Proper selection of distal fusion level is important in order to prevent DJK after SK surgery. According to this study, it is not necessary to extend the fusion down to the SSV. Fusion to FLV is sufficient and saves a level.

We report a rare case of a “giant Baker's cyst-related rheumatoid arthritis (RA)” with 95 × 26 mm dimensions originating from the semimembranosus tendon. The patient presented with chronic pain and a palpable mass behind his left calf located between the posteriosuperior aspect of the popliteal fossa and the distal third of the calf. In MRI cystic lesion which was located in soft tissue at the posterior of gastrocnemius, extensive synovial pannus inside and degeneration of medial meniscus posterior horn were observed. Arthroscopic joint debridement and partial excision of the cyst via biomechanical valve excision were performed. The patient continued his follow-up visits at Rheumatology Department and there was no recurrence of cyst-related symptoms in 1-year follow-up. Similar cases were reported in the literature previously. However, as far as we know, a giant Baker's cyst-related RA, which was treated as described, has not yet been presented.

Bicortical screw placement may provide a biomechanically superior construct than unicortical screw placement for resisting DVR maneuver during scoliosis correction. This technique may represent an effective and safe approach, particularly for the convex side of the scoliosis apex, with increased resistance to derotational forces and decreased risk of bone failure. Further clinical studies are warranted for firmer conclusions.

4.

IntroductionPosterior dislocation of the shoulder is a rare and commonly missed injury. Unilateral dislocations occur mostly due to trauma. Bilateral posterior shoulder dislocations are even more rare and result mainly from epileptic seizures. Electrical injury is a rare cause of posterior shoulder dislocation. Injury mechanism in electrical injury is similar to epileptic seizures, where the shoulder is forced to internal rotation, flexion and adduction.Presentation of caseThis report presents a case of bilateral posterior shoulder dislocation after electrical shock. We were able to find a few individual case reports describing this condition. The case was acute and humeral head impression defects were minor. Our treatment in this case consisted of closed reduction under general anesthesia and applying of orthoses which kept the shoulders in abduction and external rotation. A rehabilitation program was begun after 3 weeks of immobilization. After 6 months of injury the patient has returned to work. 20 months postoperatively, at final follow-up, he was painless and capable of performing all of his daily activities.DiscussionThe amount of bilateral shoulder dislocations after electrical injury is not reported but is known to be very rare. The aim of this case presentation is to report an example for this rare entity, highlight the difficulties in diagnosis and review the treatment options.ConclusionPhysical examination and radiographic evaluation are important for quick and accurate diagnosis.