Pedicle ossification is a rare but significant complication following mandibular reconstruction using a fibular free flap (FFF), a technique widely employed in maxillofacial surgery due to its reliable vascularized bone supply and low donor site morbidity. The FFF supports dental implantation and prosthetic rehabilitation, with its vascularized periosteum enhancing osteogenic potential. Despite these advantages, unexpected ossification of the flap’s vascular pedicle may occur, potentially mimicking tumor recurrence and causing diagnostic uncertainty. This case report describes a 38-year-old male with left buccal squamous cell carcinoma treated by wide excision, modified radical neck dissection, and reconstruction using a radial forearm free flap. Postoperative radiotherapy led to complications including trismus and alveolar bone exposure, culminating in a pathological mandibular fracture. Mandibular reconstruction was performed using an FFF. Over 4 years of follow-up, computed tomography revealed ossification within the vascular pedicle. Notably, the patient remained asymptomatic, maintaining normal speech and swallowing without functional impairment. Pedicle ossification may present radiographically as a suspicious bony change misinterpreted as tumor recurrence. Routine follow-up imaging such as computed tomography is essential for differentiation. Although trismus, bony swelling, or pain may occur, surgical intervention is typically deferred unless symptoms develop. Therefore, careful clinical assessment and monitoring remain crucial.

Pedicle ossification is a rare but significant complication following mandibular reconstruction using a fibular free flap (FFF), a technique widely employed in maxillofacial surgery due to its reliable vascularized bone supply and low donor site morbidity. The FFF supports dental implantation and prosthetic rehabilitation, with its vascularized periosteum enhancing osteogenic potential. Despite these advantages, unexpected ossification of the flap’s vascular pedicle may occur, potentially mimicking tumor recurrence and causing diagnostic uncertainty. This case report describes a 38-year-old male with left buccal squamous cell carcinoma treated by wide excision, modified radical neck dissection, and reconstruction using a radial forearm free flap. Postoperative radiotherapy led to complications including trismus and alveolar bone exposure, culminating in a pathological mandibular fracture. Mandibular reconstruction was performed using an FFF. Over 4 years of follow-up, computed tomography revealed ossification within the vascular pedicle. Notably, the patient remained asymptomatic, maintaining normal speech and swallowing without functional impairment. Pedicle ossification may present radiographically as a suspicious bony change misinterpreted as tumor recurrence. Routine follow-up imaging such as computed tomography is essential for differentiation. Although trismus, bony swelling, or pain may occur, surgical intervention is typically deferred unless symptoms develop. Therefore, careful clinical assessment and monitoring remain crucial.

Background: The lack of data on the solubility of certain crystals has resulted in conflicting findings. Therefore, establishing a standardized solubility test for use in clinical laboratories is essential. Methods: Calcium carbonate, calcium oxalate monohydrate, calcium phosphate dibasic, calcium sulfate, cystine, hippuric acid, leucine, magnesium ammonium phosphate, meglumine diatrizoate, tyrosine, uric acid, uric acid sodium salt, and xanthine were procured from SigmaAldrich Co., USA. These crystals were suspended in 30% acetic acid, 30% hydrochloric acid, 10% potassium hydroxide (KOH), distilled water, ethanol, chloroform, and ether. Their morphology and dissolution characteristics were examined under an inverted microscope. Results: The morphology and solubility of all 13 crystals were examined.Calcium carbonate, calcium oxalate, calcium phosphate, cystine, triple phosphate, tyrosine, and uric acid demonstrated solubility patterns consistent with those reported in existing literature. Meanwhile, the solubility of five crystals that lacked data was newly established. Calcium sulfate exhibited partial dissolution in 10% KOH and in distilled water at 60°C. Hippuric acid, uric acid sodium salt, and xanthine dissolved in 10% KOH, while meglumine diatrizoate dissolved in distilled water and 10% KOH.Notably, the solubility patterns of calcium sulfate, hippuric acid, and leucine differed from those documented in the literature. Conclusions This study confirmed the solubility of five crystals. Notably, the solubility of three crystals differed from that documented in existing literature. Microscopic examination, augmented by polarization, proved invaluable for distinguishing urinary crystals during the solubility test. The study findings are expected to improve the discrimination of crystals in future analyses.

