Background: Pelvic insufficiency fractures (PIF) are typical in geriatric populations with reduced bone quality, most commonly in elderly postmenopausal women. These fractures are usually caused by low-energy forces over the bones during ordinary life and cause disabling pain. Treatment options range from conservative to operative. The aim of this study is to assess the outcomes of treatments for pelvic insufficiency fractures, determining optimal approaches between surgical intervention and conservative management. Methods: This literature review systematically examines articles focusing on patients with PIF, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and using PubMed, Medline, and the Cochrane Library database. We took into account only full-text articles in indexed journals with available English abstracts, considering data about patient demographics, surgery, and outcomes. Results: After screening 128 articles, this study reviewed 20 manuscripts involving 1499 patients, mostly elderly females and focusing on sacrum fractures. Common treatments included conservative methods and sacroplasty, with a few complications reported. Osteoporosis was the prevalent comorbidity, and the survival rate post-treatment was high at 92.3%. Mobility outcomes varied, with some patients experiencing significant autonomy loss. The average follow-up period was over 17 months. Conclusions: This study found a cautious approach to surgery (timing of three weeks), which is reserved only for specific patterns, and it leads to increased autonomy and a lower risk of mortality. Due to the lack of pre- and postoperative scores as well as conflicting results, it is imperative to undertake further studies and research to be able to compare the alternative treatments efficiently.

Aim To confirm the effectiveness of the ActiPatch device in treating and preventing pillar pain following open carpal tunnel release surgery.Methods Ten elderly patients with pillar pain after carpal tunnel release surgery were treated with ActiPatch for seven days. When these patients underwent surgery on the opposite hand, they were pre-emptively treated with ActiPatch to prevent pillar pain. Pain was measured using the Visual Analog Scale (VAS), functionality was assessed using the Quick Disability of the Arm, Shoulder and Hand (QuickDASH) and Michigan Hand Questionnaire (MHQ) scoring systems, and patient satisfaction was evaluated. Results All patients showed an improvement in pain level and functional capacity after using ActiPatch for pillar pain management. Additionally, none of the patients experienced pillar pain during the subsequent preventive phase. Conclusion The use of ActiPatch proves to be a viable and effective approach for managing and preventing pillar pain in elderly patients with weight-bearing hands who have undergone carpal tunnel release surgery.

Background: Thumb carpometacarpal (CMC) arthritis affects up to 25% of women and 8% of men over 70 years of age, significantly compromising their activities of daily living. With the rapid growth of the elderly population globally and their specific clinical needs, understanding optimal surgical treatment for this age group is crucial. This systematic review compares trapeziectomy with ligament reconstruction and tendon interposition (LRTI) versus dual-mobility prosthesis for treating thumb CMC arthritis in elderly patients over 70 years old. Methods: A systematic search was conducted across PubMed, Scopus, Web of Science, and the Cochrane Library for studies published up to August 2025. Studies that directly compared both techniques were included, with subgroup analyses performed for elderly patients over 70 years of age when data were available. Primary outcomes included pain relief, functional improvement, grip and pinch strength, complications, and patient satisfaction. Results: Five studies met the inclusion criteria for direct comparison of both techniques, encompassing 313 patients (324 thumbs). While none exclusively focused on patients over 70, elderly patients represented 25–41% of study populations. Due to the absence of age-stratified data in the original studies, our analysis encompasses all age groups with specific considerations for elderly patients where identifiable. Dual-mobility prostheses demonstrated faster pain relief and earlier functional improvement, particularly within the first 3–6 months postoperatively. Prostheses consistently provided superior grip and pinch strength outcomes throughout follow-up periods. Both procedures effectively preserved thumb function, but prostheses better maintained thumb length and metacarpophalangeal stability. While complication rates were comparable, LRTI complications were typically minor and self-limiting, whereas prosthesis complications, though rare, could potentially require revision surgery. Longer-term follow-up data (>3 years) remain limited, particularly regarding implant degradation and adverse local tissue reactions. Conclusions: Both procedures effectively treat thumb CMC arthritis in elderly patients, with distinct advantages. Dual-mobility prostheses offer faster recovery, enhanced strength, and better thumb length preservation, making them potentially advantageous for elderly patients prioritizing rapid functional recovery. Trapeziectomy with LRTI provides reliable long-term pain relief with fewer serious complications, making it suitable for patients with poor bone quality or significant comorbidities. Treatment selection should be individualized based on patient characteristics, functional demands, and surgeon expertise. Future research specifically focusing on elderly populations with longer follow-up periods (>5 years) is critically needed to provide stronger evidence for this growing demographic and to better understand long-term implant performance.

