BACKGROUND Clostridium cadaveris is a motile, anaerobic, gram-positive, spore-forming bacillus usually found in soil. However, rare cases of opportunistic infections have been documented in immunosuppressed individuals. This report details the case of an immunocompetent young patient who developed septic arthritis of the knee after a traumatic injury involving a rusty nail. The aim of this paper is to provide a comprehensive literature review, shed light on the potential occurrence of Clostridium cadaveris septic arthritis, and explore its management. CASE REPORT A young patient with no medical history presented a traumatic inoculation leading to septic arthritis on a native knee by Clostridium cadaveris. The patient underwent 2 surgical debridements after an initial bad evolution under probabilistic antibiotic therapy. Bacteriological long-growing cultures and antibiotic testing were employed to guide antibiotic therapy selection. The patient had a favorable clinical outcome with no residual knee complications, with laboratory results showed good evolution. A review of the literature showed that Clostridium cadaveris septic arthritis in immunocompetent patients is very rare. The management and subsequent results emphasize the potential impact of the initial emergency room treatment on patient outcomes, especially concerning seemingly benign traumas. CONCLUSIONS This case report highlights the necessity of rapid diagnosis of the cause of septic arthritis, particularly in children, to prevent joint and tissue damage, and the rare diagnosis of knee arthritis with Clostridium cadaveris. This report expands understanding of osteoarticular infections and enhances the need for rapid diagnosis and early treatment, when managing cases with atypical presentations.

UNASSIGNED: Posterior cruciate ligament (PCL) tears in young children are rare and optimal treatment is poorly described. Diagnosis may prove challenging as young children may not be able to verbalize a complete history of injury, may be difficult to examine, and plane film radiographs often appear within normal limits. Surgical treatment carries a risk of physeal arrest, but non-operative treatment may lead to recurrent instability and pain.
UNASSIGNED: We present a case report of a fouryear- old child with a PCL avulsion off the femoral insertion who received an open reduction and internal fixation (ORIF) with combined arthroscopic synovial debridement. We performed a literature review which compared the mechanism, location, concomitant injuries, work up and management of PCL injuries in children under the age of ten compared to adolescents and adults.
UNASSIGNED: Nineteen months following surgery, physical examination revealed full knee range of motion and return to baseline function. Imaging studies confirmed there was no evidence of physeal arrest.
UNASSIGNED: ORIF with arthroscopy can be an effective method to treat PCL avulsions in children under the age of 10 years. This is similar to other case reports which reported positive outcomes with ORIF in this population. Large studies are needed to best understand optimal treatment modalities for PCL injuries in very young children. Level of Evidence: IV.

BACKGROUND: The Morel-Lavallee lesion (MLL) is a closed, degloving soft-tissue injury, wherein the skin and subcutaneous tissue are separated from the underlying fascia. This syndrome causes disruption of wound healing. Infrared thermography is a noninvasive and pain-free tool that can be used to evaluate scar and the influence of osteopathic manipulative treatment.
OBJECTIVE: To evaluate the influence of post-operative osteopathic manipulative treatment (OMT) of Morel-Lavallee lesions (MLL).
METHODS: During four osteopathic sessions on one volunteer patient, 28-year-old male, resulting in MLL of the left knee after motorcycle accident. The effects of OMT were assessed using an infrared thermal imaging camera and qualitative palpation examination of osteopathic dysfunction, scored on a scale of 1-4.
RESULTS: and discussion: Both scar and peri-scar area temperatures increased after OMT. The difference in temperature between the scar and the peri-scar area decreased after OMT. Increase in temperature was greater when the OMT was applied around the scar than when applied at a distance from the scar site. The palpation score for dysfunction of the MLL scar site decreased from 4/4 to 2/4 after the final session.
CONCLUSIONS: Several OMT sessions focusing on the MLL scar site appear necessary to obtain noteworthy results. OMT improved mobility and increased the temperature of the scar and the peri-scar area.

OBJECTIVE: To study the medial meniscus extrusion (MME) in subjects with and without medial meniscal tears on magnetic resonance imaging (MRI), supine ultrasound (US), and weight-bearing US.
METHODS: Forty-seven cases (mean age 43.7 years) with medial meniscus tears and 53 healthy controls (mean age 36.6 years) were assessed. Two experienced sonographers performed the US evaluations, and a fellowship-trained musculoskeletal radiologist assessed the menisci on MRI. Independent and paired T-tests and ICC were used for statistical analyses.
RESULTS: On supine US, the mean MME was 3.9 mm for the cases and 2.3 mm for the controls (p < 0.001). On weight-bearing US, the values were 4.2 and 2.8 mm (p < 0.001), and on MRI 3.0 and 2.0 mm (p < 0.001), respectively. The mean difference between supine and weight-bearing US extrusion was 0.38 mm for the cases and 0.49 mm for the controls (p = 0.291). Correlation between supine US and MRI MME measurements was good (ICC = 0.660, CIs [0.533-0.758]).
CONCLUSIONS: MME can be assessed using US with good correlation to MRI. US-observed extrusion was significantly increased in supine and standing positions for medial meniscus tears. The mean difference between examination positions was reduced with medial meniscus tears although this result was statistically insignificant.

