Objectives Recent studies support the opinion that central sensitization (CS) plays an important role in the pathophysiology of many chronic pain conditions. CS refers to hyperexcitability of the central nervous system, which can result in pain hypersensitivity and other somatosensory symptoms. Recognition of CS‐related symptomology is crucial in chronic pain evaluation and rehabilitation. The Central Sensitization Inventory (CSI) was created to evaluate symptoms that have been found to be associated with CS. The aim of the current study was the cross‐cultural adaptation of the CSI into Greek (CSI‐Gr). Methods To evaluate discriminate validity, 200 patients with chronic pain and 50 healthy control subjects participated. The sample was divided into 4 diagnostic groups (fibromyalgia, single pain complaints, multiple pain complaints, and a control group) and into 5 CSI severity subgroups, from subclinical to extreme. Convergent validity was determined by evaluation of the relationship between the CSI‐Gr and the Pain Catastrophizing Scale (PCS). Additionally, 30 patients completed the CSI a second time for the purpose of a test/retest analysis. Results The results showed high internal consistency (Cronbach's alpha = 0.994) and test‐retest reliability (intraclass correlation coefficient = 0.993). The standard error of measurement was 2.1. The CSI‐Gr correlated moderately with the PCS (r = 0.68). Statistically significant differences were found among the 3 comparison groups, with patients who had fibromyalgia reporting the highest CSI severity and healthy control subjects reporting the lowest severity. Conclusions As determined in the present study, the CSI‐Gr was found to be a reliable and valid tool for recognition of CS‐related symptomology.

The superior capsular reconstruction (SCR) is an arthroscopic surgical technique recently introduced as an effective solution to restore the defect of superior articular capsule in massive rotator cuff tears that cannot be repaired anatomically. The SCR retains static stability and inhibits the proximal humeral migration, thereby optimizing the force couples about the shoulder. In this surgical technique paper, we present our technique of SCR using a double bundle construct of long head of biceps tendon, called the “box” technique. It is always combined with partial rotator cuff repair.

Purpose The optimal (SBJI) surgical treatment for acute acromioclavicular (AC) joint disruption remains controversial. What is being presented is the long-term functional outcomes of a double cross-looped coracoclavicular (CC) suture technique with the intention of restoring both anteroposterior and superior displacement of the clavicle. Methods Between 2007 and 2016, 81 patients underwent surgical reconstruction for acute acromioclavicular joint (AC) disruption in two orthopaedic centers. Two patients died for reasons unrelated to the treatment, and seven missed the inal follow-up appointment, leaving 72 patients (67 males; 5 females; age 37 ± 12.4; range 15-64 years) for clinical and radiological assessments. All cases were classiied according to the Rockwood classiication as type III (n = 34), IV (n = 14) or V (n = 24). The dislocation was repaired with double cross-looped CC ixation using four Ethibond sutures passing underneath the coracoid and through a 4.5 mm drill hole in the clavicle in opposing directions to control both anteroposterior and vertical displacement. Radiological investigation preoperatively and at the last follow-up included anteroposterior and/or Zanca views, axillary or Alexander views, and comparative stress radiography of both AC joints. Patients were evaluated clinically with the Constant-Murley score (CMS) and Acromio Clavicular Joint Instability Score (ACJIS). Loss of reduction, subluxation, CC ligament ossiication, post-traumatic arthritis, and peri-implant fractures were also recorded. Results Seventy-two patients were available for the last clinical and radiological evaluations. At a median follow-up period of 6.3 ± 2.1 years (range 3-12 years), the CMS and ACJIS were 92.1 ± 7.2 (range 60-100 points) and 90.4 ± 8.6 (range 45-100 points), respectively. Complications included 9 (12.5%) patients with slight loss of reduction, 2 (1.7%) with dislocation recurrence, 1 (1.3%) with supericial infection, 1 (1.3%) with a fracture of the lateral end of the clavicle, and 2 (1.7%) with persistent tenderness in the AC joint. The incidence of periarticular ossiication was 22.4% and did not afect the inal outcome. Conclusions This technique represents an efective and low-cost treatment for acute AC joint separations. Level of evidence IV.

Fragment-specific fixation of unstable distal radius fractures using the Trimed system appears to be effective. Anatomic reduction, earlier range of motion, and improved functional results can be achieved using low-profile implants.

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