Radial neck fracture nonunion: A case report and novel fixation technique.

Non-union of radial neck fractures is a rare entity in adults, and conservative treatment is usually applied. However, when the patient is symptomatic, an optimal functional outcome can only be obtained after operative treatment. There is currently no consensus on the best surgical technique to treat this condition. We present a 34-year-old male with a radial head non-union and our proposed technique of using a cylindrical bone autograft harvested from the iliac crest and fixation with headless compression screws. At 12 months follow-up, the patient was pain free and had comparable range of motion to the uninjured side. We recommend a useful technique for the treatment of radial neck fracture nonunion. The preliminary postoperative outcomes show excellent results, while a longer follow-up and a greater number of cases are necessary to confirm the efficacy of this technique.

Arthroscopic Treatment of Luxatio Erecta Humeri Associated with Greater Tuberosity Fracture, Bankart Lesion, and Partial Rotator Cuff Tear: A Case Report.

BACKGROUND Luxatio erecta humeri (LEH) is a rare injury present in only 0.5% of shoulder dislocations. Much of the relevant literature is focused on the initial management and proper reduction techniques, although the prevalence of associated injuries can reach 80%. A case of LEH associated with greater tuberosity (GT) fracture and rotator cuff (RC) tear in a young laborer managed with closed reduction and arthroscopic repair of the labrum and rotator cuff is presented. CASE REPORT A 28-year-old man presented to our hospital with severe pain in his right shoulder after a high-impact motor vehicle accident. Standard anteroposterior radiographs revealed an inferior dislocation (LEH) of the right shoulder and a fracture of the GT. The patient was initially managed with closed reduction under mild intravenous sedation, using a 2-step maneuver followed by arthroscopic evaluation of the joint the next day. During arthroscopic evaluation, an anterior-inferior Bankart lesion, impaction of the humeral head with a minimal displaced GT fracture, and a partial RC tear were identified and successfully treated arthroscopically. The patient had immobilization in a simple sling for 6 weeks and he followed a standard 3-month physiotherapy protocol for rotator cuff, finally regaining almost normal range of shoulder motion at 1 year. CONCLUSIONS Although very good results of non-operative treatment of LEH have been reported in the literature, the co-existence of intra-articular lesions such as labral and rotator cuff tears makes arthroscopic repair an attractive alternative in individual cases.

Neurovascular Bundle Entrapment and Through Knee Amputation After Cerclage Cabling of Distal Femoral Peri-implant Fracture: A Case Report.

CASE: We report the case of an 82-year-old woman with diabetes, arteriosclerosis, chronic heart failure, and hypertension treated with an anatomical locking plate and multiple cables for a spiral-wedged periprosthetic fracture of the distal femur which was complicated by direct occlusion of the femoral artery and crush of the sciatic nerve, resulting in leg necrosis and, ultimately, through-knee disarticulation despite early recognition and arterial repair. CONCLUSIONS: Neurovascular injury is a potential complication of cerclage cables placement around the femoral shaft during complex fracture fixation. Devastating complications cannot always be corrected despite early vascular intervention.