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BACKGROUND: Isolated involvement of the medial compartment of the knee in degenerative disease is encountered in about 25% of patients with gonarthrosis. We aim to show that in a well-selected group of such patients, medial unicompartmental knee arthroplasty (UKA) is a good option. OBJECTIVES: Review the functional outcomes of patients undergoing UKA and determine the long-term survivorship of the implants and complications of the procedure. DESIGN: Analytical retrospective chart review. SETTING: Academic tertiary care medical center and tertiary care private hospital in the western region of Saudi Arabia. PATIENTS AND METHODS: We selected patients who underwent medial UKAs by the same surgeon between December 1988 and December 2009. The life table approach and the Kaplan-Meier statistical method were used to estimate the survival rate (5–30 years) with revision as the endpoint. Functional outcome scores were determined according to the Knee Society Clinical Rating System. MAIN OUTCOME MEASURES: Change in performance scores for pain, walking, and range of movement. Survivorship of the implants with removal of the implant as the endpoint; post-operative complications. SAMPLE SIZE: 218 implants on 142 patients. RESULTS: The survival rate for UKA was 94.7% at 10 years (95% CI 0.906–0.970), 80.9% at 20 years (95%CI 0.724–0.871), and at 30 years it was 77.8% (95%CI 0.669–0.855) of the total knee arthropathies. The average grand total functional score increased from 61 (maximum 200) at 0 months to above 150 at ≥6 months. CONCLUSION: UKA is a good option for isolated medial compartment gonarthrosis with excellent functional outcome and good survivorship in selected patients. LIMITATION: Single center experience, retrospective. We lost 6.0% of patients during follow-up. CONFLICT OF INTEREST: None.

Objectives Acute compartment syndrome (ACS) can be caused by multiple causes that affect people of different ages. It is considered an orthopedic emergency condition that requires immediate diagnosis and surgical intervention to avoid devastating complications and irreversible damages. This systematic review aimed to present the etiology of trauma-related forearm ACS. Methods A systematic review was performed on four different databases: Embase, Medline, Cochrane Central Register of Controlled Trials (CENTRAL) and Cochrane Database of systematic review register databases via Ovid, with no restriction on dates (last date was June 30, 2021). It included all the studies containing data about the etiology of trauma-related forearm ACS. Results A total of 4893 articles were retrieved: 122 met the inclusion criteria, 39 were excluded, 25 were out of scope and 14 had insufficient details. Hence, this review constituted 83 articles and 684 patients. The etiology of ACS causing forearm ACS was classified into three groups: fracture-related, soft tissue injury-related and vascular injury-related. The fracture-related group was the most common group (65.4%), followed by soft tissue injury (30.7%), then vascular injuries (3.9%). Furthermore, supracondylar humerus fractures were the most common cause of fractures related to forearm ACS. Blunt traumas were the most common cause of soft tissue injuries-related forearm ACS, and brachial artery injuries were the most common cause of vascular-related forearm ACS. Conclusion Frequent assessment of patients with the most prevalent etiologies of forearm ACS is recommended for early detection of forearm ACS and to save limbs.

Background: Oteoid osteoma is a benign bone tumor that affects mainly children and adolescents. Most patients complain of pain as the main symptom, which is usually managed by analgesia. Less commonly, the lesion can lead to bone deformity or restricted mobility. Ultimate treatment of this disease is to remove the lesion surgically, or by the recently adopted, less invasive, per-cutaneous radiofrequency thermo-ablation. Objective of the study: To evaluate the outcome of patients diagnosed with osteoid osteoma treated with either surgical resection or per-cutaneous radiofrequency thermo-ablation (PRT). Methods: Our data were collected during the period from January 2000 to December 2016. A total number of 28 patients who underwent either surgical resection or PRT therapy were included. We evaluated the presence of residuals after treatment, symptomatic relief, recurrence rate, and length of stay at hospital following treatment. Results: Mean age of diagnosis in our patients was 14.7 years (±7.63), and 13 patients (46%) underwent surgical treatment, and 15 had PRT therapy (54%). The presence of post-therapy residuals, symptoms relief, and recurrence rate were not significantly different between the two treatment groups, while median length of stay post-op (surgical = 4 days, PRT = 1 day) was significantly different and favored PRT treatment group (p-value=< 0.001). Conclusion: PRT therapy was shown to be less invasive, safer, and significantly reduced the lengths of stay, which could be a determinant factor in fast recovery to patients and a cost-effective option.

