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Most surgical treatment options for metastatic acetabular lesions involve variants of total hip arthroplasty (THA). However, these are technically complex reconstructions performed in very frail patients, and previous reports indicate complications such as dislocation, deep infection, aseptic loosening, and intraoperative death. A 73-year-old man presented to the emergency department at our hospital with right hip pain following a fall. He had undergone nephrectomy for the treatment of right kidney cancer at the age of 68 years. Four years after the nephrectomy, multiple lung metastases, pelvic bone metastases, and right femoral head and neck bone metastases were found. A radiograph of the hip joint showed a pathological proximal femoral fracture with a radiolucent lesion of the acetabulum. THA with acetabular reconstruction using a Kerboull-type (KT) plate through the direct anterior approach (DAA) was performed. After removal of the femoral head, curettage of the metastatic acetabular dome lesion was carefully performed under fluoroscopic guidance. After the KT plate was placed, cementation of the metastatic acetabular dome lesion was performed, and an optimally sized polyethylene liner was fixed with cement. A cemented stem was inserted after confirming the hip joint stability. At the 14-month follow-up, he could walk steadily without any complications and his modified Harris hip score was 100. The DAA conserves soft tissue because it is an intermuscular approach. Accordingly, postoperative recovery is fast and thus associated with a low dislocation rate and effective pain reduction. The acetabulum with metastatic disease was reconstructed using a KT plate for hip joint stability. Bone with metastatic disease that appears adequate at the time of THA may become incompetent after a few years. THA with acetabular reconstruction using a KT plate through the DAA was an effective treatment for metastatic bone disease of the acetabulum combined with pathological proximal femoral neck fracture.A feature of the flexor pollicis longus tendon injury is the frequency of palmar retraction so that a wrist approach is needed for retrieval of the proximal stump. We are reporting on our first outpatient zone T2 flexor pollicis longus tendon repair under WALANT with ultrasound guidance. In the event of zone T2 flexor pollicis rupture, ultrasound location of tendon extremities is used to plan surgical WALANT strategy and to guide the injection of lidocaine with epinephrine whilst limiting the injected volume to what is strictly necessary.

Traumatic burst fractures most commonly occur in thoracolumbar junction. Maintenance of spinal stability and decompression of spinal canal are the main goals of management in these cases. Either anterior, posterior or combined approaches may be selected. For anterior corpectomy, mini-open lateral incision may be used.

29years old male patient, in whom posterior segmental instrumentation had been performed previously, readmitted 4months later with a complaint of low back pain and urinary and gait incontinence. Radiological scans revealed iatrogenic kyphosis and loosening of uppermost transpedicular screws. Patient was managed via revision of posterior instrumentation and L1 corpectomy with cage and rod insertion.

In patients with thoracolumbar burst fracture, loosening of screws and consequent iatrogenic kyphosis may be seen as a late complication. Combined anterior and posterior approach may regenerate spinal stability in these patients. Moreover; mini-open lateral incision with muscle sparing thoracotomy for anterior approach may cause less postoperative complications.

In patients with thoracolumbar burst fracture, loosening of screws and consequent iatrogenic kyphosis may be seen as a late complication. Combined anterior and posterior approach may regenerate spinal stability in these patients. Moreover; mini-open lateral incision with muscle sparing thoracotomy for anterior approach may cause less postoperative complications.

Two cases are reported of femoral shaft fractures involving tombstones. A four and six year old child had similar histories of uprooting of tombstones during play, toppling them and causing injury. Treatment included non-operative and operative approaches, with both patients yielding bony union at the three month follow up.

We present the involvement of tombstones as a unique mechanism of injury for femoral shaft fractures in two pediatric cases. From our review of the literature, we believe this to be a first report. We hope to highlight the associated safety implications for the primary prevention of a similar traumatic injury.

We present the involvement of tombstones as a unique mechanism of injury for femoral shaft fractures in two pediatric cases. GPR84 antagonist 8 in vitro From our review of the literature, we believe this to be a first report. We hope to highlight the associated safety implications for the primary prevention of a similar traumatic injury.Lung hernia following minimally invasive cardiac surgery is rare with few reported cases in the literature. Surgical repair is debated, and several methods have been described including a variety of synthetic and biological materials. We report a case of a 36-year-old woman who developed lung hernia and a strong retraction of the pectoralis major muscle after minithoracotomy that was performed for mitral valve surgery. The herniated lung was reduced and the chest wall defect was repaired with a non-cross linked acellular dermal matrix (ADM) anchored to the thoracic wall. At a 6-year follow-up, she was asymptomatic and without recurrence of the hernia. Our experience suggests that ADMs are a safe and reliable surgical technique for lung hernia repair due to their biological and mechanical properties, even in those secondary hernias to minithoracotomy where a complete muscle coverage of the matrix could not be provided.Ovarian sarcomas account for 1% of all ovarian malignancies and amongst these, primary ovarian leiomyosarcoma is the rarest subtype. Primary ovarian leiomyosarcoma has a very poor prognosis, with less than 20% of patients being alive at 5 years. Only a few cases have been published in the literature and there is very limited knowledge on the clinical behaviour and optimal management of these tumours. We have performed a retrospective analysis of a prospectively maintained database to identify all primary ovarian leiomyosarcoma diagnosed and treated at the Royal Marsden NHS Foundation Trust between 1998 and 2020. Sixteen patients were identified from our database and fifteen were eligible for the analysis. Twelve patients presented with localized disease and underwent initial surgery and three patients had metastatic disease at presentation. Recurrence-free survival post-surgery was 16 months. Eight patients received first-line chemotherapy and four patients received second-line chemotherapy. Two patients had indolent metastatic disease and benefited from local therapies only.