A Study Evaluating the Functional Outcomes of Mason Type III and IV Radial Head Fractures Treated With a Radial Head Prosthesis.

Objective This research aimed to assess the functional result of type III and IV radial head fractures that were treated using a radial head prosthesis. Methods A retrospective investigation was conducted on 70 patients with type III and IV radial head and neck fractures, as classified by Mason. The patients were hospitalized and received treatment at the Orthopaedics Department, where they had radial head prosthesis surgery for three years. Results Among the total of 70 cases, 42 (60%) cases were below the age of 40, while 28 (47%) cases were over 40 years. The average age was 36.4 years. The maximum age recorded was 54 years, while the lowest age recorded was 30 years. The female population outnumbered the male population. The majority of instances (42, 60%) were attributed to falls, while the remaining cases were caused by road traffic accidents (RTAs). Out of the total 70 instances, 52 cases (74.28%) exhibited right-side dominance, whereas 18 cases (25.72%) exhibited left-side dominance. Within our case study group, 56 (80%) cases fell under modified Mason's classification type Ill, totaling 56 instances. The remaining 20% of the cases, amounting to 11 cases, were classified as modified Mason's classification type IV. Among the 70 patients, 55 cases (78.58%) did not have any ligamentous damage, whereas seven (10%) cases had lateral ulnar collateral ligament (LUCL) injury and eight (11%) cases had medial collateral ligament (MCL) injury. The P value for flexion, extension, pronation, and supination was shown to be very significant. Out of the total, 47 (67%) instances had an MEPI score (Mayo Elbow Performance Index) of more than 90, indicating exceptional performance. In addition, 16 cases (22.85%) had an MEPI score ranging from 75 to 89, which is considered a good result. Lastly, seven cases (10%) had an MEPI score ranging from 60 to 74, indicating a fair result. Conclusion The use of a radial head prosthesis is considered a viable option for managing severe and irreparable fractures of the radial head. Effective outcomes hinge on meticulous preoperative planning, skilled intraoperative techniques, and intensive postoperative rehabilitation. These elements collectively contribute to achieving consistent and favorable results in patients undergoing this surgical intervention.

A Case Report on a Syndesmotic Ankle Injury Treated With Arthrex TightRope.

Syndesmotic ankle injuries, often referred to as "high ankle sprains," pose intricate challenges in orthopedic practice, particularly among athletes engaged in high-impact sports. Conventional treatments have encompassed conservative approaches and the use of syndesmotic screws, each beset by inherent limitations. The Arthrex TightRope system has emerged as a pioneering alternative, heralded for its capacity to facilitate physiologic micromotion, eliminate the necessity for hardware removal, and expedite early rehabilitation. This case report delineates the management of a 29-year-old male professional soccer player who suffered a trimalleolar ankle fracture compounded by a severe syndesmotic injury subsequent to a road traffic accident. The patient underwent a comprehensive treatment involving open reduction and internal fixation (ORIF) of all three malleoli, complemented by syndesmotic stabilization employing the Arthrex TightRope system. Post-operative care encompassed a regimen of gradual weight-bearing and methodical rehabilitation. At the one-year follow-up, the patient demonstrated excellent ankle joint function devoid of pain or complications related to hardware, underscoring the efficacy of managing syndesmotic and malleolar fractures successfully. This case underscores the potential advantages of integrating traditional ORIF techniques with contemporary syndesmotic fixation strategies like the TightRope system for complex ankle fractures, advocating for further research to refine their optimal utilization in clinical settings.

A Rare Case of a Bilateral Olecranon Fracture in a Young Adult With a Two-Year Follow-Up.

Olecranon fractures are common in orthopedic wards and can be traumatic or pathological in origin. There are very few cases of bilateral olecranon fractures without any associated injuries to the long bones in the literature. We present a unique case of a young 21-year-old male who has an isolated bilateral olecranon fracture following a road traffic accident. The patient had a closed fracture of the ulna on both sides without any associated injuries or neurovascular compromise. Since the patient was young and had good muscle strength preoperatively, we planned fixation of both sides. The patient underwent open reduction and internal fixation with tension band wiring on the right side, which was his dominant side. The left side was operated on by open reduction and internal fixation with an anatomical plate. The patient was started on elbow range of motion on the right side from the second postoperative day and started basic activities such as having food independently by the 10th day postoperatively. The physiotherapy was continued in a stepwise manner, and by the sixth week, the patient had a full range of motion on both sides. The patient had resumed his activities of daily living independently by the sixth week following the surgery. Such cases are rare, and a case-based management plan must be devised for each patient, considering contributing factors such as age, bone quality, osteoporosis, underlying medical comorbidities, functional demands, and muscle strength. We demonstrated a good clinical and radiological outcome by using tension band wiring on the dominant side with a stable olecranon fracture and plating done on the non-dominant side, which had an unstable displaced olecranon fracture.

