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Introduction: Isolated ruptures of the vastus lateralis (VL) tendon are exceptionally rare, with few reported cases in the orthopedic literature. This case report sheds light on non-surgical management for partial VL tendon ruptures, providing insight into an alternative treatment pathway that avoids surgical intervention. Case Report: A 27-year-old Caucasian male experienced a partial, isolated rupture of the VL tendon after a minor fall. The injury was confirmed through magnetic resonance imaging at the lateral patellar insertion. The patient displayed no knee instability and was treated conservatively with platelet-poor plasma injections, a hinged knee brace, and targeted physiotherapy. Conclusion: This case illustrates that conservative treatment can be effective for patients with isolated partial VL tendon ruptures, particularly when knee stability is maintained. The patient achieved full activity recovery within 6 months, highlighting the potential of non-surgical options to provide successful outcomes in similar cases. This report enriches our understanding of tendon injury management and emphasizes the clinical viability of conservative strategies, potentially influencing treatment decisions for similar orthopedic injuries.

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Trauma is one of the main causes of death in younger people and ongoing disability worldwide. In Europe, while there is generally good organization of trauma reception and acute treatment, rehabilitation from major musculoskeletal injuries is less well defined and provided. This article documents the diverse approaches to rehabilitation after major injury in 6 European nations. The recognition of need is universal, but achieving a robust rehabilitation strategy is more elusive across the varying health care systems. Switzerland has the most robust service in the insured population. In the other countries, particularly where there is a reliance on public institutes, this provision is at best patchy. In the Netherlands, innovative patient-empowering strategies have gained traction with notable success, and in the United Kingdom, a recent randomized trial also showed this approach to be reproducible and robust. Overall, there is a clear need for learning across the national systems and implementation of a minimum set of standards.

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Introduction: Lipomas are the most common benign mesenchymal tumors found on the head, neck, shoulder, and back, but they are rarely encountered in the fingers, constituting <1% of such tumors. Case Report: This case report presents an exceptional location of a giant lipoma on the proximal phalanx of a 60-year-old Caucasian male's rightindex finger, alongside a literature review that identified 20 similar cases. The patient, with no significant health issues, reported that the growthhad been asymptomatic for 2 years before seeking consultation due to aesthetic concerns and impaired finger extension. Diagnostic imaging, including magnetic resonance imaging preoperatively, and histopathological analysis after surgical excision confirmed the diagnosis of a maturelipoma. Conclusion: This case contributes to the scarce documentation on finger lipomas, emphasizing the diagnostic challenges they present and the effectiveness of surgical removal in averting recurrence. It also highlights the unusual demographic occurrence, given the predominant presentation in middle-aged females, and underscores the necessity of considering lipomas in the differential diagnosis of finger masses. The literature review expands on the rarity of this condition, providing an analysis of 20 other cases, thereby enriching the understanding of lipoma manifestations in rare locations.

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Surgical site infections (SSIs) following open reduction and internal fixation (ORIF) of ankle fractures can lead to significant disability. This case report emphasizes a unique instance of SSI caused by Corynebacterium simulans, following ORIF of a trimalleolar ankle fracture in a 55-year-old female patient. To our knowledge, this is the first reported case of C. simulans infection after ORIF in the literature. The pathogen was detected after surgical debridement, removal and sonication of the hardware, and identified through matrix assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) and 16S rRNA gene sequencing. Specific intravenous antibiotic regimen was administered for a total duration of 4 weeks. During the 12th month follow-up, the patient presented no signs of infection and an excellent clinical outcome. This case report underscores the need for alertness regarding atypical pathogens in postoperative complications and the critical role of precise microbial diagnosis in managing rare orthopaedic infections.

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Aims: Accurate diagnosis of chronic periprosthetic joint infection (PJI) presents a significant challenge for hip surgeons. Preoperative diagnosis is not always easy to establish, making the intraoperative decision-making process crucial in deciding between one- and two-stage revision total hip arthroplasty (THA). Calprotectin is a promising point-of-care novel biomarker that has displayed high accuracy in detecting PJI. We aimed to evaluate the utility of intraoperative calprotectin lateral flow immunoassay (LFI) in THA patients with suspected chronic PJI. Methods: The study included 48 THAs in 48 patients with a clinical suspicion of PJI, but who did not meet European Bone and Joint Infection Society (EBJIS) PJI criteria preoperatively, out of 105 patients undergoing revision THA at our institution for possible PJI between November 2020 and December 2022. Intraoperatively, synovial fluid calprotectin was measured with LFI. Cases with calprotectin levels ≥ 50 mg/l were considered infected and treated with two-stage revision THA; in negative cases, one-stage revision was performed. At least five tissue cultures were obtained; the implants removed were sent for sonication. Results: Calprotectin was positive (≥ 50 mg/l) in 27 cases; out of these, 25 had positive tissue cultures and/or sonication. Calprotectin was negative in 21 cases. There was one false negative case, which had positive tissue cultures. Calprotectin showed an area under the curve of 0.917, sensitivity of 96.2%, specificity of 90.9%, positive predictive value of 92.6%, negative predictive value of 95.2%, positive likelihood ratio of 10.6, and negative likelihood ratio of 0.04. Overall, 45/48 patients were correctly diagnosed and treated by our algorithm, which included intraoperative calprotectin measurement. This yielded a 93.8% concordance with postoperatively assessed EBJIS criteria. Conclusion: Calprotectin can be a valuable tool in facilitating the intraoperative decision-making process for cases in which chronic PJI is suspected and diagnosis cannot be established preoperatively.

