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Background: Magnetic resonance image (MRI) was used with plain radiographic views for evaluation of bone and ligamentous injuries to detect any missing osteo-ligamentous injuries using single imaging modality. The purpose of this study was to ascertain the prevalence of associated ligamentous ankle injuries with an apparently isolated lateral malleolus fracture using MRI. Methods: This cross-sectional study was carried on 100 eligible patients with an acute isolated lateral malleolus closed fracture. Every patient underwent a history taking and clinical assessment (general and local assessment including inspection, palpation and neurovascular assessment of the affected lower limb) and full investigations. Imaging was done using Plain X-rays (anteroposterior, lateral, mortise and stress views) and MRI. Results: There was a significant relationship between the tenderness on medial side and Weber classification, Lauga Hansen classification and deltoid ligament injury (posterior tibiotalar ligament (PTTL), anterior tibiotalar ligament (ATTL) and tibiocalcaneal ligament (TCL)) (P value <0.001). There was an insignificant relation between radiographic anterior-posterior (AP) medial clear space (MCS) and (PTTL and ATTL), syndesmotic and Lateral collateral ligament injuries. There was a significant relationship between missed deltoid injuries with weber and Lauge. Hansen classification (P =0.005). Conclusions: MRI is valuable in the assessment of radiologically isolated lateral malleolus fracture cases. MCS in AP and stress views was insignificantly correlated to deltoid ligament injury, syndesmotic ligaments injury and lateral collateral ligaments injuries however, there was a strong link between syndesmotic ligaments injuries and both tibiofibular overlap (TFO) and tibiofibular clear space (TFCS) in AP and stress views.

Background: The fifth metatarsal base fracture is a quite frequent fracture, occurring at a rate of 6 per 100,000 yearly. Fractures of the metaphyseal-diaphyseal junction (Jones fractures) have a higher rate of non-union and occasionally do require surgery. This research aimed to assess the findings of surgical treatment of a recent fracture base of 5th metatarsal in adults’ zone II, III by percutaneous intramedullary cannulated cancellous screws (4 mm and 6.5mm). Methods: This prospective case series research was involved 21 adult patients with recent trauma and closed base of 5th metatarsal fractures. All participants were subjected to laboratory study, methods of radiological evaluation [Antero-posterior aspect of the foot, oblique aspect of the foot]. Results: AOFAS score was significantly different among age groups at 2 months and insignificantly different at 6 months. AOFAS score was insignificantly different between both sexes. Conclusions: Percutaneous intramedullary cannulated cancellous screws fixation of base 5th metatarsal fractures with a cannulated cancellous screw 4mm,6.5mm has a high union rate (100%) with early mobilization and return to work and daily activity without need to do below knee cast or slab, so it decreases post cast stiffness rate. It also increases rate of union and healing by doing compression of the fracture site using the cannulated cancellous screw and keeping hematoma without evacuation. Using of larger screws in diameter like 6.5 mm to be fit in the medulla, is more beneficial than 4 mm screws.

Introduction: The evaluation of the differences in radiological cervical sagittal parameters between symptomatic and asymptomatic individuals with radiologically- confirmed (CDDD) is fundamental for understanding the normal variation in sagittal plane parameter between individuals, to determine the age-related changes, to know the predictive sagittal parameters for unfavorable clinical symptoms and to determine the factors that participate in economic sagittal balance (compensation) in asymptomatic subjects. This will provide radiographic guidelines for the assessment and management of cervical spine patients. Objectives: This study aimed to evaluate the relation between the radiological cervical sagittal parameter changes with the presence and severity of symptoms as well as quality of life in CDDD individuals, and provided radiographic guidelines for the assessment and management of cervical spine patients. Methodology: The first 100 subjects who have visited the Outpatient clinic of Orthopedic Department in Tanta University Hospitals with radiologically-confirmed CDDD with or without clinical symptoms were reviewed. The individuals were divided into 2 groups for analysis and comparison. Group1 included the first 50 patients with symptomatic CDDD. Group2 included another 50 individuals with asymptomatic CDDD in their radiographs who visited the outpatient clinic as a relative to other patients or complained from other transient musclo-skeletal symptoms not affecting their quality of life. Results: In the Analysis of the relationships between the data of the 2 groups: There were no statistically significant differences between each of the age, sex, occupations, and BMI in comparison between the 2 groups. The T1S angle was the only significant parameter in correlation between 2 groups. In the Analysis of the relationships between the data in the symptomatic group: There was a statistically significant increase in each of the T1S, C2-C7 lordosis, C2-C7 SVA with increasing the age. T1S was significantly lower in farmers and manual workers than in housewives and office workers. There was a significantly inverse correlation between each of the CL, T1S, T1S-CL and VAS. There was a significantly positive correlation between each of the CL, T1S, T1S-CL and modified EQ-5D-3L score. In the Analysis of the relationships between the data in the asymptomatic group: There was a significant increase in each of the TIA, T1S and NT with increase age, with an insignificant increase CL and with a significant decrease in C2-C7 SVA. There were insignificantly inverse correlations with each of the CL, TIA and T1S. Conclusions: There is no difference in the C2–C7 lordosis curvature between the symptomatic patients and the asymptomatic individuals. The T1S is significantly lower in the symptomatic patients than in the asymptomatic individuals. So, Low T1S is a risk for the occurrence and development of cervical disc degeneration.

Background: Chronic plantar fasciitis is the most common cause of foot complaints making up to 11-15% of the foot symptoms requiring professional care among adults. Also, it is a common problem that affects sport participants as well as inactive middle-aged individuals. Many modalities of treatment were prescribed to relieve the symptoms such as rest, Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), bracing, physical therapy and corticosteroid injection. Newer treatment modalities have been tried, such as extracorporeal shock wave treatment, iontophoresis, and injection of botulism toxin. In case of lack of response to conservative treatment, the last resort is surgery with the primary objective of relieving pain. One novel treatment strategy is the use of local injection of platelet rich plasma. These platelets release a large proportion of biologically active growth factors that are thought to accelerate and improve the regeneration and healing process.