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Controversy still exists regarding how to reduce and fix a displaced tibial avulsion fracture. Open reduction and internal fixation may lead to morbidity due to soft-tissue injury and arthrotomy. As a result, arthroscopic techniques are increasing in popularity. In the literature, sutures, K wires, and screws are suggested to be used as the fixation devices. Screws cannot be used in small or comminuted fractures, whereas K wires and sutures may not provide strong stability. Recently, with the advent of ultrahigh molecular weight polyethylene sutures like FiberWire, it has become possible to use it as the fixation device in even comminuted avulsion fractures with acceptable reduction stability. In this paper, we describe a simple arthroscopic technique using a FiberWire to manage the displaced tibial eminence avulsion fracture., Technique Video Video 1 Our arthroscopic technique for reduction and fixation of ACL avulsion fractures. The patient is in a supine position and his leg is hung from the edge of the table with a leg holder. The visual anterolateral and working anteromedial portal is applied. A cannula is used at the anteromedial portal to facilitate suture passage through the working portal. Two FiberWire sutures are inserted into the joint and tied at each ACL borders (lateral/medial) separately. Two tibial tunnels are drilled from the anteromedial side of the tibia toward the tibial plateau (proximal tunnel endings are set at the medial and lateral sides of the fractured fragment). The endings of the 2 FiberWire sutures are passed through the drilled tunnels and tied on the bone bridge between the 2 tibial tunnels (on a suture disc). (ACL, anterior cruciate ligament.)

We aim to report a patient with vertebral brown tumor in the context of primary hyperparathyroidism presented with shoulder pain. This is the first report of C5 involvement by Brown tumor in a primary hyperparathyroid patient and emphasizes the consideration of cervical vertebral evaluation in patients with persistent shoulder pain.

As the spine is the third most common place for metastatic involvement, spinal examination is essential in patients with a known history of cancer, even in those with no related complains (ie. Backpain)., A missed spinal metastasis may lead to devastating complications (e.g. spinal cord compression).

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