Second-look arthroscopic findings at 12 months postoperatively after microfracture for osteochondral lesions of the talus revealed that 40% of lesions were incompletely healed. Nevertheless, the majority of patients achieved a good clinical outcome. Furthermore, postoperative clinical scores were found to be correlated with ICRS repair grades.

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BackgroundIn polyostotic fibrous dysplasia, particularly in lesions of the proximal femur, pathological fracture and coxa vara deformity (including shepherd's crook deformity) are likely to develop and progress.Patients and methods In 7 femurs with shepherd's crook deformity (5 patients), we performed intramedullary nailing by using multiple osteotomies and two screws crossing the femoral neck.Results Restoration of the neck shaft angle of the femur was obtained from an average of 92º prior to surgery to 129º after surgery. During the minimum 2-year follow up, no loss of neck shaft angle of the femur and no refracture occurred. All patients were able to return to normal activities of daily living.Interpretation In polyostotic fibrous dysplasia, multiple osteotomies and intramedullary nailing with neck cross-pinning can be used to correct developed or progressing shepherd's crook deformity, and to prevent recurrence and refracture.

Distraction osteogenesis for first and/or fourth brachymetatarsia provided successful lengthening of a metatarsal with eventual osseous union and was associated with similar outcomes in terms of healing index, function score, and the prevalence of complications between the two groups, although frequent complications were encountered and no improvement in foot function was found.

Purpose To investigate the usefulness of titanium lamina mesh for posterior column reconstruction after total en bloc spondylectomy in patients with spinal tumour and evaluate the radiographic outcomes of this method. Method Eight patients who underwent total en bloc spondylectomy with posterior column reconstruction using titanium lamina mesh and bone graft to treat a spinal tumour were included in this study. The mean age at the time of surgery was 50.6 years (range, 16.5-70.9 years) and the mean follow-up duration was 50.2 months (range, 28.1-68.7 months). The pathological lesions were located from the T2 to L1 vertebrae. There were four patients in each primary and metastatic tumour group. For the posterior column reconstruction, titanium lamina mesh was used and bone graft was applied over the lamina mesh. Radiographic evaluation was used to investigate the displacement of lamina mesh and union of the grafted bone above lamina mesh. Results At the postoperative six month follow-up, a bony bridge on the titanium mesh between upper and lower adjacent lamina was observed in all cases, except for one with infection. On the last follow-up, there was no collapse or displacement of titanium lamina mesh, and there was no instability or malalignment of the spinal column. Conclusions Posterior column reconstruction using titanium lamina mesh during total en bloc spondylectomy for spinal tumour was a useful surgical option that provided new lamina reconstruction for stability of spinal column and protection of the neural elements.

Turner syndrome is a sex-chromosome disorder; occurring in 1 in 2,500 female births. There are sporadic few case reports of concomitant Turner syndrome with schizophrenia worldwide. Most Turner females had a 45,X monosomy, whereas the majority of comorbidity between Turner syndrome and schizophrenia had a mosaic karyotype (45,X/46,XX). We present a case of a 21-year-old woman with Turner syndrome, mosaic karyotype (45,X/46,XX), showing mental retardation, hypothyroidism, and schizophrenia. HOPA gene within Xq13 is related to mental retardation, hypothyroidism, and schizophrenia. Our case may be a potential clue which supports the hypothesis for involvement of genes on X chromosome in development of schizophrenia. Further studies including comorbid cases reports are need in order to discern the cause of schizophrenia in patients having Turner syndrome.

The clinical and radiographic outcomes of proximal chevron osteotomy with a distal soft tissue procedure were found to be comparable for moderate and severe hallux valgus. Accordingly, our results suggest that this procedure provides an effective and reliable means of correcting hallux valgus regardless of severity of deformity.

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