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Background: Posterior sternoclavicular joint (SCJ) dislocations are rare events that can evolve into real emergencies due to the vital structures in the mediastinum. When closed reduction maneuvers fail, open SCJ reconstruction becomes mandatory, with literature proposing several stabilization techniques that either preserve or remove the SCJ's mobility. This study is a narrative review of the most recent literature regarding posterior trauma to the SCJ along with a single institution's experience of this pathology, managed either conservatively or surgically, with a figure-of-eight autologous semitendinosus graft in case of closed reduction failure. Methods: This article provides an overview of posterior traumatic SCJ dislocation, and it describes five cases of patients managed for traumatic posterior SCJ dislocation treated either conservatively or surgically with a figure-of-eight semitendinosus tendon autograft reinforced with high-strength suture tape. A comparison with the most recent literature is performed, focusing on biomechanics. Results: The demographics, the mechanism of injury, the management algorithm and the surgical strategy align with the most recent literature. Despite the final treatment, at one year of follow-up, the ROM was restored with full strength throughout the range of motion of the shoulder with no neurological deficits. The reduced joint successfully healed in imaging, and patients returned to their daily lives. The surgical site wounds and donor harvest sites were perfectly healed. Conclusions: Although recent recommendations for treating posterior traumatic SCJ dislocation have advanced, no universally accepted method of stabilization exists, and the surgical strategy is generally entrusted to the surgeon's experience. The literature still increasingly supports figure-of-eight ligament reconstruction with a biological or synthetic graft. This work further implements the literature by reporting good outcomes at follow-up. [ABSTRACT FROM AUTHOR]

Spontaneous osteonecrosis of the knee (SONK) is a rare degenerative disease, the causes of which remain largely unknown. SONK develops gradually, leading to progressive pain with functional impairment, and is often misdiagnosed due to the complexity of the clinical examination, which is hampered by pain and swelling. Early diagnosis and treatment are essential to prevent joint damage and ensure good functional outcomes. We review the current literature on SONK and present a case of bilateral SONK in a 31-year-old woman who was treated with a homologous osteochondral implant. The patient of this case report had high functional demands and no comorbidities. A two-stage procedure was performed including diagnostic arthroscopy, removal of subchondral sclerosis, and allograft insertion using the compression-fit technique. At 36-month follow-up, the patient reported significant functional improvement and a reduction in pain, demonstrating the effectiveness of this therapeutic approach. [ABSTRACT FROM AUTHOR]

Fracture-dislocation of the humeral head with intrathoracic migration is extremely rare. In our study we describe the case of a 23-year-old man who was admitted to the emergency clinic of our hospital, after being injured in a high-speed motor vehicle accident. The patient presented in a state of hemorrhagic shock and severe respiratory disease. Chest radiography showed fracture of the right humeral head and the presence of a round radio-density area resting on the diaphragm right hemithorax. The total body computed tomography scan revealed a right pneumothorax related to the presence in the chest cavity of the fractured humeral head, longitudinal fracture of the sacrum, and diastasis of the symphysis pubis. After an initial hemodynamic stabilization the patient underwent surgical excision of the humeral head and its replanting. It is important after airway management and the use of diagnostic imaging, the treatment of any injuries associated with the trauma.

Bisphosphonates are widely used for the treatment of Complex Regional Pain Syndrome type 1 (CRPS-1). Despite their clinical potential, their indication for this disease remains a subject of debate. The purpose of this manuscript was to evaluate the efficacy and benefits of making use of neridronic acid in CRPS-1. Sixteen patients with CRPS-1 were evaluated before and after treatment with intravenous infusion of neridronic acid. All patients underwent the same treatment schedule and for all of them the VAS pain scale was used, integrated with functional assessment before and after treatment. The diagnosis of CRPS-1 was made using the Budapest Criteria. The onset of symptoms varied from 1 to 90 days, with an average of 50 days. All patients fulfilled the Budapest Criteria with pain present in 100% of cases, edema in 87.50%, hyperthermia in 62.50%, hyperhidrosis in 37.50%, skin redness in 56.25%, hypothermia in 12.50%, soft tissue retraction in 6.25% and joint mobility limitation in 87.50% of cases. The mean healing time was 40 days. Most of these patients (93.75%) had no sequelae. The use of neridronic acid has shown promising results in the treatment of CRPS-1. Results of the study suggested that its application, following a specific and standardized treatment schedule, could reduce pain and improve the quality of patients' life. Certainly, further studies on the real etiopathogenesis of this pathology will help to better establish indications in treatment and clinical practice. [ABSTRACT FROM AUTHOR]

Fractures of the posteromedial tibial plateau are infrequent, for this reason also their clinical description and their treatment is poorly represented in the literature. Only six cases in the literature describe the avulsion fracture of the posterior medial tibial plateau at the insertion of the semimembranous muscle. The mechanism of injury, described in the various articles, however, does not appear univocal, as well as the type of treatment. The analysis of the literature revealed the need for adequate imaging and stable surgical synthesis, in order to obtain an optimal functional recovery. [ABSTRACT FROM AUTHOR]

Literature presents several examples of surgical techniques for the treatment of carpometacarpal osteoarthritis. In our study we used a modified Ceruso's suspended arthroplasty technique. In this study, 53 patients from 2011 to 2017 underwent arthroplasty with trapezius excision and suture suspension between abductor pollicis longus and flexor carpi radialis. The average age at surgery was 69, the participants were 43 women and 10 men. The average total operation time was 59 minutes. The modified CMC suspension arthroplasty technique provides excellent results compared with those in the literature. [ABSTRACT FROM AUTHOR]

The aim of this study was to report the clinical and radiographic outcomes of 21 patients with severe thoracic kyphosis who underwent surgical correction by pedicle subtraction osteotomy. A retrospective multicentric study was conducted among a sample of patients who underwent single-stage correction via a posterior surgical approach. Pedicle subtraction osteotomy (PSO) was performed in all patients who presented a kyphotic deformity exceeding 70°. The cohort included 5 males and 16 females, with an average age of 62.7 years at the time of surgery. The minimum follow-up was 36 months, and the mean follow-up was 39.3 months. Following surgery, kyphosis across the treated segments was reduced by an average of 26.5°. Both back pain and neurological function improved after surgical treatment. There was a 68.2% improvement in VAS scores. Severe thoracic kyphosis can be improved through corrective surgery, and deformity correction can be accompanied by improvement in clinical symptoms. [ABSTRACT FROM AUTHOR]