Isolated, displaced, talar body fracture: a case report and literature review.

Talar body fractures are uncommon fractures of the foot and its management results to be very hard due to retrograde vascularization and wide articular cartilage coverage of talar surface, which could easily lead to poor functional outcomes, avascular osteonecrosis and early post traumatic arthritis. We describe a case of displaced, vertical, talar body fracture in a 41-year-old patient treated with reduction and fixation by talar anteromedial approach coupled to medial malleolar osteotomy to better expose the fracture. Our literature review has found few studies, in addition with a low level of statistical evidence. We advocate for more studies with a bigger sample and with a design of randomized control trials.

Total hip arthroplasty and Paget's disease: case report and literature review.

Paget's disease (PDB) is a chronic osteopathy more common in male, Caucasic, European population, after the age of 50 years, that can lead to bone deformities. A challenging surgical solution for affected hip with severe hip osteoarthritis is total hip replacement (THA). We describe a case of THA in a 71-year-old patient with PDB and we present a literature review. In particular we find out that more studies comparing cementless THA with cemented one are necessary, in order to understand if one implant is better than the other.

Traumatic acute stem rupture in stress shielding bone resorption of a bipolar radial head arthroplasty: case report and literature review.

Bone resorption around the proximal portion of the stem of a radial head prosthesis is a frequent phenomenon. In the vast majority of cases it is not correlated with to be without clinical manifestations.  This radiographic sign, refers to the stress shielding effect has been more described in total hip replacement surgery. Few authors have noticed this phenomenon in radial head replacement. however, given the increasing number of these procedures, a careful surveillance is required in patients presenting this sign. We report a literature review and a case presentation of proximal stem rupture following a trauma in association to radiological periprosthetic bone resorption due to stress shielding and treated with revision surgery.

The Charcot Knee Arthropaty: The Diagnostic and Surgical Challenge. A Case of Syphilis Arthropaty and a Review of Literature.

The Charcot knee is a progressive, degenerative disease of the joint that may represent a diagnostic challenge; at the moment, poorly controlled diabetes mellitus is the main cause of this condition. We describe here a case of a man presenting with an end stage joint arthropathy who was diagnosed with neurosyphilis. Tabetic arthropathy is currently a very rare disease, but in the past represented the main cause of joint arthropathy. Finally, we discussed the different surgical options of Charcot arthropathy, our choice of megaprosthesis implant and the failure of such procedure mainly due to patient's unreliability to care leading to infective complications and peri-prosthesis fracture.

Lisfranc injuries in adolescents: A case report and literature review.

Lisfranc injuries result if bones or ligaments that support the midfoot are torn. In children and adolescents these injuries are not only rare, but are also similar to adult Lisfranc injuries, in that they are often mistaken especially if the injury is a result of a straightforward twist and fall. The goal of surgical treatment is to realign the joints. However, few studies related to Lisfranc injuries in pediatric patients exist. A case of 15 years old patient treated using an Arthrex mini tight rope is described.

Intertrochanteric hip fracture in an arthrodesed hip treated by a LCP condylar plate.

We report the case of an intertrochanteric hip fracture in a 73 years-old woman with a long-standing arthrodesis. The proper surgical treatment is controversial but we decided to treat the fracture with a single LCP condylar plate turned upside-down. After one year the patient achieved her preinjury levels of activities. This kind of fracture could be satisfactorily treated with locking plate.

Detector Response to D-D Neutrons and Stability Measurements with 4H Silicon Carbide Detectors.

The use of wide-band-gap solid-state neutron detectors is expanding in environments where a compact size and high radiation hardness are needed, such as spallation neutron sources and next-generation fusion machines. Silicon carbide is a very promising material for use as a neutron detector in these fields because of its high resistance to radiation, fast response time, stability and good energy resolution. In this paper, measurements were performed with neutrons from the ISIS spallation source with two different silicon carbide detectors together with stability measurements performed in a laboratory under alpha-particle irradiation for one week. Some consideration to the impact of the casing of the detector on the detector's counting rate is given. In addition, the detector response to Deuterium-Deuterium (D-D) fusion neutrons is described by comparing neutron measurements at the Frascati Neutron Generator with a GEANT4 simulation. The good stability measurements and the assessment of the detector response function indicate that such a detector can be used as both a neutron counter and spectrometer for 2-4 MeV neutrons. Furthermore, the absence of polarization effects during neutron and alpha irradiation makes silicon carbide an interesting alternative to diamond detectors for fast neutron detection.