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The management and underlying causes of patellar periprosthetic fractures (PPF) after total knee arthroplasty (TKA) constitute an issue of growing importance given the rising frequency of these procedures. Patella periprosthetic fractures, though relatively rare, pose significant challenges and are a frequent indication for revision surgeries. Despite a decrease in overall incidence, PPFs remain the second most common type of periprosthetic fractures after TKA. Several factors have been identified and associated with patient-specific factors, surgical technique errors, and implant-related causes. Currently extensor apparatus integrity, bone stock, and component loosening are the major concerns and indications for the selective treatment approach. In this study, a thorough review of the existing literature was performed summarizing the epidemiology, clinical manifestation, treatment approach, and functional outcome of PPF. This review aims to underline the significance of such predisposing factors, point out the severity of PPF, and offer insights into the optimal intra- and post-operative management of the patella.

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BACKGROUND: The choice between total hip arthroplasty (THA) and hemiarthroplasty (HA) to treat displaced femoral neck fractures, particularly among the elderly, is still controversial. Acetabular erosion consists of a late multifactorial process that may happen after hip HA resulting in significant postoperative burden. This study aims to investigate the impact of acetabular erosion progress after hip HA in patients over 70 years old. MATERIALS AND METHODS: This is a 5-year (2013-2018) retrospective study including consecutive series of patients >70 years who were treated with bipolar hip HA for femoral neck fractures. Patients were categorised into 3 groups for analysis (A = 70-75 years, B = 75-80 years, C = >80 years). The study enrolled a total number of 813 patients who met the inclusion criteria. We assessed acetabular erosion through radiological examinations and measured functional deterioration using the modified Harris Hip Score (mHHS) at 6 and 12 months follow-up. Our comprehensive investigation extended over a maximum period of 5 years. The correlation of patients' characteristics and HA features on erosion progress was assessed. RESULTS: There were no significant differences in sex distribution, injury side, BMI, ASA score, bipolar head diameter, mHHS and leg-length discrepancy among the groups (p > 0.05). During the follow-up period, acetabular erosion with consequential conversion to THA was observed in 6.13%, 4.22% and 1.96% for Groups A, B and C respectively (p = 0.009). A statistically significant difference of acetabular erosion was observed in Group A compared to patients of Group C. CONCLUSIONS: Age constitutes a significant factor of acetabular wear after HA in the elderly. The higher rate of acetabular wear in patients <75 years suggests that THA is a more viable option, as HA is for patients >80 years old.

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Digital addiction (DA), an umbrella term referring to addiction to any type of digital media, such as the internet, smartphone, digital games, and social media, is a significant factor influencing students' academic achievement (AA). Many scholars have contributed to this line of research from around the world. Nevertheless, the literature lacks a holistic investigation of how the DA-AA research field evolved, which could guide future studies. The current study aims to address this void and conducts a combined bibliometric and science mapping analysis of research addressing the relationship between DA and AA. Data were retrieved from the WoS database, considered one of the optimal databases for such studies with its comprehensive coverage of quality journals. One hundred eighteen articles were included in the final dataset and were analyzed using the SciMAT software, which allowed analysis over three consecutive periods and yielded comparable results regarding the conceptual and thematic evolution of the DA-AA domain. The results indicated an increased research interest in the topic, especially during the last five years. The science mapping analysis showed that the most-studied types of addiction were smartphone addiction for the first two periods and social media addiction for the last. Research in the DA-AA domain which focused on understanding the addictive use of smartphones during the first period, evolved to address factors such as self-efficacy or life satisfaction leading to smartphone addiction and lower grades. During the third period, the number of factors addressed gained significant variety and covered family-related and personal factors.

