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Linburg-Comstock syndrome is an acquired symptomatic restrictive thumb index finger flexor tenosynovitis involving a hypertrophic tenosynovium between flexor pollicis longus and flexor digitorum profundus. Patients may report synkinetic movement of the thumb and index finger, pain and swelling. We present the case of a woman in her 80s who presented with painless Linburg-Comstock syndrome after a trapeziectomy 4 months earlier for trapeziometacarpal arthritis. A literature review of PubMed-indexed case reports found that Linburg-Comstock syndrome has never been described in a post-trapeziectomy patient. This unusual presentation that arose as a side effect of hand surgery remains unreported in the literature. We present this unique complication as the first such case in the world. This case report is a valuable addition to the existing knowledge on the complications of trapeziectomy surgery.

OBJECTIVE: This study aims to evaluate the instructional efficacy of a 3D Surgical Training System (3DSTS), which combines real surgical footage with high-definition 3D animations, against conventional surgical videos and textbooks in the context of orthopedic proximal humerus fracture surgeries.
METHODS: Before the experiment, 89 participants completed a pre-educational knowledge assessment. They were then randomized into 3 groups: the 3DSTS group (n = 30), the surgical video (SV) group (n = 29), and the textbook group (n = 30). After their respective teaching courses, all participants took a posteducational assessment and completed a perceived cognitive load test. The 3DSTS group also filled out a satisfaction survey. Once all assessments were finished, the SV and textbook groups were introduced to the 3DSTS course and subsequently completed a satisfaction survey. All statistical analyses were executed using IBM SPSS version 24 (IBM Corp., Armonk, NY). For data fitting normal distribution, we employed one-way analysis of variance (one-way ANOVA) and Tukey HSD tests, whereas, for non-normally distributed data, we used Kruskal-Wallis H tests and Dunn\'s tests. The significance level for all tests was set at p < 0.05.
METHODS: Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, P. R. China.
METHODS: About 89 doctors who undergoing standardized residents training.
RESULTS: The initial assessment scores among the three groups were comparable, showing no significant statistical difference. Post-education revealed a marked difference in the scores, with the 3DSTS group outperforming both the SV and textbook groups. Specifically, the 3DSTS group exhibited statistically greater improvement in areas such as procedural steps, and specialized surgical techniques compared to the SV and textbook groups. During the 3DSTS teaching process, participants reported the least perceived cognitive load and expressed strong satisfaction, highlighting that the instructional materials are well-prepared, and considering this teaching method superior and more innovative than previous courses they had encountered.
CONCLUSIONS: The 3D Surgical Training System, integrating real videos with 3D animations, significantly enhances orthopedic surgery education over conventional methods, providing improved comprehension, lower cognitive load, and standardized learning outcomes. Its efficacy and high participant satisfaction underscore its potential for broader adoption in surgical disciplines. This study is registered with ClinicalTrials. gov ID: ChiCTR2300074730.

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This brief report discusses the diagnosis, management and surgical intervention of a man in his 30s presenting with a rare traumatic sternal manubrium dislocation following a motorcycle crash, accompanied by multiple concomitant rib fractures. The severity and complexity of the patient\'s injuries necessitated an operative approach for his sternomanubrial dislocation, emphasising the importance of multidisciplinary coordination, accurate diagnosis and prompt surgical intervention. The report provides valuable insights into the successful application of open reduction and internal fixation with plating in a real-world setting, which resulted in positive patient outcomes, despite the rarity and severity of this type of trauma. It further underscores the need for additional research to advance best practices for managing traumatic sternal manubrium dislocations in the context of high-impact injuries.

A man in his early 70s with right Takakura stage IIIB varus ankle osteoarthritis underwent medial opening wedge supramalleolar osteotomy with inframalleolar correction as joint preserving procedure. We also performed anteroinferior tibiofibular ligament (AITFL) resection with fibular shortening valgisation osteotomy to enhance the talar tilt correction. Postoperative decrease in talar tilt with dramatic symptom improvement was achieved. Performing the AITFL resection with fibular shortening valgisation osteotomy plus concomitant supramalleolar osteotomy and inframalleolar correction for Takakura stage IIIB varus ankle osteoarthritis resulted in successful improvement in talar tilt by making room for the valgus deviation of the talus.

A female underwent arthroscopic anterior cruciate ligament reconstruction (ACLR) via an outside-in drilling technique. At 4 weeks after surgery, she presented with a pulsatile painful mass on the lateral femoral condyle. Imaging confirmed a superolateral genicular artery pseudoaneurysm. Thrombin injections were administered twice, resulting in reduced size and minimal pain. This case emphasises the rare occurrence of pseudoaneurysms post-ACLR and highlights the importance of early detection and intervention for vascular complications. Although debated, we suggest tourniquet deflation before closure to facilitate identification and management of vascular issues. This report contributes valuable insights into managing pseudoaneurysms following ACLR.

Fractures of the proximal humerus with medial column instability are challenging and present an unacceptable rate of complications and reoperations. Despite good results reported with the use of locking plates and augmentation techniques using bone graft or a second plate, varus subsidence and fixation failure have been frequently reported. We describe the case of a patient presenting with a complex, multifragmentary proximal humerus fractures successfully treated with open anatomic reduction and internal fixation using a locking plate augmented with lateral traction using three bone anchors in the humerus head. After 18 months, the patient reported fully recovering the mobility and functionality of the operated shoulder. The use of bone anchors pulling the humeral in three different directions like three vectors applied from medial to lateral, posterior to anterior and lateral to anterior help to reduce the most important deformities (varus and retroversion) by applying the tension band principle. This is an interesting approach to avoid primary and secondary reduction loss of the proximal fractures of the humerus with postero-medial cortical defect. The procedure is a good alternative to be used in patients with failure or insufficiency of the medial wall and marked varus.

We present a rare case of a male child in middle childhood who presented to the emergency department with neck pain, neck deformity, low-grade fever, breathing difficulty and swallowing difficulty. The patient had a significant history of weight loss and loss of appetite. On examination, neurological deficits were observed, including mildly increased tone in bilateral lower limbs, reduced power in both lower limbs, exaggerated knee and ankle jerks, and upgoing plantar reflexes. Radiographs and MRI revealed a kyphotic deformity with apex at the T1 vertebra, lytic lesions in seven contiguous vertebrae and a large prevertebral abscess extending from C2 to T5. The patient underwent a posterior-only surgical approach with decompression, abscess drainage and stabilisation, resulting in successful cord decompression and correction of the kyphotic deformity. At 18 months follow-up, the patient is doing well with improvement to normal neurology and full return of a child to normal activities.