Complications related to extensor tendons have begun to increase with the use of volar plates in the treatment of distal radius fractures. In this study, we aimed to compare four-plane radiography and ultrasonography in the evaluation of dorsal cortex screw penetration following volar plate fixation. We recruited 47 patients (33 males, 14 females, mean age 37.4 years; range 18–58 years). To evaluate dorsal screw penetration in all patients, we performed radiographs at 45° pronation, 45° supination and obtained dorsal tangential graphs at maximum palmar flexion, and a wrist lateral radiograph. Wrist ultrasonography was performed in all patients. Dorsal screw penetration was detected in 12 of the 47 patients undergoing VLP application. While there was > 2 mm screw penetration in seven patients, there was < 2 mm screw penetration in five patients. On four-plane radiographs, screw penetration > 2 mm was detected in seven patients and screw penetration < 2 mm was detected in two patients. On four-plane radiography, dorsal screw penetration was not detected in three out of five patients, who were shown to have < 2 mm screw penetration by ultrasonography. In addition to perioperative four-plane radiographs are also required to detect dorsal cortex penetration in patients undergoing VLP due to distal radius fracture. However, the detection of screw penetrations < 2 mm is more likely with ultrasonography compared to four-plane radiography. We recommend that dorsal cortex screw penetration should be evaluated with perioperative ultrasonography. Research Registry, researchregistry3344 , Registered 10 January 2017

The purpose of this study was to investigate whether heterotopic ossification (HO) in the coracoclavicular (CC) space after surgical treatment of acromioclavicular joint (ACJ) injury is a complication or a sign of good prognosis. Fifty-nine consecutive patients who underwent CC reconstruction with or without augmentation of the ACJ for acute ACJ injuries were analyzed. Postoperative American Shoulder and Elbow Surgeons (ASES) score, Constant score (CS), subjective shoulder value (SSV), and visual analog scale (VAS) results were evaluated. For radiological evaluation, HO was evaluated, and CC distances were measured. Fifty-one patients (11 women and 40 men; mean age, 36 years [range, 17-68 years]) were evaluated after a mean follow-up of 3 years (range, 2-8 years). The mean ASES score at the follow-up was 82.73 (range, 51.6-100), mean CS was 85 (range, 50-100), mean SSV was 80 (range, 40-100), and mean VAS was 1.9 (range, 0-5). It was observed that the clinical outcomes (ASES, CS, SSV, VAS) of patients who developed ossification in the CC space were better than those who did not although it was not statistically significant. No statistically significant differences were found in the clinical outcomes (ASES, CS, SSV, VAS) between patients who underwent CC reconstruction without augmentation of the ACJ and those who were combined (P > .05). HO in the CC space is a common finding following AC joint fixation injury. We suggest that HO is not a complication and might possibly have positive effects on clinical outcomes.

Degenerative meniscal injuries are a common occurrence in orthopedic practice. However, there is currently no consensus regarding the optimal treatment algorithm and the efficacy of different treatment modalities. Therefore, this study aimed to analyze the clinical reflections of arthroscopic partial meniscectomy (APM) and physical therapy (PT) methods, as well as the potential development of osteoarthritis (OA) following treatment. The study group comprised patients diagnosed with degenerative meniscal tears who were treated with either conservative or APM methods at a center between March 2021 and January 2022. The radiographs of these patients prior to the commencement of treatment were classified according to the Kelgren–Lawrence system, and clinical and pain scores were recorded. Following a 2-year period of treatment, the radiographs and scores at the conclusion of the third, 12th, and 24th months were analyzed. Among 213 patients followed up with a diagnosis of degenerative meniscal damage, at the 3-month follow-up, the APM group demonstrated significantly better pain relief and functional outcomes compared with the PT group, with notable improvements in WOMAC (between score difference: −15.96; 95% confidence interval [CI]: −17.08 to −14.83), Lysholm (23.43; 95% CI: 22.15–24.71), and VAS (−6.98; 95% CI: −7.25 to −6.71) scores (p < 0.001). However, by the 12th and 24th months, both groups showed comparable long-term improvements. Radiographic assessments over 2 years revealed no significant differences in OA progression. These findings suggest that APM provides superior short-term benefits, but both APM and PT are equally effective in the long-term management of degenerative meniscus tears. A comparison of the APM and PT groups revealed that patients under 50 years of age who underwent APM demonstrated superior outcomes in terms of pain and functional scores at the 3-month follow-up. At the 2-year mark, the efficacy of the treatment methods was established, yet no significant differences were observed in their capacity to prevent OA. The level of evidence is III.