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Although recent diagnostic and management methods have improved the prognosis of cervical epidural abscesses, morbidity and mortality remain significant. The purpose of our study is to define the clinical presentation of cervical spinal epidural abscess, to determine the early clinical outcome of surgical treatment, and to identify the most effective diagnostic and treatment approaches. Additionally, we analyzed studies regarding cervical epidural abscesses and performed a review of the literature. In this study, four patients with spinal epidural abscess were included. There were three men and one woman with a mean age of 53 years. Three patients presented with motor deficits, and one patient was diagnosed incidentally through spinal imaging. All the patients had fever, and blood cultures were positive. Staphylococcus aureus was the most common organism cultured from abscesses. All patients underwent a surgical procedure, and three patients recovered their normal neurological functions, but one remained with mild neurological disability that was resolved two years postoperatively. The mean follow-up period was 12 months, and no deaths occurred in this series. Furthermore, we identified 85 studies in the literature review and extracted data regarding the diagnosis and management of these patients. The timely detection and effective management of this condition are essential for minimizing its associated morbidity and mortality.

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Quadriceps tendon ruptures are common injuries, however isolated ruptures are rare. Particularly, reports for isolated vastus intermedius ruptures are very scarce. We present a case of a 62-years-old male patient who sustained a complete rupture of vastus intermedius tendon with a partial rupture of vastus medialis while rectus femoris tendon was intact, after a fall from standing height. Due to lag in extension, surgical treatment was performed, consisted of an end-to-end Krakow suture technique accompanied with two anchors placed on osseous attachment to the superior pole of the patella. A hinged knee brace locked in full extension was applied for 4 weeks. Gradual range of flexion was suggested after the 3rd postoperative week. Full range of motion was achieved in the 7th postoperative week.

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INTRODUCTION: Osteomyelitis is a bone inflammation that can be related to various infectious agents. As with any other type of inflammation, the prevailing symptoms and signs may include redness, swelling, pain, and heat. Fungal osteomyelitis is rare and usually found in immune-compromised patients. CASE PRESENTATION: A non-human immunodeficiency virus immunocompromised Greek female patient, 82 years old, visited the emergency department due to a 3 day pain located mainly over the left tibia's anterior surface, accompanied by swelling and redness. There was also a subcutaneous lesion of her left breast. Medical history revealed that the patient had an unmasked close contact with pigeons, a main host of the disease. Initial x-ray imaging showed an osteolytic area in the upper third of the tibial diaphysis. The patient was admitted and underwent a computed tomography-guided biopsy. The specimen revealed a Cryptococcus neoformans infection of the bone and the breast. She was treated with 400 mg fluconazole twice a day for 3 weeks while in hospital and 200 mg twice a day upon discharge for 9 months. After that, she underwent surgical debridement because of lasting local irritation. She was closely monitored in our outpatient office, and in her last visit, 1 year after the initial admission, inflammatory signs had regressed vastly. CONCLUSIONS: To our knowledge, this is the ninth cryptococcal osteomyelitis of the tibia to be recorded since 1974, and the most unusual finding was the bifocal nature of the infection, affecting both the tibia and the breast.

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Bone healing constitutes a complex process involving cellular and pathophysiological mechanisms. Despite progress in osteosynthesis techniques, fracture union continues to be challenging. In some cases, it is not ultimately achieved or is delayed relative to the expected time resulting in economic and social outcomes for the patient and the health system. In addition to surgical treatment, biophysical methods have been developed to assist in fracture healing used in combination or individually. Biophysical stimulation is a non-invasive therapy used in orthopedic practice to increase and enhance tissue's reparative and anabolic activities. This study reviewed the existing literature, including electromagnetic fields, ultrasound, laser, extracorporeal shockwave therapy, and electrical stimulation, and revealed the efficacy of biophysical stimulation for bone healing. This study aims to define if these methods are helpful, especially in cases of non-union. Biophysical stimulation requires care and precision in use to ensure the success expected of it by physicians and patients.

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Avulsion fractures of the lesser or greater trochanter or the iliac crest are uncommon injuries in adolescents. The anterior superior iliac spine, ischium, and anterior inferior iliac spine are the most frequently affected sites. We report a rare case of a 14-year-old boy who sustained an avulsion fracture of the lesser trochanter while playing soccer. No malignancy or associated metabolic bone disease was detected. Conservative treatment was suggested, consisting of a non-weight-bearing period and analgesics. Routine follow-up was performed at one, three, and six months after the injury. Radiographs were utilized to confirm fracture healing. Full recovery and return to a pre-injury functional level were observed at six months. Within this timeframe, a thorough literature review is performed.

