Short-term Complications of Open Latarjet Procedure for Recurrent Anterior Shoulder Dislocation.

Background: Anterior dislocation is the most common type of shoulder dislocation, and even after appropriate treatment, recurrence after a primary traumatic anterior dislocation is highly frequent. Surgical options for treating recurrent anterior dislocations mainly include Bankart arthroscopic and Latarjet open surgery. We aimed to evaluate the outcomes and complication rates of the open Latarjet procedure in a series of patients with recurrent anterior shoulder dislocation. Methods: A total of 55 patients with recurrent anterior shoulder dislocation who underwent an open Latarjet procedure were included in this retrospective cohort study. Shoulder range of motion and postoperative complications, including neurapraxia, re-dislocation, hematoma, infection, dehiscence, implant failure, and pain, were evaluated. Results: The mean age of the patients was 27.7 ± 6.5 years . The mean time interval after the first dislocation was 3.4 ± 2.7 years . The mean preoperative and postoperative forward flexion (P = 0.200), abduction (P = 0.200), external rotation (P = 0.066), and internal rotation (P = 0.310) were not significantly different. Postoperative complications included 1 case of postoperative musculocutaneous nerve neurapraxia, 1 case of re- dislocation, 1 case of wound dehiscence, and 2 cases of screw breakage. Postoperative pain was also recorded in 11 (20%) patients that were either in the form of occasional night pain (n = 6) or activity-dependent pain (n = 5). Conclusion: Open Latarjet procedure is an efficient procedure for the treatment of recurrent anterior shoulder dislocation. However, its rate of complications remains relatively high, and surgeons must consider this drawback in their decision-making and address patients' expectations.

Calcaneostop Provides Favorable Short-term Outcomes in Patients With Flexible Flatfoot.

Background: Flatfoot is a relatively frequent deformity seen in almost 5% of children. It is classified into flexible and rigid flatfoot. Symptomatic flexible flatfoot (FFF) can be managed using several procedures, and calcaneostop is one of the procedures that has gained popularity recently. This study aimed to evaluate the outcome of the calcaneostop procedure using screws. Methods: We retrospectively evaluated 57 feet in 44 consecutive patients with FFF undergoing calcaneostop surgery. The same pediatric orthopedic surgeon performed all surgeries. Following a 10-mm incision on the sinus tarsi, a partial thread 6.5 cancellous screw size 40 was inserted. Achilles tendon lengthening was performed on all patients, and a short leg cast was applied. Pain relief, complications, and the change in the talocalcaneal (Kite), talometatarsal (Meary's), and calcaneal inclination (Pitch) angles were evaluated on plain radiographs using a paired t test. Results: Pain relief was achieved in 55 (96.5%) cases, and 2 (3.5%) patients experienced pain after surgery. Other complications, including nerve damage, infection, screw loosening, fracture, or position loss, were not observed. The mean preoperative and postoperative Meary's, Kite, and Pitch angles were 15.74 ± 2.02 (12.30-21.60), 8.72 ± 1.03 (7.20-10.60), 31.23 ± 1.97 (27.80-37.30), 21.30 ± 1.98 (18.50-24.60), 12.40 ± 1.64 (8.50-16.60), and 18.52 ± 1.97 (15.90-22.60), respectively. A significant improvement was observed in each angle following surgery (p<0.001). Conclusion: Calcaneostop is an inexpensive and simple procedure that avoids the involvement of several joints and uses a simple incision leaving a small scar. This procedure is remarkably successful and can be quite convenient.

Post-COVID-19 functional limitations in hospitalized patients and associated risk factors: A 3-month follow-up study.

BACKGROUND AND PURPOSE: Many patients experience post-COVID-19 functional limitations. This study aimed to monitor the functional improvement of patients over 3 months of follow-up and determine the risk factors. METHODS: This prospective cohort study evaluated 100 hospitalized patients who recovered from COVID-19 infection. The mean age was 53.2 ± 13.1 years. Fifty-nine had at least one comorbid condition. The mean lengths of the hospital and ICU stays were 7.8 ± 3.3 and 5.3 ± 2.5 days, respectively. The functional status of the patients was evaluated using functional independence measure (FIM) and post-COVID-19 functional status (PCFS) questionnaires at four time-points of discharge, 1 week, 1 month, and 3 months after discharge. RESULTS: Mean FIM score was 107.2 ± 17.4 at the time of discharge, 113.3 ± 14.9 at 1 week, 120.3 ± 10.2 at 1 month, and 124.3 ± 6.4 at 3 months after discharge (p < 0.001). The PCFS score was 2.71 ± 1.25 at discharge, 2.09 ± 1.3 at 1 week, 1.14 ± 1.1 at 1 month, and 0.64 ± 0.59 at 3 months after discharge (p < 0.001). Female sex, older age, and the lengths of hospital and ICU stays were negatively correlated with the functional status score. DISCUSSION: Post-COVID-19 functional limitations are observed in hospitalized patients and improve over 3 months after discharge. Female sex, older age, longer hospital, and ICU stays are risk factors that negatively impact functional status.

Inferior Hip Dislocation in a 60-Year-Old Man; a Case Report.

Inferior hip dislocation or luxatio erecta femoris is among the rarest hip dislocations, which has been described in limited studies. The patients usually present with their hip in flexion, abduction, and external rotation. Hip dislocation is an orthopedic emergency, and a reduction needs to be performed promptly to avoid devastating complications such as avascular necrosis. Here, we present a rare case of inferior hip dislocation in a 60-year-old man following a car-motorcycle collision. The patient presented to the emergency department with left hip flexion, abduction, external rotation, and inability to move his leg due to pain. Closed reduction under procedural sedation was attempted in the emergency department once, which was unsuccessful. The patient was then taken to the operating room for another attempt of closed reduction under general anesthesia. The patient was discharged after two days with pin traction and double crutches. After two weeks, the pin was removed, and full weight-bearing was permitted. After 12 weeks, the patient had mild pain with unusual activity and slight limping; however, imaging revealed no signs of any complications.

Prevalence of Septated First Dorsal Compartment Among Iranian Patients with De Quervain Tenosynovitis.

Background: A septum in the first extensor compartment and variation of abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons affect the development and treatment of the de Quervain disease. This study aimed to determine the prevalence of septum and the number of APL and EPB tendons in Iranian surgical de Quervain patients. Methods: In this case series, we evaluated 37 consecutive wrists from September 2019 to April 2020 that were evaluated and surgically explored by the same senior surgeon; and the number of tendons and the existence of septum were recorded. Results: Patients were mainly women (24 [67.6%]), and the mean age was 50.43 ± 16.42 years. Seven (18.9%) patients had one, 23 (62.2%) had two, and 7 (18.9%) patients had three APL tendons. All patients had EPB tendons, 34 (91.9%) had 1 EPB tendon, and 3 (8.1%) had 2 EPB tendons. A septum was observed in 23 (62.2%) patients. Conclusion: The most functional variation in Iranian patients consists of 2 APL tendons and 1 EPB tendon. Also, most affected wrists had a septum in the first extensor compartment.