Kawasaki disease is an acute febrile exanthematous disease that affects children younger than 5 years of age. It is regarded as the most common cause of childhood acquired heart disease, but ocular and neurological problems are among the other important clinical findings. We present a 3-year-old boy who developed bilateral ptosis on day 21, 5 days after intravenous immunoglobulin. The ptosis was due to bilateral paralysis of the levator palpebrae superioris muscles and resolved spontaneously on day 25. There were no cardiac sequelae.

Background: Surgical closure after removal of nonmelanoma skin cancer on the leg can be challenging. Objective: Reverdin pinch grafting is an old skin transplant approach to treat leg ulcers. We present our experience using Reverdin pinch graft to close leg surgical defects following excision of nonmelanoma skin cancers. Patients and Methods: This was a retrospective study of 35 patients with medium-large sized defects with a median ± standard deviation of 20 ± 2.7 mm. Pinch grafts harvested from the thigh were used to cover the surgical leg defects with a 6-year follow-up period. Results: The average healing time after pinch grafting was 4 weeks ± 1.12 weeks. Ten patients (28.6%) had a failure of one or two single pinch grafts. There was no hypertrophic or keloid scarring in any grafted patients. Wound infection occurred in two patients (5.7%) and postoperative hemorrhage in only one patient (2.8%). Basal cell carcinoma arose in one patient (2.8%). Conclusion: Reverdin pinch graft technique is an easy and effective closure option for medium-large surgical defects of the leg after nonmelanoma skin cancer excision.

Purpose To evaluate the flap-producing characteristics of the VisuMax femtosecond laser system and their relationship to visual and refractive outcomes after laser in situ keratomileusis (LASIK). Setting Dr. Sulaiman Al Habib Medical Center, Dubai Healthcare City, Dubai, United Arab Emirates. Design Case series. Methods A review of LASIK cases from December 2008 to December 2009 was performed. Parameters recorded included the achieved flap thickness measured with intraoperative ultrasonic pachymetry, laser energy, side-cut angle, visual outcomes including uncorrected (UDVA) and corrected (CDVA) distance visual acuities and manifest refraction, higher-order aberrations using Hartman-Shack wavefront analysis, and complications. Results The study comprised 98 patients (195 eyes). The femtosecond laser energy for flap preparation was 160 to 200 nJ. The mean achieved flap thickness was 91.35 μm ± 12.26 (SD) (attempted 80 μm), 98.5 ± 14.39 μm (attempted 90 μm), 109.94 ± 13.43 μm (attempted 100 μm), 112.7 ± 7.45 μm (attempted 110 μm), and 123.82 ± 9.64 μm (attempted 120 μm). Postoperatively, 87% of eyes were within ±0.25 diopter of the intended spherical equivalent, 75% had a UDVA of 20/16 (−0.1 logMAR) or better, and 42% gained 1 or more lines of visual acuity; no eye lost CDVA. No statistically significant relationships were found between energy, side-cut angle, achieved flap thickness, and refractive and visual outcomes. Complications were mild and did not affect final visual outcomes. Conclusion The femtosecond laser yielded precise flap dimensions with a narrow standard deviation and a high level of safety. Financial Disclosure Neither author has a financial or proprietary interest in any material or method mentioned.

Introduction– Risk factors for aseptic intracranial venous occlusive disease are varied but only few epidemiologic studies were performed to verify the relative importance of particular factors. Patients and methods– A 2-year hospital-based prospective study was conducted in two hospitals to identify the clinical characteristics and risk factors of patients with confirmed aseptic intracranial venous occlusive disease. Results– 21 patients were identified, representing 0.9% of the total neurological admissions. Men were more commonly affected than women; 81% of the patients presented in a clinical picture indistinguishable from idiopathic intracranial hypertension. Risk factors included Behcet's disease in 4, the puerperium in 3, thrombophelia in 3, familial Mediterranean fever in 2, malignancies in 1, lupus anticoagulant in 1, and the contraceptive pill in 1. Conclusion– Aseptic intracranial venous occlusive disease proved to be not rare in Arabs. It should be considered seriously in the differential diagnosis of idiopathic intracranial hypertension, particularly in males. Several risk factors were incriminated.

An unusual neurological syndrome in an Arab family with five affected siblings, is reported. Autosomal recessive inheritance is suggested by having multiple affected siblings born to phenotypically normal consanguineous parents. Similar to Davison's Pallido-pyramidal syndrome, they presented with the clinical signs and symptoms of severe parkinsonism as well as evidence of cortico-spinal tract disease. In addition, they had dementia and supranuclear upgaze paresis. MRI studies showed significant atrophy of the globus pallidus and the pyramids, as well as generalized brain atrophy in later stages. Therapy with levodopa resulted in significant improvement in the extrapyramidal dysfunction. We suggest that this probably represents a new syndrome which is closely related but not identical to the pallido-pyramidal syndrome.