Athanaselis ED, Koskiniotis A, Sourmenidi A, et al. Is there an Association between Trauma and Musculoskeletal Tumours? A Review of the Literature. Strategies Trauma Limb Reconstr 2024;19(3):149–155.

Purpose: Common surgical techniques for managing acute acromioclavicular (AC) injuries include reconstruction of the coracoclavicular (CC) ligaments using tendon grafts or high‐strength artificial looping materials, as well as fixation with a hook plate. This study presents a thorough analysis of the outcomes of anatomical reconstruction of both the CC and AC ligaments using a single‐strand semitendinosus tendon graft. Methods: All patients with acute AC joint dislocation who underwent anatomical reconstruction of the CC and AC ligaments between 2017 and 2022 were included in this retrospective analysis. Postoperative evaluation of clinical and functional outcomes was conducted using the Simple Shoulder Test, QuickDASH and Constant–Murley scores. Radiographic assessments were used to determine any loss of reduction. Results: The study included twelve male patients with a mean age of 37.8 years (range: 23–64). According to the Rockwood classification, three patients had Type III, three had Type IV, and six had Type V dislocations. All patients underwent anatomical reconstruction of the CC and AC ligaments. The most recent follow‐up, with a mean duration of 31.8 months (range: 12–64 months), demonstrated excellent postoperative functional outcomes, with scores of 87 (SD = 4.1) for the Simple Shoulder Test, 2.9 (SD = 4.5) for QuickDASH and 89.7 (SD = 3.1) for the Constant‐Murley score. Radiographic assessment showed a reduction in CC distance from a preoperative mean of 16.6–8.9 mm at final follow‐up. Partial loss of reduction was noted in two patients; however, neither exhibited functional impairment or activity limitations that required surgical revision. Minor complications included wound dehiscence (one patient) and persistent numbness at the incision site (two patients). Conclusions: Reconstruction of the CC and AC ligaments using an autologous semitendinosus tendon graft for acute AC joint dislocation results in excellent clinical outcomes and satisfactory radiographic findings. Level of Evidence: Level IV.

Although femoral shaft fractures are typically treated with intramedullary nailing, alternative fixation methods like plating are required in select cases, particularly when nailing may be contraindicated due to respiratory complications or other patient-specific factors. Currently, there are no established guidelines for the optimal surgical fixation method of femoral shaft fractures in polytrauma patients with respiratory dysfunction. We present the case of a young patient with a diaphyseal femur fracture who underwent multiple surgical interventions within three months due to recurrent injuries and complications, primarily resulting from non-adherence to postoperative guidelines. We describe this sequence as a "terrible triad injury", consisting of primary fixation of the femoral fracture, revision of the first osteosynthesis due to recurrent trauma and implant failure, and a subsequent patellar tendon rupture.

Background/Objectives: Open reduction and internal fixation with plates and screws is the treatment of choice for bicondylar tibial plateau fractures. The use of a surgical approach remains a topic of debate regarding the site and number of incisions that ensure best access for reduction with minimum additional soft tissue damage. This retrospective cohort study compared clinical, radiological, and functional outcomes of single- (anterior) versus dual-incision (anterolateral and medial) approaches that are widely used in the operative treatment of Schatzker V–VI tibial plateau fractures. Methods: Eighty-two patients treated between 2005 and 2020 were retrospectively analyzed. Fifty-two underwent a single-incision (SI) approach and 30 a dual-incision (DI) approach. Operative parameters, complications, reduction quality, Knee Society Score (KSS), Oxford Knee Score (OKS), and post-traumatic arthritis incidence were assessed. Results: Mean patient age was 50.6 years, with a mean follow-up of 8.5 years. Operative time was shorter in the SI group, though fluoroscopy time was longer. No significant difference was observed in reduction quality or wound complications. Post-traumatic arthritis occurred in 57.6% of SI and 53.3% of DI patients, with severe arthritis more frequent in SI (30% vs. 12.5%, p < 0.05). Seven patients required conversion to total knee arthroplasty (five SI, two DI). Functional recovery was similar: mean KSS 68.6% (SI) vs. 70.5% (DI) and OKS 36.1 vs. 40.8 (p > 0.05) at 5 years. Conclusions: Both single- and dual-incision approaches for complex tibial plateau fractures provide satisfactory long-term outcomes. While differences in complications and arthritis rates were minor, surgical choice should be guided by the fracture morphology, patient characteristics, and surgeon’s experience to balance reduction quality with soft tissue preservation.