Objective: To investigate whether immobilisation duration and rehabilitation initiation influence functional recovery, recurrence, and treatment failure in first-time anterior shoulder dislocation managed conservatively. Design: Retrospective multicentre cohort study. Setting: Orthopaedic departments of multiple hospitals, data were collected between 2015 and 2021. Participants: A total of two hundred and one patients with first-time anterior shoulder dislocation were managed non-surgically. Patients were divided into three groups: Group 1 (early mobilisation; n = 61) – one to two weeks of immobilisation with rehabilitation starting in week two; Group 2 (standard protocol; n = 76) – three to four weeks of immobilisation with rehabilitation starting in week four; and Group 3 (delayed rehabilitation; n = 64) – more than four weeks of immobilisation with rehabilitation starting in week six. Intervention: Non-surgical treatment with varying immobilisation durations followed by rehabilitation. Main Measures: Functional outcomes were the Rowe, Disabilities of the Arm, Shoulder and Hand, American Shoulder and Elbow Surgeons, and Western Ontario Shoulder Instability Scores. Clinical outcomes included shoulder range of motion, recurrence, return-to-activity time, and treatment failure. Results: Functional scores and range of motion did not differ significantly between groups. Recurrence occurred in 18.0% (Group 1), 23.7% (Group 2), and 23.4% (Group 3), with no statistically significant difference ( p = .135). However, treatment failure – defined as persistent instability or the need for surgical stabilisation – was significantly higher in Group 3 (23.4%) compared with Group 1 (16.4%) and Group 2 (18.4%) ( p = .022). Mean follow-up was 42.1 ± 10.2 months. Conclusions: Immobilisation duration and rehabilitation timing were not associated with statistically significant differences in functional recovery or recurrence. Prolonged immobilisation appeared to increase the risk of treatment failure. Early or standard protocols may therefore represent reasonable options, and prospective randomised studies are needed to define optimal management. Level of Evidence: Level Three.

The aim of this study was to compare the clinical, functional, and stability outcomes of arthroscopic Bankart repair performed using either a single or double soft anchor in patients with limited anterior Bankart lesions between the 1 and 5 o’clock positions. Our retrospective cohort included patients underwent arthroscopic Bankart repair for anterior shoulder instability between January 2018 and December 2023. Glenoid defects or other associated shoulder pathologies were excluded, and all patients had a minimum two years follow-up. The patients were divided into two groups: single soft anchor (n=36) and double soft anchor (n=26). Demographic data, recurrent subluxation/ dislocation, necessity of revision surgery, pain scala, functional outcomes, patient satisfaction rates, and return to sports rates were assessed at the second postoperative year. The mean age was 29.5 ± 7.7 years in the single soft anchor group and 28.0 ± 5.9 years in the double soft anchor group. Recurrent dislocation was observed in three patients in the single soft anchor group, whereas no recurrent dislocation occurred in the double soft anchor group, showing no statistically significant difference between the groups. Pain and functional outcomes were similar between groups at year two, and no statistically significant differences were observed regarding patient satisfaction or return to sports. In patients with limited anterior Bankart lesions, arthroscopic repair using a single soft anchor provides clinical, functional, and stability outcomes comparable to those achieved with double soft anchor fixation.