Journal of Orthopedic and Spine Trauma
Volume:6 Issue: 1, Mar 2020

Nowadays, orthopedic-related pathologic conditions are considered as a growing concern. Also, the conventional treatments (grafting techniques) are not efficacious enough for the growing clinical needs. In the last decades, researches have been focused on finding more effective alternative treatments. Tissue engineering (TE) is a newly emerging field of science that has great potential to reduce these clinical issues. There are three main components in TE including cells, biomaterials, and signals. Choosing the best combination of these components is a vital decision in a TE process. In this review article, we are going to discuss TE and its components and also highlight some of the researches in the field of orthopedic TE by focusing on some tissues including bone, cartilage, skin, skeletal muscle, peripheral nervous system (PNS), tendon, and ligament. In the end, TE, as a new field of science, faces some major challenges that we will address some of them in this article.

Syndesmotic injury is one of the major causes of ankle pain and arthritis in athletes. Syndesmotic instability may remain undetectable when occurring with ankle fractures.

Case Report:

 A 59-year-old man presented to the orthopedic clinic with a history of surgery for fracture-dislocation of ankle two months before his visit. During revision surgery, we performed an open reduction, tension band wiring (TBW), and syndesmotic screw fixation. The results were satisfactory, with an almost full ankle range of motion (ROM) and good skin condition.

Early diagnosis and treatment of syndesmosis injury can prevent the complications such as chronic pain, osteoarthritis (OA), and stiffness. There is no consensus on the treatment of syndesmosis injury, but the main factors in determining the treatment plan are tibiofibular joint stability or instability and the amount of time that the injury has occurred. Magnetic resonance imaging (MRI) and computed tomography (CT) can also be used in addition to X-rays in cases of suspected syndesmosis injury.

The lateral epicondyle fracture in children is a rare condition and only few cases have been reported in the literature. The isolated fracture without concomitant fracture/dislocation is even more uncommon, with unclear outcome and treatment approach.

Case Report: 

We present a case of an 11-year-old boy with restricted right elbow range of motion (ROM) after falling. The radiograph and computed tomography (CT) scan showed a displaced lateral epicondyle fracture without accompanying fracture or dislocation. Due to the stability of the joint and patient’s compliance, a closed reduction with Kirschner wires (K-wires) was selected for treatment. Follow-up results were satisfactory and showed no complications.

Closed reduction of dislocated lateral epicondyle fracture in children can result in acceptable outcomes.

Freiberg’s disease is an uncommon condition typified by bony infarction of the second metatarsal head with a vague multifactorial etiology which tends to mostly occur in women.

Case Report: 

A 22-year-old woman presented with second metatarsal head local pain exacerbating while walking without any prominent previous trauma history; clinical and imaging workups revealed metatarsal head osteonecrosis of Freiberg’s infarction.

It should be kept in mind that for those complaining of forefoot discomfort, especially in the region of metatarsal heads, Freiberg’s avascular necrosis (AVN) could be a potential pathology.