IntroductionIn patients who have undergone a total joint replacement, any mass occurring in or adjacent to the joint needs thorough investigation and a wear debris-induced cyst should be suspected.Case presentationAn 81-year-old man presented with a painful and enlarging mass at the popliteal fossa and calf of his right knee. He had had a total right knee replacement seven years previously. Plain radiographs showed narrowing of the medial compartment. Magnetic resonance imaging showed a cystic lesion at the postero-medial aspect of the knee joint mimicking popliteal cyst or soft tissue sarcoma. Fine needle aspiration was non-diagnostic. A core-needle biopsy showed metallosis. Intraoperative findings revealed massive metallosis related to extensive polyethylene wear, delamination and deformation. Revision knee and patella arthroplasty was carried out after a thorough debridement of the knee joint.ConclusionLong-term follow-up is critical for patients with total joint replacement for early detection of occult polyethylene wear and prosthesis loosening. In these cases, revision arthroplasty may provide a satisfactory knee function.

We retrospectively studied nine children and adolescents with congenital malformations, large reconstruction after tumor excision, fractures and osteotomies of the upper extremity, and hand trauma with bone and soft tissue defects treated by internal synthesis using a biocopolymer of L-and DL-stereoisomers of lactic acid polymers and trimethylenecarbonate. A total of 52 biodegradable implants were placed in bone. At a minimum followup of 7 months (mean, 17 months; range, 7-22 months), wound healing was uncomplicated; local or systemic inflammatory tissue reactions, foreign body reactions, and infections were not observed. Bone healing was complete. Six biodegradable screws broke during insertion because of inadequate drilling and tapping, and three biodegradable screws had to be replaced because of damage to the screw head during assembly with the screwdriver. Biodegradable copolymers of poly-L-lacticpoly-DL-lactic acid and trimethylenecarbonate can be used safely and effectively for reconstruction and fixation of bone in children and adolescents.

The aim of this research was to analyse the use of olive oil as a means of prevention and treatment of sports injuries in the ancient world. The method adopted was based on a thorough study of Greek and world literature. Writings of major ancient philosophers and physicians such as Hippocrates, Aristotle, Philostratus, and Lucian have been analysed in depth. According to the results, the use of massage, together with olive oil rub, helped to reduce muscle fatigue, to remove lactic acid, and to prevent the occurrence of sports injuries through flexibility provided to the skin of athletes. The therapeutic use of oil in the ancient world was fully recognized; and as a result Athenian athlothetes (sponsors of sporting events) provided free oil to all sport facilities where athletes could make free use of it [1].

The healing and regeneration capacity of the injured tissues in childhood, adolescence, and adult life differs significantly. As a result, the prognosis of compound injuries of the upper limb in different age groups varies; therefore, the decision making and management of these cases should be age-specific. This article presents a series of 32 patients aged 1.5-14 years, with compound injuries of the upper limb that have been treated in our hospital during the period of the last 6 years. Ten of the above cases involved major vascular lesions that required revascularization or replantation. The injuries were classified according to the SATT (Severity, Anatomy, Topography, Type) classification system. This study shows that the outcome of compound upper limb injuries is age-related, while the SATT classification system is a valuable tool in the decision making process. Further research should be undertaken to determine age group-specific indications for the management of compound upper limb injuries, based on the SATT classification system.

The described fascial flaps offer several advantages over other local flaps, and are rather easy to perform and cover effectively both dorsal and palmar hand defects without causing significant functional deficits to the upper limb.