Closed Reduction Nailing or Open Reduction Plating in Unstable Paediatric Forearm Fractures: A Case of Paediatric Forearm Fracture Implant Failure.

A significant amount of all paediatric fractures are forearm fractures involving the radius, ulnar shaft, or both. As surgical stabilisation lowers the likelihood of re-displacement, surgical intervention is currently recommended over conservative treatment of such fractures involving significant displacement and angulation. Open reduction and plating can better anatomically repair the majority of fractures. Bracing is necessary for the first six to eight weeks after nailing since nailing does not give a rigid fixation. External bracing is generally not necessary for plating. In our facility, paediatric diaphyseal forearm fractures are typically treated using titanium elastic nail system (TENS) nailing. However, there are occasional instances where the primary fracture site refractures after surgery, particularly in diaphyseal forearm fractures involving both bones. Our patient was a 12-year-old boy who had come to our facility with a left forearm radius shaft fracture and ulna shaft plastic deformation. The radius shaft fracture was fixed with TENS nailing, and the ulna shaft plastic deformation was corrected by the three-point bending method. Three months later, the patient came back with a refracture of the radius shaft. TENS nail removal, open reduction, and internal fixation of the radius shaft refracture were done with a plate and screws. Anatomic reduction of forearm fractures, open reduction, and the use of plate fixation enable a more thorough correction of malrotation and restoration of the radial bow, allowing for an early range of motion. Since the TENS nail is not a locking device, there is always some amount of mobility at the fracture site, causing loss of reduction, chances of implant failure, and non-union. So primary plating, especially in cases of forearm fractures, appears to be a better option compared to primary TENS nailing in juvenile patients.

Management of Grade Three Open Distal Humerus Intra-articular Fracture Using the BB Joshi External Fixator: A Case Study and Review of Outcomes.

Distal humeral intra-articular fractures often result in functional impairment if treated conservatively. These fractures are particularly challenging due to osteoporosis and severe comminution. A 32-year-old female with a grade three open distal humerus intra-articular fracture presented with a 5 cm x 5 cm open wound on her right elbow. The patient underwent open reduction and internal fixation (ORIF) using the BB Joshi external fixator and a local flap for skin coverage, achieving stable fixation and early mobilization. The patient regained a near-normal range of movements and adequate skin coverage of the wound at follow-up. Compared to traditional ORIF, it showed lower infection rates and comparable union rates, leading to better functional outcomes when compared with the studies reported earlier. The BB Joshi external fixator effectively treats grade three open distal humerus intra-articular fractures, minimizing complications and promoting functional recovery.

Outcomes of Femoral Neck System in Treating Intra-capsular Neck of Femur Fractures in a Young Adult: A Case Report.

The introduction of the Femoral Neck System (FNS) represents a promising alternative to traditional cancellous cannulated (CC) screw fixation for managing intra-capsular neck of femur (ICNF) fractures. This case report aims to validate its safety and report the outcomes in a young patient. The findings demonstrate that the FNS possesses excellent biomechanical properties and provides significantly greater overall construct stability bearing in mind, that it was used in a Pauwels Classification Grade 3 ICNF fracture.

Inferior Pole of the Patella Fracture Fixed by Percutaneous Approach: A Case Report.

Fractures of the inferior pole of the patella are rare but challenging orthopedic injuries. This case study presents the management of such a fracture using a percutaneous approach. A 70-year-old female patient presented with significant knee pain and swelling following a fall. Radiographic examination revealed a displaced fracture of the inferior pole of the patella along with an ipsilateral tibial plateau fracture. Surgical intervention was deemed necessary due to the extent of displacement and the potential for compromised knee function. A percutaneous technique was employed for fracture reduction and fixation using cannulated screws under fluoroscopic guidance. Postoperative rehabilitation focused on early mobilization and strengthening exercises. At a six-week follow-up, the patient demonstrated satisfactory clinical outcomes with restoration of knee function and minimal residual symptoms. This case highlights the efficacy of percutaneous fixation in managing inferior pole patellar fractures, offering a minimally invasive approach with favorable functional outcomes.

