The fundamental principles for treating ankle fractures, as with other intra-articular fractures, are anatomical reduction and stable internal fixation. Despite successful reduction, between 14% and 40% of patients continue to experience persistent pain or unsatisfactory functional outcomes. Furthermore, approximately 1% of patients progress to post-traumatic arthritis, necessitating further surgical intervention. Ankle fractures are frequently accompanied by intra-articular injuries, including osteochondral lesions, ligament tears, and syndesmosis injuries. Arthroscopy is becoming increasingly prevalent in managing acute ankle fractures by assessing intra-articular damage and facilitating accurate reduction. This review examined the role and indications for arthroscopy in ankle fractures, particularly emphasizing its benefits in diagnosing and managing associated injuries, including osteochondral lesions, syndesmosis, and deltoid ligament injuries. Furthermore, arthroscopy facilitates fracture reduction, offering a minimally invasive approach with a shorter recovery period and enhanced visualization. Its use extends to pediatric fractures and complex cases such as Maisonneuve and calcaneal fractures, potentially improving outcomes while minimizing complications. Understanding the evolving indications and benefits of arthroscopy for ankle fractures can lead to improved clinical outcomes and reduced complications.

The fundamental principles for treating ankle fractures, as with other intra-articular fractures, are anatomical reduction and stable internal fixation. Despite successful reduction, between 14% and 40% of patients continue to experience persistent pain or unsatisfactory functional outcomes. Furthermore, approximately 1% of patients progress to post-traumatic arthritis, necessitating further surgical intervention. Ankle fractures are frequently accompanied by intra-articular injuries, including osteochondral lesions, ligament tears, and syndesmosis injuries. Arthroscopy is becoming increasingly prevalent in managing acute ankle fractures by assessing intra-articular damage and facilitating accurate reduction. This review examined the role and indications for arthroscopy in ankle fractures, particularly emphasizing its benefits in diagnosing and managing associated injuries, including osteochondral lesions, syndesmosis, and deltoid ligament injuries. Furthermore, arthroscopy facilitates fracture reduction, offering a minimally invasive approach with a shorter recovery period and enhanced visualization. Its use extends to pediatric fractures and complex cases such as Maisonneuve and calcaneal fractures, potentially improving outcomes while minimizing complications. Understanding the evolving indications and benefits of arthroscopy for ankle fractures can lead to improved clinical outcomes and reduced complications.

The fundamental principles for treating ankle fractures, as with other intra-articular fractures, are anatomical reduction and stable internal fixation. Despite successful reduction, between 14% and 40% of patients continue to experience persistent pain or unsatisfactory functional outcomes. Furthermore, approximately 1% of patients progress to post-traumatic arthritis, necessitating further surgical intervention. Ankle fractures are frequently accompanied by intra-articular injuries, including osteochondral lesions, ligament tears, and syndesmosis injuries. Arthroscopy is becoming increasingly prevalent in managing acute ankle fractures by assessing intra-articular damage and facilitating accurate reduction. This review examined the role and indications for arthroscopy in ankle fractures, particularly emphasizing its benefits in diagnosing and managing associated injuries, including osteochondral lesions, syndesmosis, and deltoid ligament injuries. Furthermore, arthroscopy facilitates fracture reduction, offering a minimally invasive approach with a shorter recovery period and enhanced visualization. Its use extends to pediatric fractures and complex cases such as Maisonneuve and calcaneal fractures, potentially improving outcomes while minimizing complications. Understanding the evolving indications and benefits of arthroscopy for ankle fractures can lead to improved clinical outcomes and reduced complications.

The fundamental principles for treating ankle fractures, as with other intra-articular fractures, are anatomical reduction and stable internal fixation. Despite successful reduction, between 14% and 40% of patients continue to experience persistent pain or unsatisfactory functional outcomes. Furthermore, approximately 1% of patients progress to post-traumatic arthritis, necessitating further surgical intervention. Ankle fractures are frequently accompanied by intra-articular injuries, including osteochondral lesions, ligament tears, and syndesmosis injuries. Arthroscopy is becoming increasingly prevalent in managing acute ankle fractures by assessing intra-articular damage and facilitating accurate reduction. This review examined the role and indications for arthroscopy in ankle fractures, particularly emphasizing its benefits in diagnosing and managing associated injuries, including osteochondral lesions, syndesmosis, and deltoid ligament injuries. Furthermore, arthroscopy facilitates fracture reduction, offering a minimally invasive approach with a shorter recovery period and enhanced visualization. Its use extends to pediatric fractures and complex cases such as Maisonneuve and calcaneal fractures, potentially improving outcomes while minimizing complications. Understanding the evolving indications and benefits of arthroscopy for ankle fractures can lead to improved clinical outcomes and reduced complications.

Tillaux fractures, a rare type corresponding to Salter–Harris type 3, are observed in approximately 3% of pediatric ankle fractures. They are known to occur primarily via a supination–external rotation mechanism. Maisonneuve fractures, on the other hand, are proximal fibula fractures involving injury on syndesmosis, deltoid ligament, or medial malleolus fracture, occurring via a pronation-external rotation mechanism. These two types of fractures occur through different mechanisms of injury. In this study, a nine-year-old female pediatric patient presented to the outpatient department with ankle pain following a fall from a trampoline and was diagnosed with concurrent Tillaux-like fracture and Maisonneuve fractures. Surgical treatment was performed, resulting in successful recovery.

