Isolated volar distal radioulnar joint (DRUJ) dislocation is a rare condition with only a few cases reported in the literature. Its diagnosis is often overlooked in the acute phase, and there is no consensus in its management. We present the case of a 20-year-old male patient with an isolated volar radioulnar dislocation, together with a review of the literature. The aim is to present and summarize the acute management of this condition and propose a therapeutic algorithm.

Total hip arthroplasty (THA) is often regarded as one of the most successful surgical techniques developed in the twenty-first century. However, it is associated with complications such as prosthetic instability, dislocations, or infections. Dual-mobility (DM) implants have been developed with the goal of reducing the incidence of dislocations by increasing the femoral head-neck ratio, maximising hip stability, and improving the range of motion (ROM) before impingement and dislocation. This systematic review aims to comprehensively compare the safety and efficacy of DM versus fixed-bearing (FB) implants in primary THA patients. A comprehensive search strategy of PubMed, Embase, Scopus, and Web of Science Core Collection databases was executed to identify pertinent literature comparing DM and FB implants in THAs. Eligible studies underwent independent screening, and data were systematically extracted. The analysis employed pooled risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous variables, each accompanied by their respective 95% confidence intervals (CI). Our systematic review and meta-analysis included nine studies encompassing 22,277 patients. The DM group had a significantly reduced incidence of dislocations compared to the FB group (RR 0.25, 95%CI [0.13, 0.47]; p-value <0.0001) and a significantly shorter length of stay (MD -9.92, 95%CI [-15.53, -4.32]; p-value = 0.0005). The FB group, however, had a significantly shorter operative time compared to the DM group (MD 10.41, 95%CI [7.64, 13.17]; p-value < 0.00001). We did not identify any significant statistical differences between the DM and FB groups regarding patient-reported outcome measures, the incidence of all-cause readmissions, the incidence of peri-prosthetic fractures, the incidence of infections, or the incidence of groyne pain.

Medial swivel dislocation is a rare subtype of midtarsal bone dislocation, mostly associated with fracture rather than isolated dislocation. It is caused by medially or laterally direct forces to the midfoot. In case of failed closed reduction of the deformity, the patient should undergo open reduction and stabilization of the injury as soon as possible. We are presenting a 17-year-old, male, who sustained a left ankle injury and presented with a deformity, closed reduction of the deformity failed multiple times, and the patient was taken for open reduction and stabilization of the deformity in the operating theater. Intra-operatively, the dislocation was locked with the lateral process of the navicular being impacted into the taller head. Six months following the injury the patient was back to his pre-injury status and did not have any recurrent dislocation of the midfoot.

BACKGROUND: Osteoarthritis is a disabling pathology characterized by joint pain and stiffness. A prevalence of coxarthrosis of 7.4% is reported in our country. Total hip joint replacement is indicated in advanced stages, a procedure that is not free of complications, the most frequent being prosthetic dislocation, which can be prevented with dual mobility systems. The following study aims to determine the rate of complications and clinical outcomes in dual mobility systems in primary coxarthrosis.
METHODS: A retrospective study included 120 cases in 114 patients diagnosed with grade III coxarthrosis, mean age was 62.43 years, with a mean follow-up of 4.5 years. Joint replacement was performed by Hardinge approach. All cases were assessed clinically using the Harris Hip Score (HHS) and radiologically to demonstrate mid-term results.
RESULTS: The preoperative value on the HHS scale had a mean of 56.45, postoperative at one month 74.23; 6 months 85.40; 1 year 94.01 and at 5 years 94.84 points, representing a functional improvement of 17.78 postoperative month; 28.95 at 6 months postoperative; 37.56 at one year postoperative and 38.39 points at 5 years postoperative. A complication rate of 3.44%; 0.86% of complications were associated with the prosthetic components.
CONCLUSIONS: The dual mobility system should be considered as a therapeutic option in primary hip joint replacement due to excellent functional results and low complication rates. Evidence level IV. Retrospective observational case series study.

UNASSIGNED: Atlantoaxial subluxation (AAS) is a diagnosis describing misalignment of the C1 vertebra relative to C2. Excessive translation of this joint, located adjacent to the medullary brain stem, can lead to devastating neurological consequences. A higher prevalence of AAS within the Down syndrome (DS) population has been well-established. This study aims to establish a prevalence rate of DS in patients hospitalized for AAS and compare outcomes between AAS patients with and without DS.
UNASSIGNED: This study utilized the National Inpatient Sample (NIS) provided by the Healthcare Cost and Utilization Project (HCUP). In accordance with HCUP 2023 Clinical Classifications Software Refined files, data were queried using the International Classification of Diseases 10th Edition codes for DS and AAS. Demographics, comorbidities, hospital course, and outcomes were examined and compared using binary and linear multivariate regression. IBM SPSS software was used for data analysis.
UNASSIGNED: Of the 213,095 patients in the NIS database admitted between 2016 and 2020 with AAS as their primary diagnosis, 7.2% were DS patients. DS patients were significantly younger (26.56 ± 20.81 vs. 49.39 ± 27.63, P < 0.01), less likely to be female (33.30% vs. 52.10%), and had fewer comorbidities (diabetes mellitus, hypertension, and hyperlipidemia) than non-DS patients. There was no significant difference in likelihood to undergo surgical fusion between DS patients and non-DS patients with AAS.
UNASSIGNED: This large-scale study using NIS data determined that 7.2% of all patients admitted to hospitals for AAS are DS patients. The analysis of demographics, hospital course, and outcomes can influence the development of treatment protocols for AAS in the DS population.