Background: Wrist arthritis significantly impacts the quality of life in elderly populations. While total wrist arthroplasty and wrist arthrodesis are established treatments, partial resurfacing procedures are emerging as a solution offering advantages for patients over 70 years of age. Objective: To systematically evaluate the efficacy, safety, and functional outcomes of radial versus carpal resurfacing procedures for the management of wrist arthritis in patients over 70 years of age. Methods: A comprehensive search of PubMed, Scopus, and Web of Science was conducted for studies published from these databases’ inception to May 2025. Studies reporting the outcomes of either radial or carpal resurfacing in patients ≥70 years of age with wrist arthritis were included. Primary outcomes were pain reduction, functional improvement, and complication rates. Results: Twenty studies met the inclusion criteria. Both carpal and radial resurfacing provided pain relief, with mean VAS scores ranging from 0 to 3.8 across studies and DASH scores ranging from 13 to 59 points, while carpal resurfacing showed better preservation of range of motion, with flexion/extension arcs of 27–65° compared to 22–46° for radial implants. Complication rates were comparable, though implant loosening was uncommon with both radial and carpal resurfacing. Both procedures demonstrated satisfactory patient-reported outcomes at midterm follow-up (median: 32 months; range: 6–84 months). Conclusion: In patients over 70 years of age with wrist arthritis, both radial and carpal resurfacing appear to be viable options with distinct advantages. Radial resurfacing may be preferred for patients with previous distal radius fractures, while carpal resurfacing offers better motion preservation and is indicated in SLAC and SNAC wrists. Patient selection should consider specific arthritis patterns, activity requirements, and comorbidities. Long-term studies are needed to evaluate durability beyond 5–10 years in this population.

Background: Cubital tunnel syndrome is the second most common compressive neuropathy of the upper limb, and it is characterized by ulnar nerve compression at the elbow. Traditional surgical options, including simple decompression and anterior transposition, have limitations in addressing ulnar nerve instability. This study introduces and evaluates the short-term outcomes of a novel surgical technique, the fascio-aponeurotic epicondylar flap (FAEF), for stabilizing the ulnar nerve and managing its instability. Materials and methods: A retrospective study was conducted on ten patients with longstanding cubital tunnel syndrome and confirmed ulnar nerve dislocation or instability. All patients underwent surgical intervention using the FAEF technique, which involves creating a quadrangular fascial flap from the epicondylar fascia to stabilize the ulnar nerve within the retrocondylar groove. Outcomes were assessed using clinical follow-ups, the Michigan Hand Outcomes Questionnaire (MHQ), VAS, and qDASH scores over a 90-day postoperative period. Results: All ten patients experienced complete resolution of neurological symptoms, including paresthesia, pain, and nerve clicking, by the final follow-up. Postoperative recovery was uneventful, with no complications such as infections or hematomas. Grip strength and hand functionality were fully restored, with significant improvements in MHQ scores (mean: 94). Dynamic elbow mobilization initiated on the first postoperative day resulted in full recovery of elbow range of motion. No recurrence of ulnar nerve dislocation was observed. Discussion: The FAEF technique effectively stabilizes the ulnar nerve, alleviates symptoms, and restores function while minimizing risks associated with traditional procedures, such as nerve trauma and elbow instability. By preserving the anatomical integrity of the medial epicondyle and enhancing nerve mobility, this approach represents a less invasive alternative to anterior transposition and medial epicondylectomy. Conclusions: The FAEF technique is a viable and effective surgical option for managing ulnar nerve instability in cubital tunnel syndrome. It offers a less invasive solution with excellent short-term outcomes, making it a promising addition to the surgical armamentarium for this condition. Further studies are warranted to evaluate long-term efficacy and broader applicability.

Introduction: The scapholunate interosseus ligament (SLIL) is critical for wrist stability, with injuries causing carpal instability and potential scapholunate advanced collapse (SLAC). This technical note presents a novel ligament-sparing surgical technique for treating SLIL tears ranging from grade 2 to 4 of the Garcia-Elias classification. Materials and Methods: A retrospective study was performed on ten patients treated with this novel technique. The technique involves a dorsal approach to the wrist through a 5–7 cm incision ulnar to Lister’s tubercle. After exposing the scapholunate joint, reduction is performed using Kirschner wires (K-wires) as joysticks, followed by stabilisation with three K-wires through the scapholunate, scapho-capitate, and radio-lunate joints. Two 2.3 mm suture anchors with double sutures are placed where the reduction K-wires were removed. One pair of sutures connects the anchors and any remaining SLIL tissue, while the second pair create a shoelace-like capsulodesis. Post-operative care includes staged K-wire removal at one and two months, with progressive rehabilitation before returning to weight-bearing activities at six months. Results: All patients improved in pain and function. The technique addresses SLIL injuries by restoring both coronal alignment through ligament repair and sagittal alignment via dorsal capsulodesis. The use of suture anchors and direct repair preserves the native tissue while reinforcing the dorsal capsule–scapholunate septum complex, avoiding the need for tendon grafts or extensive bone tunnelling. Conclusions: This ligament-sparing technique offers several advantages, including absence of donor site morbidity, minimal damage to carpal cartilage and vascularity, and preservation of surgical options should revision be necessary. The procedure effectively addresses both components of scapholunate instability while maintaining a relatively straightforward surgical approach.