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Highlights • Marjolin’s ulcers are a rare form of malignancy that present at regions exposed to chronic inflammation. • They are classically encountered in lower extremities more commonly than in the upper extremities. • This disease should be suspected in every case of chronic ulcer, where histological studies of the lesion must be conducted. • Treatment options vary according to local and regional factors. • Early recognition and control of the disease allow for better control and relapse., Background Marjolin’s ulcers are a rare form of malignancy that present at regions exposed to chronic infection. They present with a clinical triad of nodularity, induration, and ulceration greater than 3 months. Case report We present herein, an extremely rare case of Marjolin’s ulcer of the forearm, secondary to osteomyelitis, resulting from a 30-year neglection of external fixator used to treat a war injury of the forearm. Discussion Marjolin’s ulcers are classically encountered in lower extremities at sites of burns, trauma or complicated wounds. In the upper extremity however, they are seldom mentioned in literature. The presence of risk factors raise the suspicion of the disease. Conclusion Marjolin’s ulcer is rare sequelae of chronic wound infection. Patients often present after a latency period with exacerbated pain, discharge, and exophytic mass. This disease should be suspected in every case of chronic ulcer, where histological studies of the lesion must be conducted to exclude or confirm the diagnosis.

The goal of this study was to validate a new method for determining femoral stem positioning based on 3D models derived from the EOS biplanar system. Independents observers measured stem anteversion and femoral offset using CT scan and EOS system of 28 femoral stems implanted in composite femurs. In parallel, the same parameters were measured on biplanar lower limb radiographs acquired from 30 patients who had undergone total hip arthroplasty. CT scanner and biplanar X-ray measurements on composite femurs were highly correlated: 0.94 for femoral offset (P < 0.01), 0.98 for stem anteversion (P < 0.01). The inter and intra-observer reproducibility when measuring composite bones was excellent with both imaging modalities as when measuring femoral stem positioning in patients with the biplanar X-ray system.

An irreparable tear of the subscapularis is a surgical challenge. Open approaches have been widely described to restore the anatomy and the function of the shoulder. Pectoralis major transfer is the most common technique used in this difficult clinical situation. Although this procedure has only been performed through an open approach, we describe a new arthroscopic technique for pectoralis major transfer. The critical part in this technique, in general, is the musculocutaneous nerve dissection, which is also possible through the arthroscopic approach. Together with an alternative method of harvesting using chips of bone and a minimal skin incision, this promising, less invasive technique presents all the advantages of the arthroscopic approach and provides a strong fixation to the lesser tuberosity.

Acquired cervical stenosis is caused by the combination of disc protrusion, facet joint degeneration, hypertrophy of the ligamentum flavum, and osteophyte formation. Although these mechanical factors seem to play an important role in the pathogenesis of myelopathy, the role of dynamic factors has been suggested by many authors. Based on these results, dynamic magnetic resonance imaging (MRI) was proposed to improve diagnostic techniques in patients with cervical myelopathy.The purpose of the study was to evaluate the importance of dynamic MRI in the assessment of cervical canal stenosis and to determine the percentage of levels in which cord impingement was only visible in the extension MRI and the percentage of cases in which hyperintense intramedullary lesions (HILs) were identified only on the flexion MRI.This is a retrospective case series study.Patients with spondylotic myelopathy who had dynamic cervical MRI at our department from October 2005 to February 2007 were included.Fifty-one consecutive patients with spondylotic myelopathy had MRI in the neutral, flexion, and extension positions of the cervical spine.The following entities were evaluated: canal stenosis (the evaluation of the stenosis was based on the Muhle classification) and the presence or absence of HILs.Two hundred fifty-five levels were evaluated in the three positions. At each level, the stages in extension were higher than the stages in neutral and flexion positions (p.05). From C3 to C6, around 22.5% of Stage 3 levels in the extension were Stage 1 in the neutral position. In flexion, HILs are better identified than in neutral and extension positions (p.05). In 10% of the patients, HILs were identified only in the flexion T2-weighted sequence.Extension MRI helps to identify significant cervical canal stenosis that is partially or completely absent on neutral and flexion MRI and to determine the exact number of levels to decompress surgically. Flexion MRI permits better visualization of HILs on T2-weighted sequences.