Bowing fracture of the inferior angle of the scapula, a difficult diagnosis

A 4-year-old boy presented with swelling over the inferior tip of the scapula and an unclear history. Initial radiographic findings were concerning for an aggressive lesion. This case highlights how a multimodality imaging approach was used to relieve uncertainty by diagnosing a paediatric bowing type fracture of the scapular tip

The first description in the literature, of a complication during the extraction of a retrograde expandable intra-medullary nail in three patients

Ankle fractures in elderly people are low-energy fractures characterised by fragility. In the majority, they are unstable and challenging to manage.Retrograde expandable intra-medullary nails (Fixion®, Biomet Merck Limited) inserted through the calcaneum across the sub-talar and ankle joints into the tibia have been successfully used in the treatment of fragility fractures and non-unions of the distal tibia and ankle, where the use of an antegrade locked nail would not provide adequate fracture stability for union.Primary fracture management involves removing the nail at least 3–4 months after radiological check. In cases of treatment of non-unions a longer treatment period is often required before removal of nail is considered.We present three patients where breakage of the Fixion® nail during surgery caused problems in nail extraction. Keywords: Ankle fracture, Intramedullary nail, Fixion nail, Retrogade nail, Tibia fracture, Complicatio

Experimental study of tendon healing early phase: Is IGF-1 expression influenced by platelet rich plasma gel? [Étude expérimentale de la phase précoce decicatrisation tendineuse: un gel plasmatique enrichi en plaquettes influence-t-il l'expression de l'IGF1?]

Background: It is well established that growth factors play a critical role in the healing process of connective tissues. To our knowledge, there are no studies in literature concerning the influence of platelet rich plasma (PRP) on growth factors expression. Hypothesis: The aim of this study was to assess the effect of a single application of PRP gel in a patellar tendon defect on the spatial and temporal expression of Insulin-like Growth Factor 1 (IGF-1) during tendon healing. Materials and methods: Twenty-four animals were randomized to receive PRP (PRPFast, Bioteck) in a gel form (PRP group) and 24 to serve as untreated controls (Control group). A defect of 3 mm × 10 mm was surgically created on the tendon under general anaesthetic and in the PRP group, PRP gel was applied to fill the tendon defect whereas no treatment was applied in the control group. Six animals (12 limbs) from each treatment group were sacrificed after one, two, three and four weeks following treatment. Histological and immunohistochemical staining were performed.© 2010

Temporal and spatial expression of TGF-β1 in an Achilles tendon section model after application of platelet-rich plasma

Background: To investigate the effect of platelet-rich plasma (PRP) on TGF-β1 expression during tendon healing. Methods: We used 48 skeletally mature New Zealand White rabbits. 24 rabbits received the PRP, and 24 rabbits served as an untreated control group. Equal numbers of animals were sacrificed at 1st, 2nd, 3rd, and 4th week. The surgical procedure involved a transverse incision to transect the Achilles tendon. A volume of 1. ml of PRP was then injected into the tendon mass in the PRP group. Histological and immunohistochemical evaluations with an anti-TGF-β primary antibody were performed. Results: The pattern of expression of TGF-β1 in the PRP group was characterized by a significant upregulation during the first 2 weeks and subsequently significant downregulation in the 3rd and 4th week in comparison with the controls. Conclusions: Our results suggest that PRP may affect the tendon healing process by altering the expression of TGF-β1. © 2009 European Foot and Ankle Society