Fracture and intrathoracic dislocation of the humeral head are extremely rare and often the result of a severe trauma. We herein report a case of humeral head fracture and dislocation with displacement into the chest cavity. A 75-year-old man fell down the stairs at home, landing on the right half of his body. Clinical impressive was a massive skin emphysema on the right hemithorax. A chest x-ray was performed. Conspicuous was a dubious opacity in the right subfield of the lung. The following CT-scan showed an additional fracture of the right scapula, a lung contusion and as “corpus delicti” a right intrathoracic dislocated humeral head fracture. The current case is extremely rare pattern of injury and the surgical emergency management is discussed. In most patients, a thoracotomy, which is related to a higher lethality and higher morbidity, can be avoided, if after stabilization a video assisted thoracoscopy is performed for revision of the pleural cavity and extraction of the humeral head.

Periprosthetic fracture, after total knee arthroplasty, is one of the most common reasons of revision arthroplasty and periprosthetic fracture of the patella has been shown to be very rare. Literature review has shown no reports of periproshtetic fracture of the patella around tumor endoprosthesis. Only 1 study has discussed management of open periprosthetic fractures of the patella as this type of fracture is extremely rare.
We report a particular open periprosthetic fracture of the patella around a tumor endoprosthesis in a 60 years old female, that was treated with irrigation and debridement and tension band wiring and 3 month of follow up showed satisfactory range of motion with no extension lag.
Despite the fact that operative management of periprosthetic fractures of the patella has a high rate of complications and poor outcome, it can be considered for patients with open periprosthetic fractures of the patella, especially when the extensor mechanism is compromised.

Extensive chest wall defects occur in 28% of all sternal resection cases and are a major challenge in thoracic surgery. These cases are generally considered “critical defects” requiring primary or secondary reconstruction using various types of flaps, mesh repairs, bone autografts, or endoprosthesis. The past decade witnessed rapid advances in the application of personalized endoprostheses in thoracic surgery. Surgeons began to use carbon or titanium grafts for personalized sternum replacement. The main advantages of these implants are superior cosmetic effect, biocompatibility, and low risk of infection. Herein, we present a case of a 55-year-old patient with an indication for extended sternum resection due to metastatic thyroid cancer. The patient underwent extended sternum resection, followed by the implantation of a personalized microporous titanium sternum equipped with graspers for atraumatic rib fixation.

Knee rotationplasty is a suitable reconstructive and limb salvage procedure for infected femur and knee prostheses. It involves external rotation of the lower limb with an intact neurovascular bundle to function as a knee joint. Functionally, it has better outcomes when compared to alternate options like above knee amputation. It results in better cortical reorganization and superior stance mechanics, enabling a more efficient gait and better quality of life. We report a patient who underwent modified rotationplasty for an infected knee endoprosthesis as a composite lower leg free flap.

The most important factor in the success of restoration is marginal fitness. If there is not an appropriate marginal fitness between tooth and restorations it may cause carries in the marginal area because of the food and debris in the marginal area cause gingivitis and margin discoloring and in sever cases it will have increase of pocket depth and loss of attached gingival from this problem caused this research. This is experimental research, the samples are 20 and there are chooses simple randomize. The mentioned marginal design were designed on a standard die by machines. Then impressions were provided from dies, and after making the restoration by electroforming method, the gap die and restoration measured by photo esterio microcope and T. Test. shoulder: 24.42 sloping shoulder: 13.92 P.value= 0.05 According to the P-value in comparing between of this two group of marginal design, there was significant difference. According to the significant difference, have the difference act about marginal fitness metoceramic restoration and sloping shoulder have better marginal fitness than shoulder in electroforming method.

Acute acromioclavicular (AC) joint dislocation is common in shoulder injuries. Considering the biomechanics of this joint, the use of a treatment method, which can restore joint physiology and biomechanics to the extent possible, is important. This study aimed to compare the treatment of acute AC joint dislocation by screw fixation with and without ligament reconstruction. In the present study, 28 patients with AC joint dislocation type 4, 5, and 6, were randomly treated with either coracoclavicular screw fixation with ligamentous reconstruction or screw fixation without ligament reconstruction. Screws were removed after 8 weeks. The follow-up period lasted for 2 months. The simple shoulder test (SST), disabilities of the arm, shoulder, and hand (DASH) score, and the University of California-Los Angeles (UCLA) shoulder scale were conducted using specific questionnaires. Based on the SST, mean shoulder function was better in the ligament reconstruction group compared to the group without ligament reconstruction (P = 0.028). The result of the UCLA shoulder scale indicate a significantly better returning to original and natural function of the AC joint in the ligament reconstruction group than the other group (P = 0.012). DASH score indicated a significantly lower disability rate in the group that underwent ligament reconstruction than the other group (P = 0.001). The results suggest that ligament reconstruction in the Ac joint significantly increases the rate of returning to normal function, joint stability, and normal joint physiology.