Treatment of Infected Tibia Non-union Using a Novel Solid Intramedullary Nail Custom-Made for Antibiotic-Impregnated Cement Coating.

The chronic and incapacitating condition of infected non-union of the long bones continues to be a challenging issue for surgeons in terms of efficient and economical treatment. A number of variables, such as open fractures, soft tissue or bone loss, infection following internal fixation, persistent osteomyelitis with pathologic fractures, and surgical debridement of infected bone, can result in infected non-unions. An infected non-union is typically treated in two stages. To transform an infected non-union into an aseptic non-union, the initial step involves debridement, either with or without the insertion of antibiotic cement beads and systemic antibiotics. In order to ensure stability, external or internal fixation - with or without bone grafting - is carried out in the second stage. There is a wealth of literature supporting the use of antibiotic-impregnated cement-coated intramedullary (IM) nailing for infected non-union of tibia and femur fractures. In contrast to cement beads, the cement nail offers stability throughout the fracture site, and osseous stability is crucial for the treatment of an infected non-union. When using antibiotics for this purpose, they should possess unique qualities, including low allergenicity, heat stability, and a broad spectrum of activity. The most commonly utilised medication has been gentamicin, which is followed by vancomycin. Furthermore, it has been discovered that solid nails are more resistant to local infection than cannulated IM nails. In this case study, the patient was treated with a solid IM nail that had a specially designed slot on its exterior surface for the application of cement impregnated with antibiotics. In conclusion, an easy, affordable, and successful treatment for infected non-union of the tibia is antibiotic cement-impregnated nailing. It has strong patient compliance and removes the problems associated with external fixators, which makes it superior to them. A few benefits of this approach are early weight-bearing, stabilisation of the fracture, local antibiotic treatment, and the potential for accelerated rehabilitation. Additionally, lowering the requirement for continuous antibiotic medication may lessen the chance that antibiotic resistance may arise.

Fixation of Paediatric Proximal Humerus Fractures Using Percutaneous Pinning: A Case Report.

A 12-year-old male came to our Emergency Department with chief complaints of pain and inability to move the right shoulder for one day following a fall while playing. The range of motion of the right shoulder was restricted and painful in all directions. Initial radiographs revealed a transverse, displaced proximal humerus fracture at the head-shaft junction. The patient was managed by closed reduction internal fixation with percutaneous K-wiring (Kirschner wires). The K-wires were removed after four weeks, and the shoulder was mobilized. The patient had a near-normal and pain-free range of motion at three months of follow-up. Percutaneous K-wiring remains a viable option for the treatment of paediatric proximal humerus fractures, and good post-operative rehabilitation can help restore near-normal function, as demonstrated in this report.

A Case of a Failed Hemiarthroplasty of the Hip Treated by an Extended Trochanteric Osteotomy.

Hip bipolar hemiarthroplasty, a widely employed surgical intervention for managing hip fractures and degenerative hip diseases, can pose significant challenges when revisions become necessary due to complications such as implant loosening, instability, or breakage. This case report presents the intricate management of a 58-year-old male who presented with worsening left hip pain a decade after undergoing hip replacement surgery. Despite a thorough preoperative assessment ruling out infection, intraoperative complexities included the necessity for extended trochanteric osteotomy (ETO) to address a broken stem and associated metallosis. Successful revision surgery was meticulously executed, incorporating techniques for implant removal, femoral shaft augmentation, and postoperative rehabilitation. The ensuing discussion explores the multifaceted aspects of failed hemiarthroplasty, emphasizing the critical roles of surgical precision, judicious patient selection, and ongoing research endeavors aimed at refining surgical strategies to optimize patient outcomes. This case underscores the imperative of a multidisciplinary approach and the continued imperative for advancements in surgical methodologies for effectively managing revision hip arthroplasty cases, thus enhancing the quality of patient care in this intricate clinical domain.

Bilateral Humerus Midshaft Fracture Associated With Birth Trauma: A Case Report.

