Background:A number of techniques have been described to reattach the torn distal biceps tendon to the bicipital tuberosity. We report a retrospective analysis of single incision technique using an endobutton fixation in sports persons.Materials and Methods:The present series include nine torn distal biceps tendons in eight patients, fixed anatomically to the radial tuberosity with an endobutton by using a single incision surgical technique; seven patients had suffered the injuries during contact sports. The passage of the endobutton was facilitated by using a blunt tipped pin in order to avoid injury to the posterior interosseous nerve. The patients were evaluated by Disabilities of the Arm, Shoulder and Hand (DASH) score and Mayo elbow score.Results:The average age of the patients was 27.35 years (range 21–42 years). Average follow-up was 41.5 months (range 24–102 months). The final average flexion extension arc was 0°–143°, while the average pronation and supination angles were 77° (range 70°–82°) and 81° (range 78°–85°), respectively at the last followup. All the patients had a Disabilities of the Arm, Shoulder and Hand (DASH) score of 0 and a Mayo elbow score of 100 each. All the seven active sports persons were able to get back to their respective game. There was no nerve injury or any other complication.Conclusions:The surgical procedure used by us is a simple, safe and reproducible technique giving minimal morbidity and better cosmetic results.

Recent reports on atypical femoral fracture have raised concerns about the long-term use of bisphosphonate. More recent case series focus specifically on the subtrochanteric fractures. But, there is relatively rarity and unawareness of atypical fracture in upper extremity. We report forearm fracture in two women receiving long-term bisphosphonate therapy. First woman presented with pain in the forearm and both thighs and radiographs showed incomplete fractures in a proximal ulnar shaft and bilateral femoral shaft. The other woman had a fracture in the radial shaft. This report suggests atypical fractures associated long-term use of bisphosphonate could occur in bones other than femur. More study is required to identify the magnitude of clinical features of this emerging concern.

Treatment of displaced radial neck fractures is challenging and controversial, as the risk of unsatisfactory outcome increases after operative as well non-operative treatment. Between 2004 and 2012, we treated 14 children with type IV fracture of radial neck with mean angulation of 72.8°, using the modified Metaizeau technique. The average follow-up was 39 months. Heterotrophic ossification and transient posterior interosseous nerve palsy were the only complication seen in two patients who had to undergo open reduction. We feel that the inability to achieve closed reduction can be attributed to loss of periosteal hinge. We obtained 100 % excellent clinical outcome and 79 % excellent radiological outcome at final follow-up. The modified closed intramedullary pin reduction technique proved to be minimal invasive technique for displaced radial neck fractures by allowing stable anatomic reconstruction while avoiding all the complications of classical Metaizeau technique.

Varus posteromedial rotatory instability refers to one of the complex elbow fracture-dislocation caused by anteromedial coronoid fracture with disruption of lateral collateral ligament (LCL). Recent clinical and biomechanical studies have demonstrated that this unstable complex injury resulted in incongruence of joint, which could lead to early posttraumatic arthritis. With reports of poor result after conservative treatment, surgical treatment including anteromedial fixation and LCL repair has been strongly recommended to achieve stable joint. This case series describes three patients with anteromedial coronoid fracture who were managed conservatively with excellent outcomes. This report suggests that anteromedial coronoid fracture associated with posteromedial rotatory instability might be treated using conservative treatment in selective cases when anteromedial coronoid fracture is minimally displaced and there is no evidence of elbow subluxation.

This study aims to retrospectively evaluate the results of soft tissue distraction using Ilizarov in relapsed clubfeet following a previous posteromedial soft tissue release. This study, as compared with previous studies, has a cohort of patients with relapsed clubfeet only following posteromedial soft tissue release. Fifteen patients (16 feet) were assessed using the International Clubfoot Study Group score and plantigrade foot was achieved in all except one patient who had equinus deformity. Fourteen feet were graded as showing excellent or good result on the basis of the International Clubfoot Study Group (ICFSG) score. Although no patient had an ICFSG score of 0, parental satisfaction was good. This report supports the use of Ilizarov as the benefits offered outweigh the risk of associated complications, making this potentially cumbersome apparatus a useful tool in the armamentarium to treat relapsed clubfeet following soft tissue release.