No abstract

Additional plain radiography confers a significant advantage in the planning of treatment for urolithiasis once the diagnosis has been established by NCT because of information it provides regarding radio-opacity as well as stone size and visibility. This information cannot be delivered by NCT alone. We therefore recommend that KUB imaging is performed on all new stone patients referred for treatment.

Highlights Distal fibula resection is a procedure that has been described as early as 1938 for the treatment of neoplastic lesions. Medial instability of the elbow can be traced back to the literature as far as 1946. The described technique can preserve long-term tibiotalar congruity and stability, allowing these patients to return to near normal function.

Purpose Quality of reduction is of paramount importance after acetabular fracture and is best assessed on computed tomography (CT). A recently proposed measurement technique for assessment of step and gap displacement is reproducible but has not been validated. The purpose of this study is to validate a well-established measurement technique against known displacements and to determine if it can be used with low dose CT. Methods Posterior wall acetabular fractures were created in 8 cadaveric hips and fixed at known step and gap displacements. CT was performed at multiple radiation doses for each hip. Four surgeons measured step and gap displacement for each hip at all doses, and the measurements were compared to known values. Results There were no significant differences in measurements across surgeons, and all measurements were found to have positive agreement. Measurement error < 1.5 mm was present in 58% of gap measurements and 46% of step measurements. Only for step measurements at a dose of 120 kVp did we observe a statistically significant measurement error. There was a significant difference in step measurements made by those with greater and those with fewer years in practice. Conclusion Our study suggests this technique is valid and accurate across all doses. This is important as it may reduce the amount of radiation exposure for patients with acetabular fractures.

Acute knee dislocations are a relatively rare type of injury that can lead to serious neurovascular compromise and ligament instability. These injuries can be potentially limb threatening if not properly identified and managed. The following review discusses the relevant anatomy of the knee joint and different classification systems of dislocations in order to highlight the complications that could occur. Timely evaluation and management, including reduction, is paramount to ensure stability and determine the need for additional imaging or urgent consultation. Knee dislocations are also associated with the unique presentation of a multi-ligament injury. This text provides an overview of multi-ligament knee injuries and the various surgical modalities currently being used. Finally, considerations are given on the role of the osteopathic approach in restoring function of the knee in the context of a dislocation.