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The article describes a new setup for single-surgeon paediatric supracondylar fracture pinning, which allows for reduction, easy access for pinning, and avoidance of intraoperative elbow maneuvers. The technique involves positioning the patient supine with the affected arm close to the edge of the operating table and using a padded horizontal bar support for the arm. Advantages of this setup include ease of access for reduction, good quality imaging, comfortable surgeon position for K-wire insertion, and minimal risk of fracture displacement. The authors found this setup effective in lowering operation times and avoiding complications, while also allowing for additional procedures if needed. [Extracted from the article]

Although tuberculosis (TB) is considered to be a common disease confined to undeveloped or developing countries, it may also appear in countries that accept great migrant influx from endemic areas. In terms of the skeletal system, it can be involved in 1-6% of tuberculosis patients while the knee joint is the third most frequently affected site after spine and hip. Given that systemic symptoms are present in only one-third of patients with skeletal tuberculosis and secondary septic arthritis, TB is often indolent and diagnosis can hence be missed or delayed. As a result, a high index of suspicion is imperative. Here, we aim to report a case of mono-arthritis caused by Mycobacterium tuberculosis in a native 77-year-old man who was suffering from low-grade knee pain for six months and despite multiple presentations to the Accident and Emergency department, diagnosis had not been established.

Introduction: Tension Band Wiring (TBW) has traditionally been the cornerstone of operative management for simple displaced olecranon fractures but its success is limited by high complication rates, mainly related to metalwork irritation and fixation failure. Over the last twelve years, a number of novel fixation methods not involving metalwork have been described in case series (suture fixation, SF and suture-anchor fixation, SAF) with promising early results. In this systematic review, the outcomes of SF and SAF techniques are presented alongside those for TBW for the treatment of closed olecranon fractures without elbow instability., Materials and Methods: Five databases (Medline, Scholar, Scopus, Prospero and Cochrane) were searched for clinical studies involving TBW/SF/SAF for closed Mayo 1A/1B/2A/2B olecranon fractures from January 2010 onwards. Primary outcomes included overall complication and reoperation rates, as well as the rate of each specific complication. Elbow range of movement, surgeon and patient-reported outcome measures were defined as secondary outcomes., Results: Eighteen studies were included, nine of which involved SF/SAF (99 patients) and nine TBW (382 patients). SF/SAF techniques were associated with lower rates of fracture/implant displacement (2% versus 9.7%, p  = 0.01), implant irritation (1% versus 30.1%, p  < 0.001) and overall complications (8% versus 46.1%, p  < 0.001) when compared to TBW. Reoperation rates were lower for SF/SAF (3% versus 37.2%, p  < 0.001). Total flexion/extension arc achieved was similar (130.16 ± 2.11 versus 129.45 ± 0.93 degrees). On average, patients regained a functional arc of flexion (135.21 ± 4.81 TBW versus 131.32 ± 12.99 SF/SAF) and extension (1.16 ± 7.54 SF/SAF versus 5.76 ± 7.98 TBW)., Conclusion: Current evidence suggests that SF/SAF of simple olecranon fractures is a safe and effective alternative to the current gold standard TBW fixation, with preliminary evidence suggestive of lower complication and reoperation rates. Firm conclusions of equivalence or superiority are not possible based on the current poor quality of literature available. Until the outcomes of high-quality prospective studies are available, patients should be carefully counselled that suture methods remain novel and outcomes should be regularly audited., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)