In orthopedics, bone fixation imposes the use of implants in almost all cases. Over time, the materials used for the implant have evolved from inert materials to those that mimic the morphology of the bone. Therefore, bioabsorbable, biocompatible, and bioactive materials have emerged. Our study aimed to review the main types of implant materials used in orthopedics and present their advantages and drawbacks. We have searched for the pros and cons of the various types of material in the literature from over the last twenty years. The studied data show that consecrated metal alloys, still widely used, can be successfully replaced by new types of polymers. The data from the literature show that, by manipulating their composition, the polymeric compounds can simulate the structure of the different layers of human bone, while preserving its mechanical characteristics. In addition, manipulation of the polymer composition can provide the initiation of desired cellular responses. Among the implanting materials, polyurethane is distinguished as the most versatile polymeric material for use both as orthopedic implants and as material for biomechanical testing of various bone reduction and fixation techniques.

One of the most popular and effective orthopedic surgical interventions for treating a variety of hip diseases is total hip arthroplasty. Despite being a radical procedure that involves replacing bone and cartilaginous surfaces with biomaterials, it produces excellent outcomes that significantly increase the patient’s quality of life. Patient factors and surgical technique, as well as biomaterials, play a role in prosthetic survival, with aseptic loosening (one of the most common causes of total hip arthroplasty failure) being linked to the quality of biomaterials utilized. Over the years, various biomaterials have been developed to limit the amount of wear particles generated over time by friction between the prosthetic head (metal alloys or ceramic) and the insert fixed in the acetabular component (polyethylene or ceramic). An ideal biomaterial must be biocompatible, have a low coefficient of friction, be corrosion resistant, and have great mechanical power. Comprehensive knowledge regarding what causes hip arthroplasty failure, as well as improvements in biomaterial quality and surgical technique, will influence the survivability of the prosthetic implant. The purpose of this article was to assess the benefits and drawbacks of various biomaterial and friction couples used in total hip arthroplasties by reviewing the scientific literature published over the last 10 years.

Background: The use of bromelain for the removal of eschar in deep burns is considered to be effective because it does not affect the unaffected skin and leaves a clean dermis after use. The main objective of this study is to find out whether bromelain is a good alternative to surgical debridement. In order to achieve that, we aim to evaluate its indications, limitations, and safety measures. Methods: The current study was conducted on a group of 30 patients with deep burn lesions, aged 20 to 56 years, from which 15 underwent enzymatic debridement and 15 patients acted as a control group in which primary surgical debridement was used. The mixture of enzymes enriched in bromelain, meant to dissolve burn eschar, was provided by NexoBrid™. The inclusion criteria were in agreement with the manufacturer’s protocols, but the application protocol was slightly modified in order to implement a better intern protocol and to assess its efficiency. Results: Complete eschar debridement was obtained in 13 of the 15 cases, from which 10 patients went through spontaneous healing and 3 needed to be covered with a skin graft. In the other 2 cases, partial eschar debridement was associated with surgical debridement and coverage with split-thickness skin graft in the same operation. The results obtained in the two groups were assessed with the Vancouver Scar Scale. Conclusions: Even though early excision followed by coverage with split-thickness skin graft remains the gold standard for the treatment of deep burns, enzymatic debridement can provide a series of advantages when the inclusion and exclusion criteria are respected. Bromelain is an alternative to surgical debridement that provides speed, tissue selectivity, safety, and less blood loss.

Thrombophilia, also called hypercoagulability or prothrombotic condition, usually reflects a certain imbalance that occurs either in the coagulation cascade or in the anticoagulation/fibrinolytic system. A similar imbalance may be induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Thrombotic complications are associated with multiorgan failure and increased mortality. In this context, activation of coagulation and thrombocytopenia appeared as prognostic markers in COVID-19. Our work provides a structured and updated analysis of inherited thrombophilia and its involvement in COVID-19, emphasizing the importance of diagnosing and initiating thromboprophylaxis. Since the state of hypercoagulation is directly correlated with COVID-19, we consider that studies on the genetic profiles of proteins involved in thrombophilia in patients who have had COVID-19 and thrombotic events are of great importance, both in treating and in preventing deaths due to COVID-19.

(1) Background: Necrotizing fasciitis (NF) is a severe and aggressive pathology with a rapid progression and high mortality risk. Periocular NF is a rare condition associated with a lower mortality risk but significantly higher disabling sequelae. (2) Methods: We present the case of a 67-year-old homeless patient, a victim of assault, with multiple untreated comorbidities (diabetes mellitus, cardiac conditions, and schizophrenia) and a delayed diagnosis of periocular necrotizing fasciitis. The condition showed a cyclical evolution influenced by the existing comorbidities, and the patient underwent both surgical and medical treatment with a multidisciplinary team. Additionally, we report a systematic review of cases from the literature. (3) Results: The patient’s survival outcomes were favorable; however, the sequelae were disabling, not only concerning aesthetic aspects but also due to the loss of the affected eye globe. The systematic review revealed the rarity of such cases and the peculiarities of the presented case compared to those reported in the literature up to this point. (4) Conclusions: Understanding the signs, symptoms, and predisposing factors, as well as the potential rare localizations of NF, including the periocular region, can lead to the early diagnosis and treatment with good functional and aesthetic outcomes, minimizing significant disabilities.

Background: Lipomas are the most frequent benign soft tissue tumor that are rarely found in the hand and are exceptionally rare on the fingers. The aim of this study was to investigate lipomas of atypical locations, so that they can be taken into account when making a differential diagnosis of a tumor of the hand or fingers. Methods: We studied a group of 27 patients diagnosed with lipoma of the wrist, palm, and fingers. The diagnosis was made by clinical and imaging examinations. Surgical treatment was established based on symptoms of pain, paresthesias, functional impairment, or aesthetic concerns. Treatment outcomes were assessed clinically at 1.5 years post-intervention. Results: Sizes over 5 cm were recorded in five cases, with the largest lipoma being 8 by 5 by 3.5 cm in size and weighing 125 g, located in the palm. There was one case of spontaneous tendon rupture and one case of carpal tunnel syndrome. There was no recurrence recorded at 1.5-year follow-up. Conclusions: Lipomas in the palm and fingers are rare entities (with more men affected), and surgical treatment consists of complete removal of the tumor and providing definitive healing. Despite their rarity, clinicians should consider lipomas when making differential diagnoses of soft tissue tumors of the hand.