Summary. The diagnostic accuracy of clinical examination for internal derangement of the knee were evaluated by arthroscopy in 195 patients (200 knees). Radiographs were available and 50 patients had magnetic resonance imaging. The clinical diagnosis was correct in 104 knees (52%), incomplete in 70 (35%) and incorrect in 26 (13%). When there was a single abnormality the diagnosis was correct in 70%, but when more than 3 lesions were discovered the figure was 28%. All individual lesions were diagnosed correctly in more than 90%. The lesions most difficult to diagnose were chondral fractures, partial tears of the anterior cruciate ligament and loose bodies. Knees with acute lesions and those with a single diagnosis were significantly easier to diagnose (p 50.01). Age, sex, MRI and the surgeon were not significant.

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Wilson's disease is a rare genetic disorder that has abnormal copper metabolism. Although the disease's main problems are found in liver and brain, some studies revealed manifestation of various musculoskeletal problems in the patients. In this report, we encountered a young patient who had fracture in the forearm bone. Initially, exception to a previous history of fracture from a motorcycle accident, the patient did not have any medical or drug use history, and laboratory work-ups were insignificant. However, with suspicion on his bone's integrity, bone densitometry was recommended and revealed osteopenic change. To disclose a cause for the change, questions were made to recall any particular history or event, and his complaint of recent vision loss led to ophthalmologic consultation where under slit-lamp test found Kayser-Fleischer ring. Further laboratory work-up found low levels of serum copper and ceruloplasmin and high copper level in 24-hr urine sample that led to the diagnosis of Wilson's disease. Although Wilson's disease has been frequently noticed with considerable musculoskeletal manifestation, it rarity makes the diagnosis illusive to a physician. Hence, despite of its rarity, it is imperative to remember the disease's bony manifestation, and it should be suspected in young patients with demineralized bone when the reason for brittle bone cannot be answered with other better known conditions.

Purpose: Authors compare clinical and radiological results of internal fixation group and hemiarthroplasty group for comminuted proximal humerus fracture to find out which the treatment method have to be chose for comminuted proximal humerus fractures. Materials and Methods: Patients who were treated from March 2005 to March 2007 and available for 2 years follow-up were targets of this study. The internal fixation group had 38 cases, and hemiarthroplasty group included 26 cases. The results were analyzed both clinically and radiologically. Results: On average, Bone union took 15.6 weeks in the internal fixation group. Constant score between the internal fixation and hemiarthroplasty groups were on average 75±6.5 points and 70±7.4 points (p=0.034). In 3-part fracture, Constant score between both groups were 78±5.4 points from the former and 71±2 points, respectively (p=0.028). In 4-part fracture group, Constant score were 72±8 points for the internal fixation group and 69±9.2 points for the hemiarthroplasty group (p=0.041). Conclusion: Internal plate fixation can gain better outcome than hemiarthroplasty in 4-part fracture as well as 3-part fracture of proximal humerus by careful dissection for preservation of blood supply for humeral head and optimal reduction.