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Tibial plafond fractures constitute one of the most challenging fracture types while they are commonly associated with soft tissue damage and severe bone comminution. We present the clinical outcomes of screw fixation as the initial and definitive treatment of an isolated uncommon fracture of the anterior margin of the distal tibia. This is a case of an uncommon type of fracture of the distal tibia. The patient underwent a successful screw fixation and the fracture healed in three months. There was no bone and soft tissue infection. Sixteen months after the injury, an excellent function of the ankle joint was noted. Although fractures of the anterior margin of the distal tibia are uncommon high-energy injuries, uneventful healing with very good functional results can be achieved with screw fixation as the initial and definitive treatment.

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Isolated complete ruptures of the distal biceps femoris tendon are rare injuries. To our knowledge, very few cases have been reported in English literature. We present the case of a young man who complained of pain on the posterolateral corner of the knee after a motor vehicle accident. Clinical examination and MRI findings revealed a complete rupture at the musculotendinous junction of distal biceps femoris tendon. We describe the surgical treatment performed, and the clinical outcome.

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This study explored certain popular educational apps' vital characteristics and potential profiles (n1 = 50) for kindergarten kids. The profile analysis involved a categorization ascended from an evaluation process conducted by pre-service early childhood teachers' (n2 = 295) at the University of Crete, Greece, using a new instrument, validated in the present research, the ETEA-2 scale. The categorization criteria were the five dimensions of the ETEA-2: Learning, Suitability, Usability, Security, and Parental Control. The classification based on Latent Class Analysis led to three apps' profiles: Cluster/profile 1 includes apps that have high values in Learning, Usability, Suitability, and medium Parental Control and Security; Cluster/Profile 2 includes apps with medium Learning, Usability, Suitability, but low Parental Control and High Security; Cluster/Profile 3 includes apps with medium Learning, Usability, Suitability, but low Parental Control and low Security. This profile scheme is an indicative categorization summarizing the crucial features that popular apps possess and can help parents and/or educators' decision-making on choosing the desirable application for their kids. Moreover, from an independent evaluation of these specific fifty apps sought on the internet, the members of Cluster2/Profile 2 were the most popular and preferable, as suggested by the number of downloads. This profile is distinguished for the security dimension.

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This study compares the STEM Pedagogical Content Knowledge of Greek and Turkish preschool teachers. The present research is a comparative descriptive study that aims to determine the STEM Pedagogical Content Knowledge of preschool teachers from Greece and Turkey. A descriptive survey model, a method used in quantitative research, was used as this study's primary research method. The STEM Pedagogical Content Knowledge Scale (STEMPCK) was used in this study. Six hundred sixty-nine preschool teachers - 104 Greek and 565 Turkish teachers - participated in this study. The STEMPCK Scale's construct validity and reliability were tested using this study's data set, which was found to be both valid and reliable. No significant difference was found between the STEMPCK scores of Greek and Turkish preschool teachers. The significant differentiation of STEMPCK scores based on whether the teachers had received any STEM training is discussed in light of the relevant literature. This study determines and compares STEMPCK among preschool teachers from disparate countries such as Greece and Turkey and is expected to contribute to the literature.

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The current study uses "digital addiction" as an umbrella term to refer to addiction to the Internet, social media, smartphones, digital devices, video games, or similar digital technologies. The study aims to investigate the scientific landscape of the digital addiction research field through combining bibliometric and science mapping analysis and to facilitate insight into the development and evolution of this knowledge base. Data for the analysis were extracted from the Scopus database, which covers a wide range of journal articles, with 429 articles addressing digital addiction included in the analysis. The science mapping analysis was performed over three consecutive time periods using SciMAT software to observe the thematic evolution. The results indicated that addictive behavior was the most significant theme across the three time periods. Cross-sectional studies addressing the risk factors or outcomes of addiction among adults and different sexes were prevalent during the first period (1997-2012), while interest moved to the addictive behavior of adolescents and students during the second period (2013-2017). Research during the third period (2018-2022) was driven by smartphone and social media addiction, and resilience as a preventive factor garnered more research interest than previously studied risk factors, which may indicate a perspective change by researchers. Implications are suggested for future investigations of digital addiction.

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Traumatic spinal cord injury (SCI) provokes the onset of an intricate pathological process. Initial primary injury ruptures local micro-neuro-vascularcomplex triggering the commencement of multi-factorial secondary sequences which exert significant influence on neurological deterioration progress. Stimulating by local ischemia, neovascularization pathways emerge to provide neuroprotection and improve functional recovery. Although angiogenetic processes are prompted, newly formed vascular system is frequently inadequate to distribute sufficient blood supply and improve axonal recovery. Several treatment interventions have been endeavored to achieve the optimal conditions in SCI microenvironment, enhancing angiogenesis and improve functional recovery. In this study we review the revascularization pathogenesis and importance within the secondary processes and condense the proangiogenic influence of several angiogenetic-targeted treatment interventions.