METHODS: This report describes a new pattern of meniscal tear in an 18-year-old man after a knee sprain; he had undergone anterior cruciate ligament revision (ACL-R) 3 years earlier. He was diagnosed with an anterior cruciate ligament (ACL) graft rupture, a ramp lesion (Thaunat type 4), and a posterior root avulsion fracture of the medial meniscus (MM) (LaPrade type 5). He was treated successfully with an all-inside repair of the ramp lesion, a transtibial pull-out repair of the root tear, and ACL graft revision and anterolateral stabilization.
CONCLUSIONS: This specific meniscal injury pattern should be recognized and documented, potentially warranting consideration as a new addition to Thaunat and LaPrade classifications as type 6.

UNASSIGNED: Toe symphalangism is characterized by a fusion of the interphalangeal joint between the middle and distal phalanges. While typical lesser toe fractures heal well with conservative treatment, in our clinical experience, we encountered patients with symphalangeal toe fractures who experienced long-lasting pain and delayed radiographic union. Therefore, this study aimed to report radiographic outcomes following conservative treatment of symphalangeal fractures of the lesser toes.
UNASSIGNED: We retrospectively reviewed 14 patients with symphalangeal lesser toe fractures who were treated conservatively. We investigated the mechanism of injury and measured the time from the initial injury date to the complete radiographic union. The fracture gap distance was measured on an initial lateral radiograph.
UNASSIGNED: Symphalangeal fractures involved the fourth toe in 4 patients (28.5%) and the fifth toe in 10 patients (71.4%). Regarding the mechanism of injury, 6 patients (42.9%) were injured by stubbing or bumping into the door, 5 patients (35.7%) were injured by tripping, 2 patients (14.3%) were injured by heavy objects falling directly on their toes, and 1 patient (2.3%) complained of pain after wearing pointed shoes for half a day. The mean time to complete union was 9.1 months, and the median period was 5.5 months (range, 0.8-29 months). The initial gap of the fracture was 0.60 mm (range, 0.30-1.04 mm).
UNASSIGNED: The results of our case series may help counsel patients in the outpatient clinic that prolonged healing time may be required for the union of symphalangeal toe fractures.

Popliteal cysts are a collection of synovial fluid found in the popliteal fossa that typically form in adults in association with traumatic injuries, degenerative conditions, or inflammatory arthritis of the knee. While often asymptomatic, popliteal cysts may become problematic as enlarging and ruptured cysts may compress surrounding neurovascular structures, resulting in lower extremity edema or peripheral neuropathy. We report a unique case of a symptomatic popliteal cyst in a patient with both compressive neuropathy and venous congestion in the setting of a non-ruptured popliteal cyst after a surgically repaired intraarticular injury. Magnetic resonance imaging (MRI) showed a synovial cyst abutting the posterior neurovascular bundle and evidence of avascular necrosis. An open posterior cyst decompression was done, and the patient was able to report significant symptomatic improvement over the course of two weeks postoperatively. The previously noted varicose veins also demonstrated noticeable resolution. While relatively common, popliteal cysts may require prompt surgical decompression in order to provide effective symptomatic relief.

Anterior cruciate ligament (ACL) rupture is a very important epidemiological pathology in our environment. It has a peak incidence between 16 to 39 years of age. It is estimated that between 70-84% of ACL injuries are non-contact. The \"no return\" position describes the knee in valgus, femoral external rotation, tibial internal rotation and semiflexion, promoting injury to this ligament. Geometric measurements of the knee have been associated with an increased probability of non-contact ACL injury. The management of ACL tears is divided into two: conservative treatment and surgical management. Early OA (osteoarthritis) is the most common consequence of an ACL tear. We present the case of a 35-year-old patient with an inveterate ACL rupture of 10 years of evolution. With conservative management initially that progresses to knee instability and pain in the medial and lateral joint line as well as increased volume and functional limitation. After diagnostic studies, it was decided to perform diagnostic-therapeutic arthroscopy and continued close follow-up for associated pathology.
La ruptura de ligamento cruzado anterior (LCA) es una patología epidemiológicamente muy importante en nuestro medio. Tiene un pico de incidencia entre los 16 a 39 años de edad. Se calcula que entre 70-84% de las lesiones de LCA son sin contacto. La posición de \"no retorno\" describe a la rodilla en valgo, rotación externa femoral, rotación interna tibial y semiflexión, promoviendo la lesión de este ligamento. Las medidas geométricas de la rodilla se han asociado con un aumento en la probabilidad de lesión del LCA sin contacto. La ruptura crónica del LCA conlleva al desarrollo de artrosis en pacientes jóvenes. El manejo de la ruptura del LCA se divide en dos: tratamiento conservador y manejo quirúrgico. La osteoartrosis temprana es la consecuencia más común de la ruptura del LCA. Presentamos el caso de un paciente de 35 años con ruptura inveterada del LCA de 10 años de evolución. Con manejo conservador inicialmente que progresa a inestabilidad de rodilla y dolor en línea articular medial y lateral, así como aumento de volumen y limitación funcional. Tras estudios diagnósticos, se decide realizar artroscopía diagnóstica-terapéutica y se continúa con seguimiento estrecho por patología asociada.

暂无摘要。

METHODS: A 29-year-old man sustained a bilateral acute patellar tendon rupture (PTR) while jumping on a trampoline. He was initially treated with bilateral transosseous patellar tendon repairs. Bilateral rerupture occurred during a fall 10 weeks after. He subsequently underwent staged bilateral patellar tendon reconstructions using an Achilles tendon allograft. At 3-year follow-up, he has maintained full range of motion and leg strength without rerupture or other complications.
CONCLUSIONS: The use of Achilles tendon allograft in the presence of inadequate and poor-quality tendon tissue for reconstruction of the patellar tendon in the revision setting is a viable and effective treatment option.