A Closer Look at Fibrous Dysplasia Femur Fracture Five-year Follow-up: A Unique Case.

Introduction: Fibrous dysplasia (FD) is a benign skeletal disorder characterized by the replacement of normal bone tissue with disorganized fibrous tissue. Fractures are a significant complication of FD, particularly in the proximal femur, where deformities such as Shepherd's crook deformity can increase the risk. Case Report: We present a case study of a 44-year-old male with unilateral monostotic FD, Shepherd's crook deformity, and a pathological femoral shaft fracture. The initial surgical approach involved valgus osteotomy, dynamic condylar screw (DCS) fixation, and multiple osteotomies of the femoral shaft. However, the patient experienced a refracture and implant failure, necessitating a second surgical intervention with a double-angled DCS and additional fixation. Post-operative follow-up revealed successful bone union and deformity correction, although a limb length discrepancy was noted. Conclusion: This case highlights the challenges in managing FD-related fractures and the importance of addressing deformities and achieving optimal alignment. Individualized treatment approaches, careful implant selection, and post-operative rehabilitation are crucial for successful outcomes in FD-associated fractures.

Tailored Precision: A Unique Case of Pelvic Osteosarcoma Management.

Introduction: Osteosarcoma of the pelvis poses challenges in surgical resection due to its anatomical location and extensive nature. This case report focuses on the clinical presentation and therapeutic outcomes of a 20-year-old patient with osteosarcoma of the right iliac bone. The study highlights the efficacy of 3D printing technology in creating customized implants for improved surgical outcomes. Case Report: The case report presents the clinical presentation, management, and outcomes of a patient with osteosarcoma of the right iliac bone. It emphasizes the impact of surgical resection extent and endoprosthetic reconstruction. The study highlights the advantages of 3D printing technology in creating customized implants that accurately fit the remaining bone. Limb-sparing surgery is advocated for better functional and psychological outcomes compared to amputation. The report also emphasizes the need for further research on alternative composite materials and discusses the limitations of 3D printing technology in orthopedics.The limitations of 3D printing, such as mechanical safety and material restrictions, are discussed, calling for future advancements to improve the reliability and effectiveness of 3D-printed implants in orthopedics. Conclusion: The present case report provides valuable perspectives into the efficacious management of pelvic osteosarcoma and underscores the distinctive advantages of 3D printing technology in improving surgical results. Limb-sparing surgery demonstrates enhanced functional and psychological outcomes compared to amputation. Utilizing 3D custom-made implants, significantly reduces the likelihood of revision surgeries attributed to implant failure, improves the surgical outcome and precision.

How to assess scapular dyskinesis precisely: 3-dimensional wing computer tomography--a new diagnostic modality.

BACKGROUND: Aberrations in scapular motion are believed to be associated with the presence of shoulder or elbow pathologies. There are many methods to evaluate scapular kinematics, but they have certain limitations. Nevertheless, it is believed that appropriate rehabilitation for each type of scapular dyskinesis is important. METHODS: Eighty-nine athletes were videotaped and seven blinded observers categorized scapular dyskinesis into 4 types, which was followed by 3-dimensional (3D) wing computer tomography (CT). Four blinded examiners evaluated 5 angles [upward rotation (UR), internal rotation (IR), anterior tilting (AT), superior translation (ST), and protraction (PRO)] on the 3D wing CT. Inter-rater reliability (IRR) was calculated for both the methods. CT scan measurements were compared with the 4 observational types to establish the validity. RESULTS: The IRR with observational assessment of scapular dyskinesis into 4 types was good, 0.780. The 3D wing CT analysis had a very high IRR, 0.972. There was a statistically significant correlation between observational assessment and 3D wing CT analysis. The UR angle, ST angle in type 3 scapular dyskinesis, and AT angle in type 1 scapular dyskinesis were increased as compared with those in the other types of scapular dyskinesis. All these measurements were made in the resting position of the scapula. CONCLUSION: The 3D wing CT analysis allows precise quantification of a position associated with scapular dyskinesis. Therefore, 3D wing CT can be considered as an alternative method for assessing scapular dyskinesis.