Closed rupture of the anterior tibial tendon is uncommon, with 33 cases being reported previously. In this report we add another to these few. The literature is reviewed; late diagnosis is frequent, and the injury occurs in middle-aged and elderly patients after distorsion of the foot in plantar flexion and eversion. The treatment of the rupture in early and delayed cases is discussed.

Continued observation in asymptomatic cases is a reasonable clinical approach. We propose surgical treatment with curettage and bone grafting only in symptomatic cases.

Infection following total joint replacement remains a problem that has not been solved so far. The treatment options include removal of the implant and a delayed reconstruction or a direct exchange operation. Among patients with stable implants and short duration of infection as well as in patients who for certain reasons are inoperable, antibiotic therapy with a combination of rifampicin-ciprofloxacin may be a reasonable treatment option for curing staphyloccocal infection without removal of the implant. A case study of a Staphylococcus epidermidis (coagulase-negative) infection following delayed revision total knee replacement after septic loosening of a knee arthroplasty and its successful conservative treatment with rifampicin-ciprofloxacin is described. Alternative rifampicin combinations are discussed with respect to recently developed pharmacodynamical and pharmacokinetical findings of biofilm active drugs.

Prophylactic dynamic screw fixation (DSF) of clinically and radiographically unaffected hips of 34 patients with a contralateral slipped capital femoral epiphysis and no evidence of an endocrinopathy or systemic disorder was performed using a single cannulated screw. Follow-up ranged from 2 to 12 years (average, 5.4 years). There was no case of perioperative complication and no avascular necrosis or chondrolysis occurred. No preslip or slip became apparent. In all 34 hips, no tendency toward premature closure of the epiphysis could be observed, no growth disturbance including greater trochanteric overgrowth, coxa brevis, or coxa vara was noted. This study supports the prophylactic treatment of the asymptomatic hip, using a simple and safe fixation method.