There is no consensus regarding the best method of reconstruction in pediatric population following the wide resection of malignant bone tumors. More exploration of the complications of osteoarticular reconstruction leads to less existing controversy of this type of reconstruction, which is the main point of this article.
Long-term outcomes and complications of osteoarticular allograft reconstruction of primary distal femoral bone sarcomas in 22 children with mean age of 10.7 years old were reviewed in this study. Musculoskeletal Tumor Society (MSTS) scoring system was used for functional evaluation of the allografts.
With an average follow-up time of 81 months, the outcomes of 16 patients with allografts at the final follow up were evaluated. As expected, Limb length discrepancy (LLD) was observed in all patients (mean LLD= 2.73cm), which was significantly correlated to allograft survival time (P Osteoarticular allograft reconstruction could result in several complications including DJD. Despite its considerable biologic advantage over endoprosthesis, osteoarticular allograft reconstruction is a long-lasting but still a temporary solution before performing megaprosthesis. This allows patients to preserve their remaining physis for limb growth and become old enough for an adult megaprosthesis.

Megaprostheses are one of the preferred choices of reconstruction after tumor resection. Periprosthetic joint infections are one of the most serious complications of joint prostheses surgeries. In this study, our aim was to analyze the efficacy of silver-coated megaprostheses in reducing the risk of prosthesis-related infection. One hundred forty-two patients who had undergone implantation of a mega-endoprosthesis for nonneoplastic or post-neoplastic conditions were included in this retrospective study. The end-point of the survival analysis was the prosthesis failure due to infection.  Thirty-eight patients had undergone implantation of a silver-coated megaprosthesis and 104 patients a megaprosthesis without silver coating. The survival analysis showed an overall infection-free survival rate of 82.3% at five years and 61.9% at 10 years. Silver-coated prostheses had an HR of 0.72 (95% CI: 0.26-2.05; P=0.54). Implantation of a silver-coated mega-prosthesis in non-oncological patients did not significantly reduce the risk of prosthesis-related infection.Level of evidence: III

Metallic alloys are utilized widely as implants and bio-tools due to their prominent mechanical properties. They can be used as endoprostheses, dental implants, cardiovascular devices parts, and surgery tools. The working conditions and the environmental characteristics of the body cause the implants to be exposed to various types of wear. Abrasion is a critical factor in controlling the life cycle of the implant and the metallic parts used in the body and many of these objects fail to function properly due to abrasion phenomena. Moreover, the fine particles produced due to abrasion can actively produce inflammation and loosening at the interface between the implant and the host tissue. In this paper, various metallic alloys that are used as implants and the bio-tools and their corresponding wear mechanisms have been reviewed, comprehensively. Moreover, the coating techniques that enhance the tribological performance of the objects and implants have been studied and their advantages and disadvantages have been discussed.

With Currently, Endoscopic retrograde cholangiopancreatography (ERCP) has evolved as a therapeutic intervention for treating disorders related to the biliary system and plays an important role in treating benign and malignant strictures of the biliary system.
The placement of biliary stents is a frequent and useful procedure to decompress the biliary system, and endoscopic biliary stenting seems relatively simple. However, in some cases, it can lead to several complications. Distal or proximal migration of endoscopically placed biliary stents is one of the known complications of ERCP and can affect up to 6-10% of patients.
Several factors, including those related to the patient, endoscopy, or stent, are involved in stent migration. When migration occurs, it is necessary to remove or replace endoprosthesis to prevent recurrent biliary complications and more severe consequences such as cholangitis and sepsis.
This review explores the frequency, etiology, risk factors, complications, and management strategies pertaining to biliary stent migration, consolidating diverse management approaches for informed decision-making.