Background: Posterior sternoclavicular joint (SCJ) dislocations are rare events that can evolve into real emergencies due to the vital structures in the mediastinum. When closed reduction maneuvers fail, open SCJ reconstruction becomes mandatory, with literature proposing several stabilization techniques that either preserve or remove the SCJ’s mobility. This study is a narrative review of the most recent literature regarding posterior trauma to the SCJ along with a single institution’s experience of this pathology, managed either conservatively or surgically, with a figure-of-eight autologous semitendinosus graft in case of closed reduction failure. Methods: This article provides an overview of posterior traumatic SCJ dislocation, and it describes five cases of patients managed for traumatic posterior SCJ dislocation treated either conservatively or surgically with a figure-of-eight semitendinosus tendon autograft reinforced with high-strength suture tape. A comparison with the most recent literature is performed, focusing on biomechanics. Results: The demographics, the mechanism of injury, the management algorithm and the surgical strategy align with the most recent literature. Despite the final treatment, at one year of follow-up, the ROM was restored with full strength throughout the range of motion of the shoulder with no neurological deficits. The reduced joint successfully healed in imaging, and patients returned to their daily lives. The surgical site wounds and donor harvest sites were perfectly healed. Conclusions: Although recent recommendations for treating posterior traumatic SCJ dislocation have advanced, no universally accepted method of stabilization exists, and the surgical strategy is generally entrusted to the surgeon’s experience. The literature still increasingly supports figure-of-eight ligament reconstruction with a biological or synthetic graft. This work further implements the literature by reporting good outcomes at follow-up.

Hip surgery is normally the chosen therapy for proximal femur fractures. Surgery within 24-48 h after hip fracture is recommended, but surgery may not always be performed promptly. Consequently, skin-traction is applied to reduce complications. The purpose of this review is to assess both advantages and disadvantages of skin traction. A scoping review was conducted. The research question was: which are the effects of skin traction, its advantages and disadvantages in adult patients with proximal femur fractures hospitalised in orthopaedic wards? The search was done in the databases PubMed, CINAHL, Cochrane, Embase, DOAJ, ClinicalTrials.gov and OpenDissertation. 9 records were included, skin traction effects were summarised in 7 categories: pain, pressure sores, comfort and relaxation, thromboembolism, damage from adhesive, complications and quality of care. The possible advantage is pain reduction between 24 and 60 h, the possible disadvantage is skin damage. The routine use of skin traction does not appear recommended, but more consistent evidence is necessary to make clinic decisions. Future RCTs could focus on the effects of skin traction 24-60 h after hospitalisation and before surgery.

Background: Femoral neck fractures (FNFs) in elderly patients are a growing concern given increased life expectancy and functional demands. Hemiarthroplasty is the standard treatment, but optimal fixation, approach, and perioperative management remain debated. This study aims to describe implant characteristics, perioperative details, survival, and complications of hemiarthroplasty in patients aged ≥75 years. Methods: A descriptive retrospective analysis was performed using the Emilia Romagna arthroplasty registry (RIPO). All patients ≥ 75 years who underwent hemiarthroplasty for FNFs between 2000 and 2021 were included. Data on demographics, implant fixation, surgical approach, complications, and revisions were analyzed. Implant survival was assessed with Kaplan–Meier analysis. Results: A total of 43,657 procedures were identified; the mean age was 85.5 years, and 73.7% were female. Cemented stems were used in ~76% of cases. The lateral approach was most common (52.6%), followed by posterolateral (43.7%) and anterior (2.9%). Overall revision rate was 93% of cases. Ninety-day mortality reached 13.9%. Conclusions: In this large registry study, cemented stems and the lateral approach were predominant. Despite low revision rates, dislocation remained the main cause of failure. High perioperative mortality highlights the vulnerability of this population and the importance of multidisciplinary care. Future high-quality studies, as prospective studies, will be necessary to determine the optimal solutions in this frail elderly population.

Introduction: Rotator cuff injury represents a common shoulder dysfunction, that causes significant disability to the patient; in most complex cases this condition is treated with surgery and subsequent rehabilitation. Literature does not clarify which outcome domains should be investigated by the physiotherapist after rotator cuff repair. The goal of this review work was to verify which outcome domains are relevant for physiotherapists’ evaluation. Materials and Methods A systematic review conform to PRISMA statement, was planned; PICO framework guided research queries. RCTs about rehabilitation following cuff rotator repair, published from 2018 to 2023, were considered suitable, without differences in terms of surgical technique. PubMed, Google Scholar, Cochrane Database, EBSCO, PEDro and Scopus were systematically screened. Critical appraisal was carried out through Jadad and Pedro scores. A data extraction table was built with author/year, country, sample, intervention, outcome/tools by included studies. Results: The search yielded 14,323 records, of which 12 RCTs were finally included; they all had high methodological quality. Common physiotherapy evaluations regarded pain, joint mobility, strength, and functionality. Additional outcome domains were kinesiophobia, pain catastrophizing, quality of life, patient satisfaction. Conclusion: The review highlighted the need to integrate the classic assessment of shoulder through Costant-Murley Score/UCLA scale/Visual analogue scale, with that of kinesiophobia (Tampa scale), pain catastrophisation (Pain Catastrophizing Scale), patient satisfaction (0-10 scale) and quality of life (EQ-5D-5L).

Pain assessment is essential in nursing care. The Numerical Rating Scale (NRS) is widely used but may not fully capture pain's multidimensional nature. The Pain Assessment in Advanced Dementia (PAINAD) scale is reliable for assessing pain in cognitively impaired patients. This study aims to evaluate the validity of the Italian version of PAINAD (PAINAD-IT) for postoperative pain assessment in geriatric patients with femur fractures. This study employs the PAINAD-IT, which was translated and validated for the Italian context by Costardi et al. (2007). Face and content validity (I-CVI and S-CVI) for non-cognitively impaired patients were evaluated by experts. Pain assessments were conducted at rest (T0) and during movement (T1). Convergent validity was tested using Spearman correlation, discriminant validity with the Wilcoxon test, and inter-rater reliability with Cohen's kappa. Sensitivity and specificity were calculated. I-CVIs were ≥0.90 and S-CVI was 0.96. 75 patients were included. Cohen's kappa was 0.918 at T0 and 0.881 at T1. Both PAINAD and NRS detected a significant increase in pain from T0 to T1 (Wilcoxon p < 0.001). Sensitivity was 26 % and specificity was 99 % for PAINAD-IT scores ≥3. PAINAD showed strong reliability and correlation with NRS, effectively distinguishing between rest and pain stages, these results suggest that PAINAD-IT may be a useful tool for pain assessment in geriatric patients operated for femur fracture. PAINAD-IT scores ≥3 may suggest severe pain. Further multi-centre studies with larger sample sizes are needed to fully validate PAINAD-IT for postoperative pain assessment in geriatric patients with.