Bilateral humerus fractures as a result of birth trauma are a rare occurrence in neonatal care, necessitating special consideration due to their potential long-term implications. Birth-related injuries involving neonatal skeletal structures, especially fractures of the humerus, require special attention and a comprehensive approach to diagnosis and management. Here, we present the case of a newborn female child who experienced bilateral humerus fractures due to birth trauma. The subsequent management involved the application of splints to immobilize the affected arms, a standard practice in the treatment of fractures.

A Pilot Study of Functional Outcomes in Adult Patients Treated With Valgus Intertrochanteric Osteotomy as a Primary Modality for Intracapsular Femoral Neck Fracture.

Background Intracapsular femoral neck fractures account for a majority of hip fractures. This study aimed to investigate the efficacy of valgus osteotomy as a primary treatment for intracapsular femoral neck fractures in adult patients aged 15-60 years, assessing its impact on functional outcomes and fracture union. Methodology A retrospective clinical analysis was conducted at the Department of Orthopedics and Traumatology, Osmania Government General Hospital, Hyderabad, India, focusing on patients treated with primary intertrochanteric valgus osteotomy for intracapsular femoral neck fractures. The study reviewed medical charts and radiographs of six patients aged between 15 and 60 years, diagnosed with recent isolated intracapsular femoral neck fractures, presenting between May 2019 and October 2021. The intervention involved Pauwels' intertrochanteric valgus osteotomy with various fixation methods. Main outcome measures included radiographic union, functional ability assessed by the Harris Hip Score, and evaluation for complications. Results All six patients achieved radiographic union at fracture and osteotomy sites, totaling a 100% success rate. The average follow-up duration was 14.8 months (12-20 months), with an average time of 5.1 months (2.5-6 months) from surgery to radiographic union. One patient experienced union with retroversion, while another developed avascular necrosis (AVN) by the study's conclusion. No instances of hardware failure or non-union were observed. The average Harris Hip Score obtained during the most recent clinical follow-up was 84, ranging from 69 to 94. All six patients regained independent walking ability without any support by the end of the follow-up period. Conclusion The combination of primary Pauwels' intertrochanteric valgus osteotomy with fixed-angle plating proves to be a highly effective method for addressing recent intracapsular femoral neck fractures, resulting in a 100% success rate in achieving union among the patient cohort.

A Glomus Tumor Presenting on the Ventromedial Aspect of the Little Finger Causing Bony Erosion: A Rare Case From India.

Glomus tumors are rare neoplasms originating from the glomus body that predominantly manifest in the subungual region of the digits and are distinguished by severe pain and a heightened sensitivity to cold. Bony erosion associated with glomus tumors is a rare phenomenon. Here, we present a unique case of a glomus tumor situated on the ventromedial aspect of the little finger, leading to notable bony erosion. A 42-year-old female from India presented with a chief complaint of severe and localized pain in the ventromedial region of her right little finger, exacerbated by exposure to cold temperatures. Radiological investigations demonstrated focal bone erosion at the site of the tumor. Surgical excision of the lesion was performed. A fish-mouth incision was made on the ventromedial aspect of the little finger, which was extended to the tip of the finger. The nail bed was kept intact. The tumor was excised using small forceps. The patient experienced complete resolution of symptoms postoperatively and reported no recurrence during the follow-up period. This case report highlights the exceptional presentation of a glomus tumor causing bony erosion on the ventromedial aspect of the little finger, a manifestation rarely encountered in clinical practice. Furthermore, this case contributes to the limited body of literature on this combination of uncommon clinical entities, shedding light on its diagnosis and management.

Pain-related hospitalization and emergency room visit following initial analgesic prescription after outpatient surgery.

PURPOSE: Our study examined the association between outpatient postsurgical analgesic prescription and risk of insufficiently managed pain characterized by pain-associated hospital admission and emergency room (ER) visit. METHODS: Eligible individuals were children 1-17 years of age who filled an incident analgesic following an outpatient surgery during 2013-2018. Pain-associated hospital admission or ER visit were measured within 30 days following the outpatient surgical procedure. A hierarchical multivariable logistic regression model with patients nested under prescribers was fitted to test the association between incident analgesic prescription and risk of having pain-associated hospital admission or ER visit. RESULTS: Of 14 277 children meeting the inclusion criteria, 6224 (43.6%) received an incident opioid and 8053 (56.4%) received an incident non-opioid analgesic prescription respectively. There were a total of 523 (3.7%) children undergoing surgical procedures that had pain-related hospital admissions or ER visits with 5.1% initiated on non-opioid analgesics and 1.8% on opioid analgesics. The multilevel model indicated that initial opioid analgesic recipients were 32% less likely of having a pain-associated hospital admission or ER visit [aOR: 0.68 (95% CI: 0.3-0.8)]. CONCLUSION: Majority of postsurgical patients do not require additional pain management strategies. In the 3.7% of patients requiring additional pain management strategies, those initiated on non-opioid analgesics are more likely to have a pain-associated hospital admission or ER visit compared with their opioid recipient counterparts.