Purpose: The aim of this study was to assess the effects of tyrosine kinase inhibitors (TKIs) following metastasectomy in patients with metastatic renal cell carcinoma (mRCC). Materials and Methods: A systematic search of multiple electronic databases was conducted. The inclusion criteria encompassed randomized clinical trials evaluating the use of TKIs after metastasectomy in mRCC patients. Study outcomes were relapse-free survival (RFS)/disease-free survival (DFS), overall survival (OS), and adverse events of TKIs. Results: Two studies with 197 randomized participants that compared TKIs following metastasectomy versus metastasectomy alone were identified. According to these studies, TKIs following metastasectomy may result in little to no difference in RFS/DFS (hazard ratio [HR], 1.01; 95% confidence interval [CI], 0.65–1.57; I2=29%; low-certainty evidence). TKIs after metastasectomy may slightly increase OS, but the CI crossed the line of no effect (HR, 0.80; 95% CI, 0.06–9.87; I2=86%; low-certainty evidence). TKIs after metastasectomy likely resulted in a large increase in adverse events (risk ratio, 2.76; 95% CI: 1.65–4.62; I2=not applicable; moderatecertainty evidence). Conclusions TKIs following metastasectomy did not improve RFS/DFS, but slightly improved OS. It is likely that TKIs following metastasectomy increase adverse events compared to surgery only. The certainty of evidence ranged from moderate (signaling confidence that the reported effect size is likely close to the true effect) to low (indicating that the true effect may be substantially different from the effect estimate). The findings of this study should help to inform future guidelines and clinical decision-making at the point of care.

An aneurysmal bone cyst (ABC) can occur in many parts of the human body, but a primary ABC of the talus is extremely rare. ABCs are benign, but aggressively growing tumors that usually occur in the first two decades of life. Patients mainly complain of pain, limited movement of the involved joint or a palpable mass. Pain may worsen suddenly because of pathological fractures. If not treated properly, ABC has a risk of local recurrence, followed by the destruction of the joint and a significant functional deficit. While the complete removal of the bone tumor is essential, it is also important to treat the resultant bone defect after removal. The talus has an important part to play in weight-bearing. Therefore, an appropriate bone graft is required for large bone defects that occur after an ABC removal from the talus. We report a primary ABC of the talus in a 28-year-old male that was treated by curettage and a bone pillar pattern graft of autologous tricortical iliac crest bone. The patient had an excellent functional outcome with early weight-bearing, and there was no recurrence at 16 months of follow-up.

The outbreak of coronavirus disease 2019 (COVID-19), which began in December 2019, is still ongoing in Korea, with >9,000 confirmed cases as of March 25, 2020. COVID-19 is a severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection, and real-time reverse transcription-PCR is currently the most reliable diagnostic method for COVID-19 around the world. Korean Society for Laboratory Medicine and the Korea Centers for Disease Prevention and Control propose guidelines for diagnosing COVID-19 in clinical laboratories in Korea. These guidelines are based on other related domestic and international guidelines, as well as expert opinions and include the selection of test subjects, selection of specimens, diagnostic methods, interpretation of test results, and biosafety.

A 3rd degree burn on the heel including the Achilles tendon is vulnerable and requires active treatment to improve the functional outcomes. Previously, there have been a few treatments on severe burns, such as amputation, debridement or simple skin graft. The cooperative technique of an anterior lateral thigh flap with Achilles tendon reconstruction can be an innovative procedure that preserves the major arteries. The authors review a case and report the clinical outcome.
Achilles Tendon* ; Amputation ; Arteries ; Burns* ; Debridement ; Free Tissue Flaps* ; Heel* ; Reconstructive Surgical Procedures ; Skin ; Surgical Flaps ; Thigh* ; Transplants

Pancreatic cancer is well known as a relentlessly progressive and fatal disease. Although distant metastasis is common at the time of diagnosis, brain metastasis originating from pancreatic cancer is rare and its clinical manifestation remains poorly described. Additionally, it is generally known that the prognosis for patients with pancreatic cancer and brain metastasis is very poor. Surgical resection of brain metastasis may play a limited role or may allow long-term survival in patients for whom the primary pancreatic cancer is well controlled. We present a case of brain metastasis in patient with pancreatic cancer after pylorus-preserving pancreaticoduodenectomy and complete response to chemotherapy for hepatic metastases. Brain metastasis was resected successfully, but survival period was relatively short, even though the patient received curative treatment for pancreatic cancer. This case demonstrated that resection of brain metastatic lesion from pancreatic cancer being controlled may be helpful, but the timing of resection is also important.
Brain* ; Diagnosis ; Drug Therapy ; Humans ; Neoplasm Metastasis* ; Pancreas ; Pancreatic Neoplasms* ; Pancreaticoduodenectomy ; Prognosis