Congenital pseudoarthrosis of the clavicle is a rare condition. It is diagnosed at an early age by a defect in the supraclavicular fossa and the absence of a central zone portion of the clavicle in the X-ray image. Origins of the condition are not well understood nor are the best age for, and need for treatment, since it is asymptomatic in many cases. If the clinical presentation is neurovascular compression or shoulder dysfunction, reconstruction of the clavicle with a plate and bone graft from the iliac crest seems to be the most commonly accepted option.

Our case corresponds to a girl aged 9 years with an established diagnosis and a dysfunctional clinical history of the shoulder, as well as a progressively worsening esthetic defect due to the progression of the malformation. The patient was treated using a 2.7 mm mandibular reconstruction plate shaped to resemble an adult clavicle plate with an iliac crest graft. Evolution after treatment was favorable.

Currently, mandibular reconstruction plates are broadly available for treatment in orthopedic and traumatology surgery departments, mainly in pediatric surgery, since they provide the same advantages as adult reconstruction plates but with lower profiles. Their main advantage lies in the availability of support materials for three-dimensional modeling systems allowing for the plate to be adapted to the particular anatomical site, which in this case would be the clavicle.

In this paper we have attempted at proposing a new classification of scapholunate instability that in our opinion can be used in majority of cases with scapholunate complex injury. Incomplete and isolated scapholunate interosseous ligament lesions are of no clinical relevance to SL dissociation or carpal instability. We have concluded that the new classification can be used in all types of SLIL lesions and we are convinced that it will help in choosing the right type of surgery.

Study Design: Repeated Measures.

Objectives: To determine the short term impact of cold water immersion on sensory and vascular functions in patients with Distal Radius Fracture (DRF) and compare responses in the injured and uninjured hands.

Background: Cold exposure is used to assess neurovascular function. Cold is also used as therapeutic agent to reduce pain and swelling. There is a scarcity of trials that have looked at the impact of cold exposure in patients with DRF.

Methods: Twenty patients with DRF, aged 18 to 65 yrs. were recruited after cast removal. All patients underwent Immersion in Cold water Evaluation (ICE) which consisted of 5 min of hand immersion in water at 12°C. Skin Blood Flow (SBF) in hands, Skin Temperature (S Temp.) in index and little fingers and sensory Perception Thresholds (sPT) at 2000Hz (for Aβ fiber) and 5 Hz (for C fiber) were obtained from ring finger, before ICE, immediately after (0 min, 1 min) and 10 min later. Differences were analyzed using repeated measures.

Results: In the DRF hand, SBF increased immediately (Mean Difference = -42.2 A.U), at 1 min (-35 A.U) and 10 min after ICE (-1 A.U). Skin Temp. In index and little fingers decreased immediately after ICE (9.9°C and 9.1° C) and did not return to baseline by 10 min (4°C and 4.1°C). ICE had no effect on sPT at 5 Hz (p>0.05). There was no difference between the DRF and uninjured hand on all measures(p>0.05) except for the sPT at 2000Hz, which remained high on the DRF side for up to 10 min (-1.8 m. A).

Conclusion: Normal cold responses consistent with ‘hunting reaction’ were observed after ICE in both hands. Aβ fibers on DRF side became less sensitive after ICE. These findings suggest that a brief immersion in cold water does not produce any adverse events associated with cold exposure.

We present a case of a 38-year-old right-handed male physical worker with traumatic divergent dislocation of both the scaphoid and lunate bones. He was referred to our ward five days post-accident. After open reduction, he was treated with a novel technique of free tendon reconstruction of the scapholunate ligament complex and internal fixation with K-wires through the dorsal approach. At a 18-month-follow up the patient was pain-free, had a good wrist function with no evidence of avascular necrosis of the scaphoid nor lunate, and was satisfied with the general result.

Today orthopedic surgery is becoming progressively interesting. The rapid stride related to excellence of implants, technologies and techniques