No abstract

A 20-year-old man sustained an open medial dislocation of the ankle without an associated fracture after a low-energy inversion injury. Prompt debridement and reduction with primary wound closure of the skin were performed without suture of the capsule. Immobilisation in a non-weight-bearing cast for 30 days followed by ankle bracing for two weeks and subsequent physiotherapy, produced full functional recovery by three months. At follow-up at one year there was a full range of pain-free movement, although the radiographs and MR scan showed early post-traumatic degenerative change at the medial aspect of the tibiotalar and the calcaneocuboid joints.

Morton's neuroma is a common injury of the forefoot that affects the third web space of the toes. The pain, localized to the forefoot and toes, may appear gradually but usually becomes significant and persistent. Often it occurs after walking and is relieved by removing the shoe and manipulating the forefoot. The management of this condition varies widely and includes conservative and surgical treatments. There is no general agreement on the optimal treatment for this pathology. The aim of this review was to collect and assess the scientific evidence reported in the literature supporting the different treatments in the management of Morton's neuroma, comparing the different outcomes of conservative and surgical treatments. A literature analysis was performed on the different managements in the search for the best scientific evidence on this topic.

Calcaneal fracture is the most common of the tarsal fractures and represents 1%-2% of all fractures. The fractures may be divided into extra-articular (not affecting the joint) and intra-articular (involving the talo-calcaneal and calcaneal cuboid joints) types. The management of heel fractures includes nonoperative and operative treatments, but no clear consensus has been reached. The choice of operative treatment is still controversial with many factors influencing the final clinical outcome. Many studies have assessed the outcome of treatment of calcaneal fractures, but there is a general disagreement on their management. The objective of this study was to collect and evaluate the scientific evidence reported in the literature supporting the different treatments for calcaneal fractures.

Acute anterior dislocation of the shoulder is a common injury associated with a high rate of recurrence in young active men. Management of traumatic anterior shoulder dislocation aims to restore range of motion, to reduce the risk of recurrence and to assure an improved quality of life with a stable and painless shoulder. It includes conservative and surgical-open or arthroscopic treatment, followed by rehabilitation. No clear consensus has been reached on the best management, surgical or conservative, to adopt in first-time anterior shoulder dislocation. The aim of this review was to collect and evaluate the scientific evidence supporting the effectiveness of immediate surgical treatment versus immobilization and rehabilitation for first-time traumatic anterior shoulder dislocation. There is some evidence to support primary surgery in young active patients with an acute first traumatic shoulder dislocation, in order to reduce the risk of recurrence, but there is no evidence for the best surgical technique or best conservative approach, nor is there information regarding the best treatment in other categories of patients.