Introduction: AVULSION of extensor carpi radialis brevis (ECRB) insertion from dorsal base of the third metacarpal with or withoutbony chips is rarely reported. Case Presentation: The current study reported the case of a young male that after falling down the stairs, referred to emergencyroomwith dorsal wrist painandweakness in wrist extension, andthe lateral X-rayshowedabonefragment of dorsal capitate, but thecomputed tomography (CT) scan proved that the fragment was detached from the third metacarpal base. Then, with the diagnosisof ECRB AVULSION FRACTURE of its metacarpal base, the patient was operated and the fragment and accompanying tendon were fixedwith 3 k-wires to its anatomic location and after 6 weeks of casting the pins were removed and at 6 months post-operation the rangeof motion and strength were the same as those of contralateral side. Conclusions: ECRB AVULSION is a rare condition, and its diagnosis can be difficult, and it should be in differential diagnosis of wristtrauma with tenderness on the base of the third metacarpal bone.

Background: Only 3% of all proximal tibial FRACTUREs result in an AVULSION FRACTURE of the tibial tuberosity. It is often seen in youngsters between the ages of 3 and 6 and is less frequent after puberty. Case Report: A 15-year-old boy was presented with severe left knee pain following a high jump. X-ray and computed tomography (CT) scan showed a tibial tuberosity FRACTURE with joint surface involvement. The damaged part was fixed with a 4.5mm cannulated screw and washer, reinforced with 2 SwiveLock anchors. In the sixth week, full weight bearing and full range of motion (ROM) were obtained. Conclusion: The primary objective in managing tibial tubercle FRACTUREs is the restoration of both the extensor mechanism and the integrity of the joint surface in cases where they have been compromised.

Background: Ulnar collateral ligament(UCL) FRACTURE-AVULSION of the thumb which involves small osseous fragments is among common injuries to the thumb metacarpophalangeal (MCP) joint. Methods: This case series was conducted on 11 patients (9 males and 2 females) with a mean age of 25. 4± 4. 8 years with acute traumatic UCL FRACTURE-AVULSION with instability and Stener Lesion. A low-profile 2-mm stainless steel hook plate with a 2-mm screw was used for the internal fixation. Immobilization was performed for 10 days. Range of motion movements (ROM), grip power, and pinch strength were measured after three months. At the end of the follow-up period, functional outcomes were determined by the visual analog scale (VAS), and Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH). Results: The mean follow-up period was reported as 12. 4± 2. 3 months. the union of avulsed small osseous fragments occurred at the end of the three-month follow-up. A number of 10 patients were treated by one hole 2-mm plate with a screw and a mean VAS score of 22. 5± 2. 4, while a female patient had more severe pain with a mean score of 45. This patient complained about the irritation of the plate, especially in the thumb grip. The mean Quick DASH score was 9. 6± 1. 4. The postoperative ROM was similar to that of the other side. Grip power and pinch strength were lower in the treated thumb, as compared to that in the opposite side; nonetheless, the difference was not statistically significant. Conclusion: As evidenced by the obtained results, it can be concluded that the hook plate technique is a strong fixation method for thumb UCL FRACTURE-AVULSION, raising the possibility of earlier joint movements and rapid recovery; nevertheless, in some cases, it can reduce efficiency and induce painful grip.

Background: The lateral epicondyle FRACTURE in children is a rare condition and only few cases have been reported in the literature. The isolated FRACTURE without concomitant FRACTURE/dislocation is even more uncommon, with unclear outcome and treatment approach. Case Report: We present a case of an 11-year-old boy with restricted right elbow range of motion (ROM) after falling. The radiograph and computed tomography (CT) scan showed a displaced lateral epicondyle FRACTURE without accompanying FRACTURE or dislocation. Due to the stability of the joint and patient’ s compliance, a closed reduction with Kirschner wires (K-wires) was selected for treatment. Follow-up results were satisfactory and showed no complications. Conclusion: Closed reduction of dislocated lateral epicondyle FRACTURE in children can result in acceptable outcomes.

