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Flail chest is now usually treated by conservative methods and surgical fixation remains indicated in selected cases. Different techniques can be used for fixation. The aim of this paper is to present a case in which Judet and Sanchez-Loret plates were employed and to discuss the usefulness of this traditional technique.

A 79-year-old woman was admitted for left thoracic trauma with severe antero-lateral flail chest. She was affected by COPD with chronic respiratory failure, ischemic heart disease, autoimmune thrombocytopenia treated on chronic steroid therapy and severe osteoporosis. CT-scan detected multiple rib fractures, left hemothorax and lung contusions. An initial conservative treatment of flail chest involved compressive bandage and then internal pneumatic stabilization in ICU, but it failed. The patient underwent successful surgical treatment of the flail chest by fixation of the anterior fractures from the second to the eight rib. Judet and Sanchez-Lloret plates were used. A bilateral pneumonia developed during the rehabilitation period and the patient died two months after operation.

Judet and Sanchez-Lloret plates represent a traditional technique for fixation of flail chest. This technique is less and less used and progressively replaced by newer materials, especially titanium plates with screws or intramedullary struts. Our patient had multiple comorbidities and a very fragile bones that advised against use of screws or intramedullary struts.

Judet and Sanchez-Lloret plates can be still considered a useful tool for the fixation of flail chest in cases of thin and fragile bones.

Judet and Sanchez-Lloret plates can be still considered a useful tool for the fixation of flail chest in cases of thin and fragile bones.

Bilateral hip dislocation is a rare injury. Bilateral asymmetrical fracture-dislocation is an even rarer type of injury. Apart from its rarity, prompt diagnosis of this condition and emergent treatment is necessary to prevent complications.

Here we present a 32 years old patient admitted with bilateral asymmetrical dislocation of hips following high energy motor traffic accident.

Computed tomography revealed bilateral asymmetrical hip dislocations (Left hip anterior dislocation and the right hip posterior dislocation) with a small femoral head fracture on the right side and a large Pipkin I fracture on the left side.

Closed reduction of bilateral hips failed under general anaesthesia and rendered immediate open reduction of both hips through different approaches and fixation of the osteochondral fragment. Rehabilitation was challenging as the patient has been recovering from a head injury and bilateral lower limb involvement. The patient is under follow-up for any evidence of avascular necrosis of the femoral heads and myositis ossificans.

Bilateral irreducible asymmetrical fracture-dislocations of the hip joint are rarest of its kind. Pre-operative emergent computed tomography is very helpful to identify fracture-dislocations and help in the planning of osteosynthesis. Preparation for open reduction while undergoing a close reduction is essential.

Bilateral irreducible asymmetrical fracture-dislocations of the hip joint are rarest of its kind. Pre-operative emergent computed tomography is very helpful to identify fracture-dislocations and help in the planning of osteosynthesis. selleck chemicals Preparation for open reduction while undergoing a close reduction is essential.

Appendiceal mucocele is a rare obstructive dilatation of the appendix caused by intraluminal accumulation of mucoid material. Having no typical clinical picture, patients presenting with lower right quadrant abdominal pain are sometimes mistaken for acute appendicitis. An untreated mucocele may progress leading to high mortality.

A 47-year-old female presented with dull pain in the right lower abdomen, associated with generalized weakness and nausea since 6 months. Other than mild tenderness over the right iliac fossa. Physical and laboratory examination was insignificant. Abdominal sonography was doubtful between appendicular abscess and mucocele appendix. Dual contrast CT scan of abdomen was highly suggestive of an appendicular mucocele.

The patient had a vertical midline incision exploratory laparotomy done and a cystic mass measuring 7 × 4 × 4 cm

was found arising from the body of appendix. With suspicion of malignancy because of size, right hemicolectomy with ileotransverse anastomosis was done. Histopathological examination showed features of low grade appendiceal mucinous neoplasm.

Pre-operative diagnosis of appendicular mucocele is difficult, nevertheless, it is important for the selection of the appropriate surgical procedure in order to prevent intra-operative complications and early surgical intervention has excellent long-term prognosis.

Pre-operative diagnosis of appendicular mucocele is difficult, nevertheless, it is important for the selection of the appropriate surgical procedure in order to prevent intra-operative complications and early surgical intervention has excellent long-term prognosis.

Long-term use of minocycline at high doses is associated with hyperpigmentation with multiple sites of involvement. While the cutaneous organs and the oral cavity are most commonly affected, bone discoloration is a rare entity.

A 19-year-old male patient with a history of acne vulgaris and intermittent treatment with high dose minocycline for three years presented with recurrent anterior cruciate ligament (ACL) tear. During arthroscopic surgery, however, hyperpigmentation of the femur and synovium was observed. Abnormal tissue was biopsied and confirmed through histopathological examination to contain melanin-related minocycline pigmentation. Revision surgery was re-scheduled with no intraoperative complications and excellent long-term clinical outcomes.

There are several possible causes of hyperpigmentation, including hemosiderin deposition, infection, aseptic necrosis, demineralization, and metastatic disease. Black bone disease, caused by minocycline-induced hyperpigmentation, is rare. While the appearance is grossly abnormal in black bone disease, there has been no evidence suggesting that tissue integrity is compromised.

This case confirms that hyperpigmentation does not affect bone integrity and that surgical procedures can be performed safely. Knowing the adverse effects of minocycline administration could reduce inappropriate postponement of surgical procedures, thereby saving time and resources.

This case confirms that hyperpigmentation does not affect bone integrity and that surgical procedures can be performed safely. Knowing the adverse effects of minocycline administration could reduce inappropriate postponement of surgical procedures, thereby saving time and resources.