Asymptomatic Congenital Absence of Lateral Pedal Rays.

Complete absence of 1 or more pedal rays is a rare condition. In the present report, the case of an adult male with complete congenital absence of his right fourth and fifth pedal rays is described. The condition had been asymptomatic until he had sustained an acute third metatarsal fracture and was satisfactorily treated with cast immobilization.

Watch out for luxatio erecta of the shoulder.

Traumatic inferior dislocation of the shoulder (also termed "luxatio erecta") is a very rare injury. The correct diagnosis may be overlooked and results after reduction can often result in significant morbidity of the affected joint. It is described in a clinical case in which a male adult reported a luxatio erecta that was correctly diagnosed and reduced with uneventful recovery. Since it is a quite rare event in the emergency room, a careful review of the literature warned us about potential pitfalls in diagnosis and treatment of this peculiar injury. Our brief case report is intended to furnish educational images and stress the importance of a correct clinical and radiographic evaluation.

A minimally invasive reduction and synthesis method for calcaneal fractures: the "Brixian bridge" technique.

Calcaneal fractures are difficult to treat because of their often-related sequelae. The authors present a simple, rapid, economic, and easy-to-perform technique that uses percutaneously positioned Kirschner wires plus a plaster cast for the reduction and stabilization of certain calcaneal fractures. A review of the relevant literature is also provided.

The "wall-socket" technique. Proposal of a new surgical procedure for revision acetabular arthroplasty.

Prosthetic socket revisions are always difficult and affected by problems such as possible bone-stock losses, leading to an increase in morbidity associated with surgery. These aspects are more important in elderly patients due to their frequently poor health. The bone deficit may be filled in different ways, with techniques that are nevertheless technically demanding and at risk of complications. In the opinion of the Author it is possible to leave a migrated but well-fixed cup/shell in place, simply by loading through the insertion of a second cemented cup alongside. We considered two cases of verticalized sockets: a cemented socket and a non-cemented one which, by demonstrating stability in removal attempts, forced the surgeon to leave them in place and to place a second cemented polyethylene cup alongside. This cheap surgical choice allows to shorten surgical times, to diminish blood losses and to achieve an immediate rigid fixation, aspect of utmost importance in elderly patients, allowing them to walk with a 100% load by the second post-operative day. The unremoved prosthetic cup, that is even better stabilized by the new cement, works as a "support wall" in DeLee and Charnley's zone 3, an acetabular X-ray sector notoriously subordinated to damaging tensile forces which may cause loosening of the original prosthetic cup. Because of the positive clinical and radiographic results demonstrated over time by this "enforced" revision solution, the author proposes to name it as the "Wall-Socket" technique.