UNASSIGNED: Irreducibility is a rare complication of pure posterior hip dislocation requiring surgical intervention.
UNASSIGNED: We present a case of a 22-year-old female with posterior hip dislocation following a motor vehicle accident. Despite unsuccessful closed reduction attempts, open surgical reduction successfully released the incarcerated muscles and achieved reduction. Follow-up examinations showed excellent functional outcomes without complications.
UNASSIGNED: Irreducibility remains a rare complication of traumatic posterior hip dislocation. Three possible entities can cause soft tissue incarceration: labral buttonholing, intra-articular osteochondral bodies, and entrapment of the piriformis muscle. The posterior-lateral approach provides excellent exposure of the posterior hip structures, but it carries the risk of injury to the medial circumflex artery. After successfully reducing the dislocation, it is essential to perform a computed tomography (CT) scan to detect any osteochondral lesions, including femoral head impaction. Functional outcomes are better with early mobilization and prompt resumption of weight-bearing. However, femoral head osteonecrosis complicates 52.9 % of hip dislocations reduced beyond 6 h, whereas it occurs in only 4.8 % of dislocations reduced within this timeframe.
UNASSIGNED: This case underscores the importance of prompt recognition and appropriate surgical intervention for irreducible hip dislocations to prevent further complications and optimize patient outcomes.

The differences in complication rates between the direct anterior and posterior approaches for hemiarthroplasty in elderly patients with femoral neck fractures are not yet fully understood. Dislocation, a severe complication associated with increased mortality and often requiring additional surgery, may occur less frequently with the direct anterior approach compared to the posterior approach. Careful consideration of patient demographics is essential when planning the surgical approach. Future research in this area should focus on robust randomized controlled trials involving elderly patients recovering from femoral neck fractures.

Total hip arthroplasty (THA) is one of the most successful elective operations in orthopedic surgery for improving pain and functional disability in patients with end-stage joint disease. However, dislocation continues to be a troublesome complication after THA, as it is a leading cause of revision and is associated with substantial social, health, and economic costs. It is a relatively rare, usually early occurrence that depends on both the patients\' characteristics and the surgical aspects. The most recent and important finding is the special attention to be given preoperatively to spinopelvic mobility, which is closely related to the incidence of dislocation. Consequently, clinical and radiographic assessment of the lumbar spine is mandatory to identify an altered pelvic tilt that could suggest a different positioning of the cup. Lumbar spinal fusion is currently considered a risk factor for dislocation and revision regardless of whether it is performed prior to or after THA. Surgical options for its treatment and prevention include the use of prostheses with large diameter of femoral head size, dual mobility constructs, constrained liners, and modular neck stems.

BACKGROUND: Management of patients with recurrent anterior glenohumeral instability in the setting of subcritical glenoid bone loss (GBL), defined in this study as 20% GBL or less, remains controversial. This study aimed to compare arthroscopic Bankart with remplissage (ABR+R) to open Latarjet for subcritical GBL in primary or revision procedures. We hypothesized that ABR+R would yield higher rates of recurrent instability and reoperation compared to Latarjet in both primary and revision settings.
METHODS: A retrospective study was conducted on patients undergoing either arthroscopic ABR+R or an open Latarjet procedure. Patients with connective tissue disorders, critical GBL (>20%), < 2 year follow-up, or insufficient data were excluded. Recurrent instability and revision were the primary outcomes of interest. Additional outcomes of interest included subjective shoulder value (SSV), strength and range of motion (ROM) RESULTS: 108 patients (70 ABR+R, 38 Latarjet) were included with an average follow-up of 4.3 ±2.1 years. In the primary and revision settings, similar rates of recurrent instability (Primary: p=0.60; Revision: p=0.28) and reoperation (Primary: p=0.06; Revision: p=1.00) were observed between Latarjet and ABR+R. Primary ABR+R exhibited better SSV, active ROM, and internal rotation strength compared to primary open Latarjet. However, no differences were observed in the revision setting.
CONCLUSIONS: Similar rates of recurrent instability and reoperation in addition to comparable outcomes with no differences in ROM were found for ABR+R and Latarjet in patients with subcritical GBL in both the primary and revision settings. ABR+R can be a safe and effective procedure in appropriately selected patients with less than 20% GBL for both primary and revision stabilization.

Femtosecond laser ablation of Cu0.70Zn0.30 targets in ethanol led to the formation of periodic surface nanostructures and crystalline CuZn alloy nanoparticles with defects, low-coordinated surface sites, and, controlled by the applied laser fluence, different sizes and elemental composition. The Cu/Zn ratio of the nanoparticles was determined by energy dispersive X-ray spectroscopy, X-ray photoelectron spectroscopy, and selected area electron diffraction. The CuZn nanoparticles were about 2-3 nm in size, and Cu-rich, varying between 70 and 95%. Increasing the laser fluence from 1.6 to 3.2 J cm-2 yielded larger particles, more stacking fault defects, and repeated nanotwinning, as evident from high-resolution transmission electron microscopy, aided by (inverse) fast Fourier transform analysis. This is due to the higher plasma temperature, leading to increased random collisions/diffusion of primary nanoparticles and their incomplete ordering due to immediate solidification typical of ultrashort pulses. The femtosecond laser-synthesized often nanotwinned CuZn nanoparticles were supported on highly oriented pyrolytic graphite and applied for ethylene hydrogenation, demonstrating their promising potential as model catalysts. Nanoparticles produced at 3.2 J cm-2 exhibited lower catalytic activity than those made at 2.7 J cm-2. Presumably, agglomeration/aggregation of especially 2-3 nm sized nanoparticles, as observed by postreaction analysis, resulted in a decrease in the surface area to volume ratio and thus in the number of low-coordinated active sites.