Background: Our study aimed to evaluate the clinical and radiologic results of all-arthroscopic treatment of terrible triad injuries followed-up for a minimum of 5 years and investigate how arthroscopic partial excision for radial head fractures affects the results at the final follow-up. Methods: We retrospectively reviewed consecutive patients with terrible triad injuries who underwent all-arthroscopic treatment between January 2011 and June 2018. In group I, we performed conservative or arthroscopic fixation of stable radial head fractures, while in group II, arthroscopic partial excision of unstable radial head fractures involving <30%–50% of the articular surface area was performed. Clinical outcomes were measured by visual analog scale score and assessment of instability, range of motion (ROM), and Mayo Elbow Performance Score. Radiological outcomes were evaluated using x-rays, and the integrity of the repaired lateral collateral ligament complex was confirmed through magnetic resonance imaging. Results: Thirty-two patients with an average age of 49.5±16.2 years met the inclusion criteria and were followed-up for a mean of 82.7±22.2 months. Twenty patients were assigned to group I and 12 patients to group II. Clinical outcomes showed no significant differences between the two groups at the final follow-up (P>0.05). On radiological evaluation, more heterotopic ossifications were found in the radial head excision group (group II, 66.7% vs. group I, 35%; P=0.02); however, there was no significant difference in ROM between the two groups (P>0.05). Conclusions In all-arthroscopic treatment of terrible triad injuries, arthroscopic partial excision of the radial head did not seem to have a significant impact on elbow joint stability.Level of evidence: III.

Background: The lack of data on the solubility of certain crystals has resulted in conflicting findings. Therefore, establishing a standardized solubility test for use in clinical laboratories is essential. Methods: Calcium carbonate, calcium oxalate monohydrate, calcium phosphate dibasic, calcium sulfate, cystine, hippuric acid, leucine, magnesium ammonium phosphate, meglumine diatrizoate, tyrosine, uric acid, uric acid sodium salt, and xanthine were procured from SigmaAldrich Co., USA. These crystals were suspended in 30% acetic acid, 30% hydrochloric acid, 10% potassium hydroxide (KOH), distilled water, ethanol, chloroform, and ether. Their morphology and dissolution characteristics were examined under an inverted microscope. Results: The morphology and solubility of all 13 crystals were examined.Calcium carbonate, calcium oxalate, calcium phosphate, cystine, triple phosphate, tyrosine, and uric acid demonstrated solubility patterns consistent with those reported in existing literature. Meanwhile, the solubility of five crystals that lacked data was newly established. Calcium sulfate exhibited partial dissolution in 10% KOH and in distilled water at 60°C. Hippuric acid, uric acid sodium salt, and xanthine dissolved in 10% KOH, while meglumine diatrizoate dissolved in distilled water and 10% KOH.Notably, the solubility patterns of calcium sulfate, hippuric acid, and leucine differed from those documented in the literature. Conclusions This study confirmed the solubility of five crystals. Notably, the solubility of three crystals differed from that documented in existing literature. Microscopic examination, augmented by polarization, proved invaluable for distinguishing urinary crystals during the solubility test. The study findings are expected to improve the discrimination of crystals in future analyses.

An avulsion fracture occurs when a muscle-tendon unit attached to a bone produces sufficient force to tear a fragment of the bone. If not treated properly, this injury can lead to deformity, nonunion, malunion, pain, and disability. Although avulsion fractures around the foot and ankle can occur anywhere there are tendon and ligament attachments, they are common in the anterior talofibular ligament, anterior-inferior tibiotalar ligament, calcaneal tuberosity, the base of the fifth metatarsal, and navicular bone. The optimal treatment for each fracture depends on the location and severity of the fracture.Conservative treatment involves limiting weight bearing for a period, splint immobilization, and using various orthoses. Surgical treatment is usually reserved for cases of severe displacement or when nonsurgical treatment has failed. The goals of surgery include reduction of the fracture fragment, prevention of nonunion or malunion and soft tissue injury, and early return to function. The decision for each treatment modality may depend on the patient demographics or preferences and the surgeon experience. This review summarizes previous and current views on the pathogenesis, diagnosis, and treatment of common avulsion fractures to guide the treatment and diagnosis.

Background: The lack of data on the solubility of certain crystals has resulted in conflicting findings. Therefore, establishing a standardized solubility test for use in clinical laboratories is essential. Methods: Calcium carbonate, calcium oxalate monohydrate, calcium phosphate dibasic, calcium sulfate, cystine, hippuric acid, leucine, magnesium ammonium phosphate, meglumine diatrizoate, tyrosine, uric acid, uric acid sodium salt, and xanthine were procured from SigmaAldrich Co., USA. These crystals were suspended in 30% acetic acid, 30% hydrochloric acid, 10% potassium hydroxide (KOH), distilled water, ethanol, chloroform, and ether. Their morphology and dissolution characteristics were examined under an inverted microscope. Results: The morphology and solubility of all 13 crystals were examined.Calcium carbonate, calcium oxalate, calcium phosphate, cystine, triple phosphate, tyrosine, and uric acid demonstrated solubility patterns consistent with those reported in existing literature. Meanwhile, the solubility of five crystals that lacked data was newly established. Calcium sulfate exhibited partial dissolution in 10% KOH and in distilled water at 60°C. Hippuric acid, uric acid sodium salt, and xanthine dissolved in 10% KOH, while meglumine diatrizoate dissolved in distilled water and 10% KOH.Notably, the solubility patterns of calcium sulfate, hippuric acid, and leucine differed from those documented in the literature. Conclusions This study confirmed the solubility of five crystals. Notably, the solubility of three crystals differed from that documented in existing literature. Microscopic examination, augmented by polarization, proved invaluable for distinguishing urinary crystals during the solubility test. The study findings are expected to improve the discrimination of crystals in future analyses.

