Pelvic fixation is still associated with a very high rate of mechanical failure. Major risk factors appear to be age and type of fixation. Although could not be shown to be statistically significant, failure to restore the optimal sagittal balance may be a contributing factor as well. So in conclusion, in cases with suboptimal sagittal plane correction, S2AI with polyaxial screws seem to have higher risk of short-term acute failure compared to IwL.

This study demonstrated that a single best treatment modality for ASD may not exist. Conservative treatment appears to yield higher (up to 6 %) QALE compared to surgery, most probably secondary to a higher baseline QALE. On the other hand, surgery provides a significantly higher increase in QALE. Especially in patients with significant disability at baseline, the final QALE tended higher in the S group (although not significant). Finally, chances of a relevant improvement at first year turned out to be significantly lower with NS treatment.

IntroductionUntreatable foot problems in diabetics may require lower extremity amputation, which has a high level of patient mortality. This high mortality rate is worse than most malignancies. The present study aimed to identify parameters that can be used to estimate survival in DM patients undergoing below-knee amputations for diabetic foot problems.Materials and methodsA total of 470 patients (299 males, 171 females) with a mean age of 64.32 years who underwent below-knee amputation for diabetic foot problems between 2004 and 2014 were enrolled in the study. The length of time from the operation to time of death was recorded in days. Patient details were obtained, including age during surgery, BMI, oral antidiabetic and insulin usage, dialysis therapy history, lower extremity endovascular intervention, previous amputation at the same extremity, the need for stump revision surgery during follow-up, and above-knee amputation at the same site. Biochemical test results of pre-operative HbA1c, ESR, and levels of CRP, BUN, and creatinine were also obtained.ResultsA total of 333 patients (70.9%) died and 137 (29.1%) survived post-surgery. Survival rates were 90% in the first 7 days, 84% in the first 30 days, and 64% after the first year. Patient median life expectancy post-surgery was 930 ± 106 days. Hemodialysis treatment (p = 0.001), endovascular intervention (p = 0.04), sex (p = 0.004), age (p = 0.001), BUN level (p = 0.001), and duration of insulin use (p = 0.003) were shown to be effective predictors of mortality.ConclusionsLife expectancy is low (<3 years) in DM patients requiring below-knee amputations for untreatable foot problems. Survival could be predicted by duration of insulin use, age, sex, and renal insufficiency.Level of evidenceLevel IV, Therapeutic study.

These findings reiterate the importance of patient diagnosis, age, and/or the amount of lordosis as the most important factors affecting HRQL in ASD. Gender, BMI, and sagittal vertical axis appear to be consistently important co-variables whereas coronal balance and magnitude of L curves may also be important in SRS-22. These may aid in better understanding the problem in ASD and may be useful in future classifications.

Glomus tumors are benign neoplasms originating from the glomus body. They are most frequently found in the nail bed of the hands, and their occurrence in other parts of the body is rare. A 75-year-old man presented with left anterior knee pain of 30-year history, that became more intense with light touch or clothing and increased in severity despite medical treatment. Physical examination showed a painful, soft, mobile, red-purple colored mass, 2 x 2 cm in size, at the inferior border of the patella. Plain radiographs showed no pathology other than mild degenerative changes. Magnetic resonance imaging revealed a mass lesion, 1.5 x 1.1 x 2 cm in size, located at the anterior border of the patellar tendon, which showed hypointensity on T1A-weighted sequences and hyperintensity on T2-weighted sequences and T2-weighted sequences with fat saturation. The mass was excised and the histopathological diagnosis was reported as glomangioma. Postoperatively, the patient had no complaint of pain and no recurrence was observed during a two-year follow-up.