Improving Value in Colorectal Cancer Care: An Economic Analysis of Enhanced Recovery Protocols at a Community Hospital.

Background: Enhanced recovery protocols (ERPs) have been shown to improve the outcomes of gastrointestinal cancer care, leading to reduced morbidity of gastrointestinal treatment and reduced delays in systemic therapy. ERP implementation has also previously shown a reduction in length of stay (LOS) without changing the readmission rate; however, the economic cost associated with these measures has not yet been quantified. The aim of this study was to evaluate the economic costs of ERP implementation for colorectal cancer at a community hospital. Methods: The Diagnostic Related Group (DRG) codes were used to assess costs associated with the hospitalizations of cases in the ERP versus non-ERP groups. The American Hospital Association (AHA) Annual Survey from 1999 to 2015 was used to provide the expenses per day for inpatient hospitalization in the United States. Postoperative LOS, average healthcare costs, and postoperative complications between ERP-protocol and non-ERP protocol groups were analyzed using analysis of variance (ANOVA) and independent t-tests. Results: The AHA survey estimated that $2,265 was incurred per day for non-profit hospitals in Florida and $2,346 was incurred per day for the United States. For all DRG codes, the ERP-participating group was associated with a shorter LOS and reduced health care costs. LOS-associated cost was compared between ERP and non-ERP groups: for DRG 329, the total savings was $162,118.8 (n = 12 non-ERP versus n = 8 ERP, P = 4.39 × 10-18); for DRG 330, $314,552.64 (n = 36 non-ERP versus n = 24 ERP, P = 2.72 × 10-22); and for DRG 331, $89,302.73 (n = 11 non-ERP versus n = 23 for ERP, P = 4.19 × 10-20). Conclusions: The implementation of an ERP protocol for colorectal cancer was associated with significantly reduced costs in a community hospital.

Trends in Repeat Opioid Analgesic Prescription Utilization for Acute Pain in Children: 2013-2018.

OBJECTIVE: Our study examined the change in repeat opioid analgesic prescription trends in children and adolescents experiencing acute pain between 2013 and 2018. METHODS: Eligible individuals were children and adolescents between 1 and 17 years of age enrolled in a Medicaid Managed Care plan and filled an incident opioid analgesic prescription from 2013 to 2018. A repeat opioid prescription was defined as receiving a subsequent opioid prescription within 30 days from the end of the incident opioid prescription. A generalized linear regression analysis was conducted to examine changes in repeat opioid analgesic dispensing over time at quarterly intervals from January 1, 2013, to December 31, 2018. RESULTS: The cohort comprised 17,086 children and adolescents receiving an incident opioid analgesic. Of these, 1780 (10.4%) filled a repeat opioid analgesic prescription. There was a significant decline in the repeat opioid analgesic trend from 11.5% in Q1 2013 to 9.6% in Q4 2018. Stratified analyses by age, sex, and race and ethnicity in a sub-cohort of patients undergoing surgical procedures showed that a significant decline in repeat opioid utilization over time has been observed in all racial/ethnic groups stratified by age and sex, with the most significant decline found in non-Hispanic White children and Hispanic adolescents. At the end of the 6-year follow-up, the racial and ethnic variations in repeat opioid utilization associated with surgical procedures had significantly reduced in children yet persisted among adolescents. CONCLUSIONS: Approximately 10% of incident pediatric opioid analgesic recipients received a repeat opioid prescription. There has been a moderate but steady decline (∼7% per quarter) in repeat opioid analgesic utilization between 2013 and 2018.

Reduction of esters to alcohols and iodides using aminodiborane (µ-NH2B2H5): scope and mechanistic investigations.

