Case report and presentation of a new classification system for hip acetabular and periacetabular ossifications and calcifications.

This report describes a rare case in which double calcifications of the acetabular labrum and rectus femoris occurred concomitantly in a middle-aged female patient who was treated successfully with surgical intervention via hip arthroscopy. Contribution: This case highlights the existence of various types of calcifications around the acetabulum, with a proposed new classification system for acetabular and periacetabular rim ossifications.

Adhesive Capsulitis Secondary to COVID-19 Vaccination - A Case Series.

Introduction: Shoulder injury related to vaccine administration (SIRVA) is a group of pathologies defined by pain and stiffness after intramuscular administration of vaccine to the upper arm and has been reported after COVID-19 vaccination. We aim to discuss its pathophysiology, clinical presentation, treatment and outcomes. Materials and methods: We retrospectively identified patients presenting with adhesive capsulitis within four weeks of administration of COVID-19 vaccine to the affected arm at our tertiary institution from March 2021 to December 2022. Result: Based on the above criteria, we identified seven cases of adhesive capsulitis, comprising one male and six female patients, with average age of 60 years. We present initial symptoms, signs and the duration from when the vaccine was administered. We have highlighted our treatment strategies as well as the clinical and functional outcomes reported by these patients after treatment. We have reported improvement in both Visual Analogue Scale (VAS) and range of motion (ROM) in all our patients after non-surgical management which included physiotherapy and, in some cases, hydrodilatation. Conclusion: SIRVA related adhesive capsulitis is rare and under-reported with limited information in current literature. This study highlights that adhesive capsulitis is a potential complication arising from improper COVID-19 vaccine administration and reinforces traditional wisdom of administering vaccinations on the non-dominant arm. Conservative treatment strategies appear to be effective, particularly hydrodilatation combined with physiotherapy, and patients are expected to have a good return of function.

Peri-Implant Fractures Distal to an Antegrade Femoral Nail: A Case Series.

Peri-implant fractures distal to an antegrade femoral nail are uncommon injuries, with no current consensus on the best treatment modality. We are presenting three cases of periimplant fractures distal to an antegrade femoral nail. All patients sustained an initial traumatic injury, which was managed with an antegrade femoral nail fixation. They subsequently suffer a second injury which causes periimplant fracture. Our first two patients were managed with removing the intramedullary nail followed by Less Invasive Stabilization System (LISS) plate fixation. In our third case, the intramedullary nail was left in-situ, and the fracture was fixed with a polyaxial locking plate We discuss their injury pattern, investigations and surgical management. Polyaxial locking plates show great promise in this setting as they allow fixation of the fracture whilst maintaining the existing nail to protect the entire femur from further injury.