The purpose of this study is to define the function of the pronator quadratus muscle after plating of a distal radius fracture using anterior (volar) approach. Fourteen cases with volar plating after for a distal radius fracture were included in the study. Sixteen healthy volunteers were selected to determine the effect of dominant arm on pronation torque of the forearm for the control group. Biodex System 4 PRO (Biodex Medical Systems Inc., New York) torque meter was used for pronation torque measurement. In healthy volunteer group, there was no statistically significant difference in mean pronation torque values between the dominant arm and nondominant arms. The mean loss of pronator strength was 18.5 % and the mean loss of pronator durability was 12.9 % indicating a pronator insufficiency in the cases operated by a volar approach compared to uninjured forearm. Two patients among the operated group, who had further strengthening exercises beyond their own rehabilitation regimes, had improved pronator torque compared to uninjured forearm. In conclusion, the results of this study indicate that following volar plating of distal radius fractures, there is a significant loss in pronator strength of the forearm. As the two of the patients had improved pronator strength of their operated forearm, further rehabilitation regimes should be considered to prevent pronator weakness following volar plating for distal radius fractures.

Purpose. The use of uncemented unicompartmental knee prostheses has recently increased. However, few studies on the outcomes of uncemented unicompartmental knee prostheses have been performed. The purpose of this study was to compare the outcomes of cemented and uncemented Oxford unicompartmental knee arthroplasty. Materials and Methods. This retrospective observational study evaluated the clinical and radiological outcomes of 263 medial Oxford unicompartmental prostheses (141 cemented, 122 uncemented) implanted in 235 patients. The mean follow-up was 42 months in the cemented group and 30 months in the uncemented group. Results. At the last follow-up, there were no significant differences in the clinical results or survival rates between the two groups. However, the operation time in the uncemented unicompartmental knee arthroplasty group was shorter than that in the cemented unicompartmental knee arthroplasty group. In addition, the cost of uncemented arthroplasty was greater. Conclusion. Despite the successful midterm results in the uncemented unicompartmental knee arthroplasty group, a longer follow-up period is required to determine the best fixation mode.

Instability surgery performed using a single arthroscopic anterior portal provided findings comparable with the literature regarding clinical outcomes, postoperative shoulder movements and low recurrence rates, emphasizing the importance of appropriate patient selection rather than the number of the portals. The use of a single portal is less invasive and reduces the surgical period.

Our results support the idea that open reduction with the triradiate approach provides good visualization and direct reduction of combined acetabular fractures. Its learning curve for combined fractures is shorter than that for single approaches and provides at least the same rate of anatomical reduction. It should be in the armamentarium of a surgeon dealing with such fractures.

If conservative treatment is insufficient for patients with irreparable rotator cuff tears, biodegradable balloon method has yielded favorable outcomes in terms of pain and functionality in comparison with other surgical methods. Moreover, lesser morbidity, short procedure time and absence of postoperative rehabilitation requirement can be considered as advantages of this method.

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Objective Surgical approach of fractures of the proximal humeral shaft should protect the muscular insertions and the vascularisation of fragments, improving bone union and functional recovery. The aim of this study is to review cases operated with an original anteromedial approach, in cases of specific fractures of the proximal humeral shaft. Materials and methods Prior to clinical application, a cadaveric study was accomplished. Based on the results, six clinical cases had surgery using an approach medial to the biceps and brachialis. The osteosynthesis was performed with locked plates and 4.5 screws. The approach was indicated in fractures presenting with a large lateral wedge including the deltoid muscle insertion. Stable osteosynthesis achieved with this approach allowed early postoperative mobilization of the arm in all cases. Results The case-series consisted of three women and three men with a mean age of 52.1 years (range 38-68). The minimal follow-up was 1 year. Bone union was observed at an average time of 11.2 weeks. There were no intra-or postoperative complications. Discussion Open reduction and internal fixation with compression plating is a standardized and successful procedure in the treatment of humeral fractures. Internal fixation with lateral plating is difficult in the proximal third of the humeral shaft, where the positioning of the implant may hurt the long biceps tendon and the deltoid insertion. This approach was successful and safe in the presented cases. Conclusion The antero-medial approach with metaphyseal locking plate protects the muscular insertions and the vascularisation of the wedge fragment, leading to good results in all the cases in this series.

The role of the platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in the prediction of length and cost of hospital stay in patients with infected diabetic foot ulcers: A retrospective comparative study