Background: Our study aimed to evaluate the clinical and radiologic results of all-arthroscopic treatment of terrible triad injuries followed-up for a minimum of 5 years and investigate how arthroscopic partial excision for radial head fractures affects the results at the final follow-up. Methods: We retrospectively reviewed consecutive patients with terrible triad injuries who underwent all-arthroscopic treatment between January 2011 and June 2018. In group I, we performed conservative or arthroscopic fixation of stable radial head fractures, while in group II, arthroscopic partial excision of unstable radial head fractures involving <30%–50% of the articular surface area was performed. Clinical outcomes were measured by visual analog scale score and assessment of instability, range of motion (ROM), and Mayo Elbow Performance Score. Radiological outcomes were evaluated using x-rays, and the integrity of the repaired lateral collateral ligament complex was confirmed through magnetic resonance imaging. Results: Thirty-two patients with an average age of 49.5±16.2 years met the inclusion criteria and were followed-up for a mean of 82.7±22.2 months. Twenty patients were assigned to group I and 12 patients to group II. Clinical outcomes showed no significant differences between the two groups at the final follow-up (P>0.05). On radiological evaluation, more heterotopic ossifications were found in the radial head excision group (group II, 66.7% vs. group I, 35%; P=0.02); however, there was no significant difference in ROM between the two groups (P>0.05). Conclusions In all-arthroscopic treatment of terrible triad injuries, arthroscopic partial excision of the radial head did not seem to have a significant impact on elbow joint stability.Level of evidence: III.

Background: The lack of data on the solubility of certain crystals has resulted in conflicting findings. Therefore, establishing a standardized solubility test for use in clinical laboratories is essential. Methods: Calcium carbonate, calcium oxalate monohydrate, calcium phosphate dibasic, calcium sulfate, cystine, hippuric acid, leucine, magnesium ammonium phosphate, meglumine diatrizoate, tyrosine, uric acid, uric acid sodium salt, and xanthine were procured from SigmaAldrich Co., USA. These crystals were suspended in 30% acetic acid, 30% hydrochloric acid, 10% potassium hydroxide (KOH), distilled water, ethanol, chloroform, and ether. Their morphology and dissolution characteristics were examined under an inverted microscope. Results: The morphology and solubility of all 13 crystals were examined.Calcium carbonate, calcium oxalate, calcium phosphate, cystine, triple phosphate, tyrosine, and uric acid demonstrated solubility patterns consistent with those reported in existing literature. Meanwhile, the solubility of five crystals that lacked data was newly established. Calcium sulfate exhibited partial dissolution in 10% KOH and in distilled water at 60°C. Hippuric acid, uric acid sodium salt, and xanthine dissolved in 10% KOH, while meglumine diatrizoate dissolved in distilled water and 10% KOH.Notably, the solubility patterns of calcium sulfate, hippuric acid, and leucine differed from those documented in the literature. Conclusions This study confirmed the solubility of five crystals. Notably, the solubility of three crystals differed from that documented in existing literature. Microscopic examination, augmented by polarization, proved invaluable for distinguishing urinary crystals during the solubility test. The study findings are expected to improve the discrimination of crystals in future analyses.

Background: The lack of data on the solubility of certain crystals has resulted in conflicting findings. Therefore, establishing a standardized solubility test for use in clinical laboratories is essential. Methods: Calcium carbonate, calcium oxalate monohydrate, calcium phosphate dibasic, calcium sulfate, cystine, hippuric acid, leucine, magnesium ammonium phosphate, meglumine diatrizoate, tyrosine, uric acid, uric acid sodium salt, and xanthine were procured from SigmaAldrich Co., USA. These crystals were suspended in 30% acetic acid, 30% hydrochloric acid, 10% potassium hydroxide (KOH), distilled water, ethanol, chloroform, and ether. Their morphology and dissolution characteristics were examined under an inverted microscope. Results: The morphology and solubility of all 13 crystals were examined.Calcium carbonate, calcium oxalate, calcium phosphate, cystine, triple phosphate, tyrosine, and uric acid demonstrated solubility patterns consistent with those reported in existing literature. Meanwhile, the solubility of five crystals that lacked data was newly established. Calcium sulfate exhibited partial dissolution in 10% KOH and in distilled water at 60°C. Hippuric acid, uric acid sodium salt, and xanthine dissolved in 10% KOH, while meglumine diatrizoate dissolved in distilled water and 10% KOH.Notably, the solubility patterns of calcium sulfate, hippuric acid, and leucine differed from those documented in the literature. Conclusions This study confirmed the solubility of five crystals. Notably, the solubility of three crystals differed from that documented in existing literature. Microscopic examination, augmented by polarization, proved invaluable for distinguishing urinary crystals during the solubility test. The study findings are expected to improve the discrimination of crystals in future analyses.