暂无摘要。

BACKGROUND: Proximal interphalangeal joint (PIPj) fractures are a common yet challenging injury, particularly in athletes. This case study explores innovative surgical techniques combined with targeted rehabilitation to optimize recovery and functionality.
METHODS: A 20-year-old male soccer goalkeeper sustained a severe Proximal Interphalangeal Joint fracture-dislocation of the third finger during a game. He was treated using the wide awake local anesthesia no tourniquet (WALANT) technique and a Medartis TriLock plate, originally designed for the proximal phalanx but adapted for use on the middle phalanx.
UNASSIGNED: Immediate postoperative mobilization was facilitated by the WALANT technique, enhancing pain management and functional recovery. The adaptation of the TriLock plate, typically not used in this context, proved crucial for stabilizing the complex fracture. Follow-up included regular physiotherapy, focusing on mobility exercises and strength training, which were instrumental in the patient\'s quick return to sport.
CONCLUSIONS: This case underscores the effectiveness of combining innovative surgical adaptations with early rehabilitation in treating complex hand injuries. Such approaches can lead to successful outcomes, significantly improving recovery times and functional results in athletic populations. This strategy may set a precedent for future treatment protocols in sports-related hand injuries.

BACKGROUND: Open injury of the medial malleolus is relatively rare, and it can cause instability of the ankle joint and affect the walking function of the lower extremity. We describe an original plan for the reconstruction of medial malleolus defects using the bone sliding technique and report as follows.
METHODS: A 48-year-old female presented with an isolated open injury to her right ankle by a traffic accident. The skin of the medial ankle was severely contaminated with mud, and the medial malleolus, part of the Talus\'s cartilage and soft tissue, were defective. The anterior tibial artery was cut, and the anterior and posterior tibial tendons were ruptured.
CONCLUSIONS: We describe the reconstruction of the medial malleolus using a bone sliding technique. At two years follow-up, she had a good outcome with a nearly painless, stable ankle with functional plantarflexion but restricted dorsiflexion. The original method is a new choice for the reconstruction of the medial malleolus.

It was the aim of the study to determine retrospectively cranio-caudal stifle instability following TTA (tibial tuberosity advancement) using fluoroscopic kinematography. Ten stifles (eight dogs, mean body weight 27.3 kg) with complete rupture of the cranial cruciate ligament and a mean follow-up of 12.8 weeks (5.4 - 28.4 weeks) after TTA underwent latero-lateral, uniplanar fluoroscopic kinematography while walking on a treadmill. Immediately before TTA, each stifle was explored arthroscopically and in the case of a longitudinal or bucket-handle tear of the caudal horn of the medial meniscus the unstable axial portion was resected. The high-speed fluoroscopic video sequences obtained were inspected visually for femoro-tibial translation (cranial drawer). The influence of postoperative patellar tendong angle (PTA), cage size and meniscal surgery on stifle stability was analyzed using logistic regression analysis. In three stifles, resection of unstable meniscal tissue was necessary. Fluoroscopically, nine out of ten stifles showed cranio-caudal instability. Three stifles were potentially overcorrected (post PTA < 90°), seven potentially undercorrected (post PTA > 90°). None of the three parameters analyzed had a significant influence on postoperative in vivo stability (p=0.0988). In conclusion, it appears that inadequate cranialization of the tibia tuberosity might be an expected result of the TTA procedure, as well as persistent cranio-caudal instability during walking. However, instability cannot solely be attributed to insufficient cranialization because three out of nine unstable stifles were sufficiently or even overcorrected (PTA ≤ 90°). Further in vivo studies are needed to resolve these conflicting findings.