Herein, we report an efficient methodology for the reduction of esters, carbonates, and anhydrides to alcohols using in situ generated aminodiborane from iodine and ammonia borane. This methodology also finds use for the transformation of esters to iodides by varying the stoichiometry of reagents. The protocol has broad substrate scope for transformation of esters to alcohols and iodides with excellent yields. The method is also useful for synthesizing pharmaceutically and industrially important compounds such as a Cinacalcet precursor, a Streptoindole analogue, and 1,4-pentanediol. Control studies and DFT calculations carried out to study the reduction mechanism of esters using aminodiborane indicate that a dioxaborinamine intermediate is formed during the reaction.

A Bench-stable 8-Aminoquinoline Derived Phosphine-free Manganese (I)-Catalyst for Environmentally Benign C(α)-Alkylation of Oxindoles with Secondary and Primary Alcohols.

Herein, we report a new air-stable phosphine-free 8-AQ (8-aminoquinoline) based Mn(I) carbonyl complex as the catalyst for the C(α)-alkylation of oxindoles with alcohols. The Mn complex [(8-AQ)Mn(CO)3 Br] works effectively as a catalyst for the α-alkylation of oxindoles by both secondary as well as primary alcohols. The procedure has been used for the synthesis of pharmaceutically important recently developed oxindoles such as 3-(4-methoxybenzyl)indolin-2-one, 3-(4-(dimethylamino)benzyl)indolin-2-one, 3-(4-(dimethylamino)phenyl)-5-fluoroindolin-2-one and 3-(benzo[d][1,3]dioxol-5-ylmethyl)indolin-2-one, which are found to be effective in preventing specific types of cell death in neurodegenerative disorders. Control experiments have been carried out to investigate the reaction mechanism and the crucial role of metal-ligand cooperation via -NH2 moiety during catalysis.

Association Between Initial Opioid Prescription Duration and 30-Day Risk of Receiving Repeat Opioid Among Children.

OBJECTIVE: Our study evaluated the association between initial opioid prescription duration and receipt of a repeat opioid prescription in children. METHODS: Eligible individuals were children between 1 and 17 years of age who enrolled in a Medicaid Managed Care plan and filled an incident opioid prescription during 2013 to 2018. An incident prescription was defined as receipt of an opioid analgesic without a prior use for 12 months. A repeat opioid prescription was defined as receipt of a subsequent opioid prescription within 30 days since the end of incident opioid prescription. A hierarchical multivariable logistic regression model was fitted to test the association between incident opioid prescription duration and the likelihood of receiving a repeat prescription. RESULTS: The cohort consisted of 17,086 children receiving an incident opioid prescription in which 6272 (36.7%) received 1 to 3 days' supply, 8442 (49.4%) received 4 to 7 days' supply, 1434 (8.4%) received 8 to 10 days' supply, and 938 (5.5%) received >10 days' supply. Of these incident opioid recipients, 1780 (10.4%) filled a repeat opioid prescription. The multilevel model results indicated that, children receiving 4 to 7 days' supply (adjusted odds ratio [aOR]: 0.98 {0.9-1.1}), 8 to 10 days' supply (aOR: 1.03 [0.8-1.3]), and >10 days' supply (aOR: 0.85 [0.7-1.1]) had comparable likelihoods of receiving a repeat prescription as those receiving 1 to 3 days' supply. DISCUSSION: Nearly 10% of children who filled an opioid prescription for acute pain received a repeat prescription. Initial prescription duration was not associated with the risk of receiving a repeat prescription.

Clinal variation as a tool to understand climate change.

Clines are observable gradients that reflect continuous change in biological traits of species across geographical ranges. Clinal gradients could vary at geographic scales (latitude and altitude). Since clinal variations represent active genomic responses at the population level they (clines) provide an immense power to address questions related to climatic change. With the fast pace of climate change i.e. warming, populations are also likely to exhibit rapid responses; at both the phenotypic and genotypic levels. We seek to understand how clinal variation could be used to anticipate climatic responses using Drosophila, a pervasively used inter-disciplinary model system owing to its molecular repertoire. The genomic information coupled with the phenotypic variation greatly facilitates our understanding of the Drosophilidae response to climate change. We discuss traits associated with clinal variation at the phenotypic level as well as their underlying genetic regulators. Given prevailing climatic conditions and future projections for climate change, clines could emerge as monitoring tools to track the cross-talk between climatic variables and organisms.