Correction to: Biomechanical reconstruction parameters obtained after direct anterior approach total hip arthroplasty do not compromise clinical outcome.

The original version of this article unfortunately contained a mistake. Figures 3 and 4 captions were interchanged.

Biomechanical reconstruction parameters obtained after direct anterior approach total hip arthroplasty do not compromise clinical outcome.

INTRODUCTION: Accurate reconstruction of biomechanical parameters following total hip arthroplasty (THA) is crucial for good joint function. We investigated how reconstruction parameters achieved by minimally invasive anterior (MIS) THA may influence function and patient-related outcomes. METHODS: A consecutive series of 95 patients treated by MIS THA for primary osteoarthritis were retrospectively reviewed. Primary outcome measures were Harris Hip Score (HHS), hip disability and osteoarthritis outcome score (HOOS) and EQ-5D. Femoral offset (FO), abductor lever arm (ALA), centre of rotation (CoR), leg length discrepancy (LLD), cup version and stem alignment were measured pre- and post-operatively. Obtained reconstruction parameters compared to the contralateral hip were used as independent variables in a multivariate regression with each primary outcome measure as dependent variable. RESULTS: Mean age at surgery was 69 years. HHS rated 94.7% of patients as good/excellent and mean EQ-5D was 0.82. Post-operative HOOS subscales showed no statistical difference compared to the Italian benchmark population. Stem alignment averaged 0.2° valgus, mean cup inclination was 37.8° and mean anteversion was 12.8°. When compared to the contralateral side, CoR was post-operatively elevated by 2.6 mm and medialized by 2.4 mm averagely. An average FO reduction of -0.5 mm was observed while FO ratio increased by 1.9% averagely. ALA decreased by -3.3 mm while LLD was 2.3 mm averagely. Multivariate regression analysis revealed a significant contribution of ALA to HHS only. CONCLUSIONS: Biomechanical parameters achieved by MIS THA are satisfactory with negligible impact on functional results and no impact on patient-related outcomes certifying the high quality achieved in THA.

Optimization of detection strategies for epithermal neutron spectroscopy using photon-sensitive detectors.

In this work, we discuss an improved detection procedure for the photon-sensitive yttrium-aluminum-perovskite detectors installed on the VESUVIO spectrometer at the ISIS pulsed neutron and muon source. By decreasing the low-level energy threshold of detected photons, we observe an increased count rate up to a factor ∼3, and a decrease of relative error bars and noise of ∼40% and 35%, respectively, for deep inelastic neutron scattering measurements. In addition, we demonstrate how the reported optimization may increase the accuracy in the line shape analysis of neutron Compton profiles, as well as in the application of the mean-force approach to detect the anisotropy and anharmonicity in the single-particle local potential. We envisage that such an upgrade of the detection procedure would have a substantial impact on the VESUVIO scientific programme based on deep inelastic neutron scattering investigations.

Mini open versus open repair techniques in Achilles tendon rupture: clinical and isokinetic evaluation.

BACKGROUND: The aim of the study was to compare the mini-open to the classic open repair techniques for Achilles tendon ruptures. METHODS: We retrospectively evaluated at a minimum of 2 years follow-up 32 subcutaneous Achilles tendon ruptures; 17 underwent mini-open surgery (Group A) and 15 the open technique (Group B). RESULTS: No difference in Achilles Tendon Total Rupture Score and in modified Leppillahti score was observed. With respect to the contralateral side the width of the operated Achilles tendon was 4.07 mm thicker in Group A and 7.67 mm in Group B (p<.05); the calf circumference reduction was respectively 10 mm and 23.75 mm (p<.05). Iso-kinetic peak force measurement of the calf muscle strength showed a loss of 8.21% in Group A versus 17.25% in Group B (p <.05). The mean Patient Satisfaction Score was 96.76 in Group A and 88.67 in Group B (p<.01); respectively 82.3% vs 66.7% of patients were able to return to previous levels of sporting activity. There were two post-operative complications in Group B and one in Group A. CONCLUSION: Mini-open technique minimizes the risk of complications, leads to an improved tendon healing process and functional recovery with higher patient satisfaction. LEVEL OF EVIDENCE: IV.