"Hands Up" and Social Distancing: A Rare Case of Bilateral Luxatio Erecta During the Second Wave of the COVID-19 Pandemic Lockdown Period.

In this paper, we present an interesting and very rare case of bilateral luxatio erecta as a result of unattended at-home sports activities during the lockdown period due to the second COVID-19 pandemic wave. A 31-year-old man presented to the emergency department (ED) with the characteristic "hands up" position after an injury on both shoulders while he was performing unsupervised weightlifting training at home during the lockdown. After the successful reductions, the neurovascular status for both upper extremities was evaluated and confirmed without impairment. The patient has fully recovered and has gained full range of motion on both shoulders without any signs of instability. Luxatio erecta is a low-incidence injury, while the presence of this injury in both upper extremities is thought to be extremely rare, with only a few cases published in the literature to date. Bilateral cases are associated with a high rate of complications. ED physicians should maintain an increased awareness for prompt recognition, particularly in polytrauma patients, as the presence of this injury increases the complexity of managing this type of patient in the ED due to the abducted arms.

Osteitis Pubis in Athletes: A Literature Review of Current Surgical Treatment.

Osteitis pubis (OP) is a self-limiting, noninfectious inflammatory disease of the pubic symphysis and the surrounding soft tissues that usually improves with activity modification and targeted conservative treatment. Surgical treatment is required for a limited number of patients. This study aims to investigate the current literature on the surgical treatment of OP in athletes. A systematic review was conducted on two databases (MEDLINE/PubMed and Google Scholar) from 2000 to 2021. The inclusion criteria were adult patients with athletic OP who underwent surgical treatment and studies published in English. The exclusion criteria included pregnancy, infection OP, or postoperative complications related to other surgical interventions, such as urological or gynecological complications. Fifty-one surgically treated cases have been reported in eight studies, which included short-term, mid-term, and long-term studies ranging from one patient to 23 patients. The surgical treatment methods were as follows: (a) pubic symphysis arthrodesis, (b) open or endoscopic pubic symphysectomy, (c) wedge resection of the pubic symphysis, and (d) polypropylene mesh placed into the preperitoneal retropubic space endoscopically. The main indication for surgical intervention was failure of conservative measures and long-lasting pain, disability, and inability to participate in athletic activities. Wedge resection of the pubic symphysis has been the less preferred surgical treatment in the recently published literature. The most common surgical method of treatment of OP in athletes, which entailed the existence of posterior stability of the sacroiliac joint, in the current literature is open pubic symphysis curettage. Recently, there has been a tendency for pubic symphysis curettage to be performed endoscopically.