Although Iselin's disease, apophysitis of the fifth metatarsal base, is not infrequent in clinical practice, it is accepted as a rare cause of lateral foot pain in young adolescents. Usually a simple clinical examination and radiographs are sufficient for diagnosis. We present a patient with Iselin's disease and discuss its clinical and radiographic characteristics, differential diagnosis, aetiopathogenesis and treatment.

This study aims to evaluate the radiological and functional outcomes of locked compressive intramedullary nailing (IMN) cases in adult humerus shaft fractures. A total of 24 patients (12 males, 12 females; mean age 42 years; range 23 to 55 years) with humerus fractures were treated with locked compressive IMN at the Orthopedics and Traumatology Clinic, Antalya Training and Research Hospital between December 2009 and March 2015. Fluoroscopy was used only to check fracture reduction before the reaming procedure. Of the patients, closed IMN was performed in 21, while open reduction was performed in three. Lock screws were locked without fluoroscopy in all patients. Of the patients in whom open reduction was performed, radial nerve lesion developed in one. Anteroposterior and lateral graphs of all patients were taken postoperatively. Fracture union was assessed according to existence of the fracture line and the callus tissue in the anteroposterior and lateral graphs. The Constant-Murley scoring system was used for functional evaluation. The mean follow-up period was 24 months (range 12 to 72 months). Finite element analysis was performed for the stress distribution on fracture site. Radiological fracture union was achieved in all patients at mean 14.8 weeks (range 12 to 17 weeks). The Constant-Murley score was mean 90 (range 72 to 100). There was a statistically significant, negative and strong correlation between union period and the Constant-Murley score (r=-0.78, p<0.001). In one patient who developed postoperative radial nerve symptoms, all functions were regained in fourth month. No infection occurred in any patient. In two patients, tip of the nail remained high. Of these patients, one developed impingement findings, and the other patient had no problems. Treatment of humerus shaft fractures with locked compressive IMN provides sufficient fixation and early movement opportunity in the shoulder and elbow joints, and gives satisfactory radiological and functional results.

Although elbow injuries and fractures of the forearm are common in children, the combination of these injuries is rare. We present a case of a 5-year-old patient with a concomitant ipsilateral supracondylar humerus fracture and Monteggia lesion. After physical and radiographic examination of the injured extremity in the emergency department, closed reduction and percutaneous pinning were performed under image intensifier under general anaesthesia. A long-arm cast was applied for postoperative immobilisation. Excellent radiological and functional outcomes were obtained at the end of 1-year follow-up and no deformity was observed at 5-year follow-up.

Objectives: This study aims to investigate the effects of different amounts of compression used in intramedullary nailing on the stress values of the fracture surface and time of the union process in tibia diaphysis fractures treated with intramedullary nails. Patients and methods: Seventy patients (50 males, 20 females; mean age 34.0 +/- 10.7 years; range, 20 to 56 years) who had suffered from tibial shaft fractures between January 2007 and December 2015 were included in the study. Patients who had A2, A3, and B2 type fractures according to AO (Arbcitsgemeinschaft fur Osteosynthesefragen) classification and those with closed fractures were included. The patients were divided into three groups. No compression was applied to Group A, dynamic compressive fixation intramedullary nailing was applied to Groups B and C. Amount of applied compression was 1 mm for Group B and 1.5 mm for Group C. Postoperative and follow-up radiographs of patients were evaluated according to Rust criteria, and functional results were evaluated according to Johner-Wrush criteria. Additionally, finite element analyses were performed separately for 1 mm and 1.5 mm compressions that were applied in Group 13 and C, respectively. The data were analyzed using a statistical software package. Results: Clinical and radiological union was achieved in all patients. The average time of radiological union was 15.05-12.06 weeks in Group A, 12.48 +/- 1.42 weeks in Group B, and 11.64 +/- 1.63 weeks in Group C. The time of union for the group in which no compression was applied (Group A) was significantly longer than the other groups in which compression was applied (Group B and C) (p<0.001). Functional outcomes were 17 patients (85%) with excellent and three patients (15%) with goodmoderate results in Group A, 23 (92%) excellent and two (8%) goodmoderate in Group B, and 23 (92%) excellent and two patients (8%) with good-moderate results in Group C. In total, seven patients had knee pain. No infection was seen in any patient. Conclusion: Interlocking compression intramedullary nailing is a very effective treatment method for tibial shaft fractures. As the compression applied by the nail increases, the time of union shortens significantly.

Ipsilateral shoulder and elbow dislocation is very rare and only six articles are present in the literature mentioning this kind of a complex injury. With this presentation we aim to emphasise the importance of assessing the adjacent joints in patients with trauma in order not to miss any accompanying pathologies. We report a case of a 43-year-old female patient with ipsilateral right shoulder and elbow dislocation treated conservatively. The patient reported elbow pain when first admitted to emergency service but she was diagnosed with simultaneous ipsilateral shoulder and elbow injury and treated conservatively. As a more painful pathology may mask the additional ones, one should hasten to help before performing a complete evaluation. Any harm caused to the patient due to this reason would not be a complication but a malpractice.

Isolated bilateral absent patella is seen very rarely. It is generally encountered as a part of nail-patella syndrome. An 18-year-old male patient presented with left absent patella and right small patella.