Cementless reverse total shoulder arthroplasty in a patient affected by Osteogenesis Imperfecta: a case report and review of the literature.

BACKGROUND AND AIM OF THE WORK: Osteogenesis Imperfecta is a rare genetic condition. The use of total shoulder arthroplasty in these patients is very uncommon, with only two cases reported in the literature. This study describes a cementless reverse total shoulder arthroplasty (rTSA) for a multi-fragmented fracture in a patient affected by Osteogenesis Imperfecta (OI) type 1 and aims to review literature results of shoulder replacement in patients affected by this uncommon condition. METHODS: the case of a woman affected by OI type 1 treated with a cementless rTSA for a multi-fragmented proximal humerus facture is reported. Focusing on the fixation technique, a research of all articles regarding the orthopaedic treatments in patients affected by Osteogenesis Imperfecta was performed and compared to the techniques used in the unaffected population. RESULT: Our patient shows good results in terms of clinical and radiological outcomes at the short term follow up. Few studies treat the orthopaedic manifestation of this rare genetic condition and only two are focused on shoulder arthroplasty. Cement is the preferred method for fixation in both papers. CONCLUSION: Cementless reverse shoulder arthroplasty may be an option in patients affected by OI type 1, although literature seems to support cement as the fixation method of choice.

Simultaneous bilateral olecranon fracture: a case report and review of the literature.

BACKGROUND AND AIM OF THE WORK: A bilateral fracture of the olecranon is a rare injury, with only few cases reported in the literature. METHODS: A single case of bilateral Mayo type II A olecranon fracture in a 88 years old woman is described. A research of all articles regarding simultaneous bilateral olecranon fracture was performed in the PubMed database. RESULT: The reported case demonstrated good clinical and radiographic results at 5 months follow-up with surgical treatment. The literature search produced other 6 cases in 5 case reports. Except for one case of fatigue fracture that had been treated conservatively, the others received surgical treatment with satisfactory results. CONCLUSION: Simultaneous bilateral olecranon fracture is very uncommon. Bilateral internal fixation yields good clinical and radiographic results in most cases.

Analysis of clinical utility of abdominopelvic computed tomography in the follow-up of Stage I seminoma: a single center evaluation.

BACKGROUND: Abdominopelvic computed tomography (CT) is widely used in the follow-up of seminoma patients after radical orchidectomy. The aim of this study was to evaluate the clinical utility of abdominopelvic computed tomography in the follow-up of patients with Stage I seminoma. METHODS: The pathological reports of all patients that have undergone radical orchidectomy in our tertiary referral center between January 2002 and January 2018 have been retrospectively reviewed. All patients with Stage I seminoma and negative serum tumor markers after radical orchidectomy were included. Patients with follow-up shorter than 12 months were excluded. Surveillance records of every patient were reviewed with regard to abdominopelvic imaging. RESULTS: Of the 133 patients who have undergone radical orchidectomy in our center, 55 had Stage I pure seminoma with normal levels of serum tumor markers after surgery. Two patients were excluded as the follow-up was inadequate. Mean follow-up was 63.2 months (IQR: 30-73). The results of 211 abdominopelvic CTs performed as part of the follow-up were reviewed. Two (3,7%) patients developed recurrence; one consisted of a scrotal lump and was diagnosed with ultrasonography (US) while the second appeared as paraaortic nodal metastasis and was diagnosed with abdominopelvic CT. The recurrence was successfully treated in both patients. A single abdominopelvic CT was useful for the detection of recurrent disease in our entire study population. No cancer specific death has been reported in the study population. CONCLUSIONS: Follow-up schedules for Stage I seminoma expose patients to potential risks of radiation-induced tumors, emotional distress and represent a significant burden for the healthcare system. The current series suggests that a better risk adapted patient-tailored follow-up program is needed in order to avoid unnecessary investigations.