Metatarsophalangeal joint dislocations are uncommon injuries. Herein, an irreducible dislocation of fifth metatarsophalangeal joint with fractures on the second, third, and fourth metatarsal head was reported. Joint reduction could not be achieved which necessitated open reduction. Six months after surgery the patient was walking and doing his daily activities without any complaints. He had returned to his pretrauma functional level.

Background and Objectives: Screw cut-out is the most common mechanical complication after intertrochanteric fracture fixation with proximal femoral nails (PFNs). While the traditional tip–apex distance (TAD) is widely used, the calcar-referenced TAD (CalTAD) may better represent inferomedial cortical support. This study aimed to identify radiographic predictors of cut-out in dual-screw PFN fixations and establish a clinically relevant threshold for inferior-screw-based CalTAD. Materials and Methods: A retrospective cohort of patients treated with a dual cephalic screw PFN between 2017 and 2024 was analyzed. The implant uses two equal-diameter screws. Radiographic parameters included TAD, inferior-screw CalTAD, reduction quality, lateral wall thickness (LWT), collodiaphyseal angle (CDA), and Cleveland zone positioning. Logistic regression analyses were used to identify independent predictors of mechanical failure. Results: Both TAD and CalTAD values were significantly higher in patients who experienced screw cut-out. ROC analysis identified an inferior-screw-referenced CalTAD cutoff with strong predictive accuracy (AUC = 0.84). Optimal screw positioning, particularly avoiding superior placement on AP radiographs, was associated with reduced cut-out risk, while anterior positioning on the lateral view demonstrated only a borderline effect. Reduction quality showed borderline significance in univariate testing but remained independently predictive in multivariate modeling, while LWT and CDA were not significantly different between groups. Conclusions: Ensuring the inferior lag screw is positioned close to the calcar and achieving a low CalTAD, together with proper Cleveland zone alignment, appear to be key technical goals for minimizing mechanical cut-out in dual-screw PFN fixations. These findings support the use of inferior-screw–referenced CalTAD as a reliable and reproducible parameter for surgical optimization.

Background/Objectives: This study aimed to compare the histopathological effects of subacromial corticosteroid (CS) and platelet-rich plasma (PRP) injections following in situ repair of bursal-sided partial supraspinatus tears in a rat model. Methods: Twenty-seven Wistar Albino rats were included in the study. Partial bursal-sided supraspinatus tears were surgically created and repaired in situ. Animals were randomly assigned to receive a subacromial injection of 0.6 mL of normal saline (control), methylprednisolone sodium succinate (CS; 4.8 mg/kg, 0.6 mL), or 0.3 mL of activated PRP per rat. After four weeks, the repair sites were harvested for histopathological evaluation of cellular morphology, apoptosis, collagen organization, and vascularity. Results: PRP preserved the normal spindle-shaped morphology of tendon cells at the osseotendinous junction, whereas CS induced a rounded cellular morphology (p < 0.05). CS significantly increased apoptosis scores (p < 0.05), while PRP showed apoptosis scores comparable to those of the control group (p > 0.05). Collagen organization was preserved in the PRP group but significantly disrupted following CS administration (p < 0.05). Vascularity was higher in the PRP group than in the CS group (p < 0.05); however, the vascularity findings should be interpreted cautiously. Conclusions: Following in situ repair of bursal-sided partial rotator cuff tears, PRP preserved tendon architecture and was associated with a more favorable histopathological profile than corticosteroids. In contrast, CS adversely affected histopathological characteristics by increasing apoptosis and disrupting cellular morphology and collagen organization. These findings suggest that PRP may represent a biologically favorable adjunct following in situ repair of partial-thickness rotator cuff tears; however, the present histopathological findings do not establish accelerated healing, functional superiority, or clinical benefit, and further clinical studies are needed to determine whether these histopathological differences translate into improved clinical outcomes.