficiency. All 4 cases were conservatively treated successfully, the implants were retained, and the patients progressed without further issue. Conclusions: MFSs allow to successfully treat failed CMN and adverse variations in femoral anatomy with a device that will permit simultaneous correction of leg length, offset and version to relieve pain, restore function and create a durable prosthetic to host composite.

No abstract

Septic arthritis due to Listeria monocytogenes (LM) is extremely rare and most infections due to this organism are seen in immunocompromised patients. We describe a patient without immunological compromise, with a late total knee arthroplasty infection caused by LM treated with one-stage revision surgery. She had an elevated erythrocyte sedimentation rate (79 mm/h) and C-reactive protein (13 mg/dL). Aspiration of the knee joint yielded purulent fluid; cultures showed LM. The patient was given 6 weeks of intravenous ampicillin, followed by trimethoprim/sulfamethoxazole, and finally amoxicillin orally for 7 months. Two years after revision surgery, radiographs showed no evidence of implant loosening. This is a single case and although one-stage approach seemed to have worked, it should not be recommended on the basis of a single report.

<p>Introducción: En pacientes sometidos a cirugía ortopédica y con antecedente de Enfermedad tromboembolica, la profilaxis común suele ser insuficiente para prevenir eventos tromboembólicos. Los filtros de vena cava (FVC) removibles pueden considerarse una alternativa. Objetivos: Estimar la tasa de complicaciones hematológicas, mecánicas y muertes asociadas al uso de FVC removibles en cirugía ortopédica. Métodos: Se diseñó una cohorte retrospectiva de pacientes con historia previa de Enfermedad tromboembolica (ETE) sometidos a procedimientos ortopédicos que requirieron FVC removible, entre el 2006-2014 en el servicio de ortopedia del Hospital Italiano de Buenos Aires. Se definió complicación asociada al FVC a las complicaciones mecánicas, hematológicas (recurrencia de ETE, síndrome postrombotico  y sangrado mayor) y muerte. Para estimar la asociación con factores de riesgo, subclasificamos a las cirugías en 5 grupos: 1, artroplastia/no artroplastia; 2, primaria/revisión; 3, electiva/urgente; 4, oncológica/no oncológica; 5, filtro pre/postoperatorio. Resultados: Se incluyeron 68 pacientes, de los cuales 31 presentaron algún tipo de complicación. Las complicaciones mecánicas ostentaron un 16%, precisando de una revisión del filtro. 64% de los filtros revisados fallaron mecánicamente y no pudieron ser extraídos. Las tasas de recurrencia de ETE, síndrome postrombotico  y sangrado mayor fueron del 33%, 15% y 4.5%, respectivamente. Las cirugías espinales presentaron un mayor riesgo de recurrencia de ETE. La mortalidad global fue del 28% y  4% asociada a recurrencia de ETE. Conclusiones: Las cirugías ortopédicas exhibieron un riesgo elevado de complicaciones mecánicas y hematológicas luego de usar un FVC removible. Empero, la mortalidad debido a dichas complicaciones fue baja.</p>