Symptomatic pseudoarthrosis secondary to a stress fracture of the acromion

Summary. Fractures of the acromion are uncommon clinical entities, and stress fractures are even more rare, with few cases reported. Due to their rarity, stress fractures are often misdiagnosed. Here, we report a case of an elderly patient with an acromion stress fracture, which was overlooked, resulting in nonunion followed by the displacement of the distal portion of the acromion. The purpose of this report was to discuss this rare fracture, highlighting the importance of an accurate evaluation of radiological imaging as well as clinical data

Profiling Insulin Like Factor 3 (INSL3) Signaling in Human Osteoblasts

Abstract BACKGROUND: Young men with mutations in the gene for the INSL3 receptor (Relaxin family peptide 2, RXFP2) are at risk of reduced bone mass and osteoporosis. Consistent with the human phenotype, bone analyses of Rxfp2(-/-) mice showed decreased bone volume, alterations of the trabecular bone, reduced mineralizing surface, bone formation, and osteoclast surface. The aim of this study was to elucidate the INSL3/RXFP2 signaling pathways and targets in human osteoblasts. METHODOLOGY/PRINCIPAL FINDINGS: Alkaline phosphatase (ALP) production, protein phosphorylation, intracellular calcium, gene expression, and mineralization studies have been performed. INSL3 induced a significant increase in ALP production, and Western blot and ELISA analyses of multiple intracellular signaling pathway molecules and their phosphorylation status revealed that the MAPK was the major pathway influenced by INSL3, whereas it does not modify intracellular calcium concentration. Quantitative Real Time PCR and Western blotting showed that INSL3 regulates the expression of different osteoblast markers. Alizarin red-S staining confirmed that INSL3-stimulated osteoblasts are fully differentiated and able to mineralize the extracellular matrix. CONCLUSIONS/SIGNIFICANCE: Together with previous findings, this study demonstrates that the INSL3/RXFP2 system is involved in bone metabolism by acting on the MAPK cascade and stimulating transcription of important genes of osteoblast maturation/differentiation and osteoclastogenesis

The subcutaneous achilles tendon rupture comparison of three surgical techniques

The authors report their experience with subcutaneous Achilles tendon rupture: its frequency, the morbidity of the different surgical treatments and the related results at different periods of time from the end of treatment. The study population consists of 55 patients who were treated in the Orthopedic and Traumatologic Clinic of the University of Padova from 1994 to 2000. Twenty-four patients were treated with heavy suture of Silverski\uf6ld, modified by Vigliani; 22 with end-to-end \u2018placed\u2019 suture; and 9 with the modified percutaneous suture according to Ma and Griffith. All 55 patients have been seen with an average follow-up of 3 years and 6 months (range from 1 year to 5 years and 9 months) from surgery. The results have been satisfactory in all the patients with the same score, regardless of the surgical technique applied. Of the three main surgical techniques examined, the one with the least morbidity is the end-to-end \u2018placed\u2019 suture

A case of progressive scoliosis in a patient with craniocleidopelvic dysostosis

The authors describe a case of craniocleidopelvic dysostosis in a patient with progressive scoliosis. They attribute the pathogenesis of the vertebral deformity to imbalance of the shoulder girdle muscles and dysplasia of the vertebral metameres. They agree with the majority of authors in regarding craniocleidopelvic dysostosis as a specific clinical manifestation of a complex hereditary syndrome

Osteochondritis dissecans of the talus. A report on 7 cases

The clinical and radiological findings in 7 cases of osteochondritis dissecans of the talus indicate that this is a potentially progressive condition. Surgical treatment was carried out in 4 cases while the remaining 3 were treated conservatively. Surgery produced good clinical and radiological results. The conservative treatment consisted of immobilisation and abstention from weight-bearing. This was unsuccessful in 2 adult patients but in a 9 year old girl it led to a virtually complete recovery in 3 months

Spondylocostal dysplasia (Jarcho-Levin syndrome)

The authors report 3 cases of rare spondylocostal dysplasia (Jarcho-Levin syndrome) associated with multiple visceral anomalies (V.A.C.TE.R.L. syndrome). The difficulty encountered in treating the disease because of the complexity and multiplicity of the visceral anomalies, and the extent and type of associated vertebral deformities is emphasized. The cases described revealed a moderate amount of progression, and were able to be treated non-surgically. It is also emphasized that even when there is moderate scoliosis associated costal deformities may cause anti-cosmetic thoracic gibbosity