Statement of Problem: In a previous study it was reported that a durable resin-ceramic tensile bond could be obtained by an appropriate silane application without the need for HF acid etching the ceramic surface. Evaluation of the appropriate application of silane by other test methods seems to be necessary.Purpose: The purpose of this study was to compare the interfacial FRACTURE toughness of smooth and roughened ceramic surfaces bonded with a luting resin.Materials and Methods: Ceramic discs of 10 mm in diameter and 2 mm in thickness were prepared.Four different surface preparations (n=10) were carried out consisting of (1) ceramic surface polished to a 1µm finish, (2) gritblasted with 50µm alumina, (3) etched with 10% HF for 2 min, and (4) gritblasted and etched. The ceramic discs were then embedded in PMMA resin. For the adhesive area, the discs were masked with Teflon tapes. A circular hole with diameter of 3 mm and chevron-shaped with a 90° angle was punched into a piece of Teflon tape. The exposed ceramic surfaces were treated by an optimised silane treatment followed by an unfilled resin and then a luting resin cylinder of 4mm in diameter and 11 mm in length was built. Specimens were stored in two different storage conditions: (A): Distilled water at 37°C for 24 hours and (B): Distilled water at 37°C for 30 days. The interfacial FRACTURE toughness (GIC) was measured at a cross-head speed of 1 mm/min. The mode of failure was examined under a stereo-zoom microscope and FRACTURE surfaces were examined under Scanning Electron Microscope.Results: The mean interfacial FRACTURE toughness values were; Group A: 1) 317.1±114.8, 2) 304.5±109.2, 3) 364.5±169.8, and 4) 379.4±127.8 J/m2±SD. Group B: 1) 255.6±134.4, 2) 648.0±185.1, 3) 629.3±182.6 and 4) 639.9 ±489.0 J/m2±SD. One way Analysis of Variance showed that there was no statistically significant difference in the mean interfacial FRACTURE toughness for groups A1-A4 (P>0.05). However, the mean interfacial FRACTURE toughness for group B1 was significantly different from that for groups B2, B3 and B4 (P<0.05). Independent-ٍٍٍSamples T-Test results showed that there was a significant increase in the GIC mean value for groups B2 and B3 after 30 days water storage (P<0.05). The modes of failure were predominantly interfacial or cohesive within the resin.Conclusions: The FRACTURE toughness test method used in this study would be appropriate for analysis of the adhesive zone of resin-ceramic systems. From the results, it can be concluded that micro-mechanical retention by gritblasting the ceramic surfaces could be sufficient with no need for HF acid etching the ceramic surfaces when an appropriate silane application procedure is used.

Background & Aim: The prevalence of avulsed teeth is high and wrong treatment can complicate dental problems, so emergency treatment and making the right decision is crucial. This study was going to assess knowledge of general dentists regarding this issue in order to proper orientation in future education. Material & Methods: This descriptive-cross sectional research was done on 300 dentists who have participated in operative and oral disease congress in 2018. Volunteers answered to 11 multiple choice questions in 4 stages of very good, good, fair, poor. Dentists whose grade were in range of very good to good were considered as acceptable score. Dentists whose grade were in range of fair to poor, they were considered as unacceptable score. Findings were evaluated by chi-square analysis. Results: From 300 dentists who were tested, 33% of them had acceptable point and 67% had unacceptable point. The most difficulty they had was knowing the appropriate time to start root canal treatment in mature teeth (76/7%). Insufficient knowledge was significantly higher in more experienced dentist (P=0/003) and dentists who had no experience about treatment of traumatic teeth (P < 0/00). Conclusion: It seems the amount of knowledge for treatment of avulsed teeth is low and concerning among general dentists especially those graduated from university for a long time ago, the amount of knowledge is decreased.

Background: The posterior cruciate ligament (PCL) presents commonly as AVULSION FRACTUREs from the tibial attachment site. Isolated tears of the PCL can be caused by a fall on the flexed knee or dashboard injury in road traffic accident. Such a mechanism (the upper tibia driven posteriorly with the knee flexed) may produce PCL disruption as the only clinically detectable instability. For the PCL AVULSION FRACTUREs fixation, there are various methods available like closed reduction and internal fixation (CRIF), open reduction and internal fixation (ORIF), and arthroscopic fixation. This study was performed to assess the result of PCL AVULSION FRACTURE managed with ORIF with cannulated cancellous screw. Methods: We performed ORIF using cannulated cancellous screws with the posterior approach in 11 patients with isolated PCL tibial AVULSION injuries. The minimum follow-up period was 6 months. The results were assessed radiologically and clinically. The spectrum of outcomes following PCL tibial AVULSION FRACTURE were measure using the Lysholm knee scoring system and range of motion (ROM) of the knee joint. Results: 63. 6, 27. 3, and 9. 1 percent of the cases had excellent, good, and moderate FRACTURE healing, respectively. Conclusion: PCL tibial AVULSION FRACTUREs managed with open reduction with cannulated cancellous screw fixation yields good functional outcome with less complications.

We report a case of lateral tibia plateau FRACTURE whose PCL AVULSION was missed in primary radiographic studies. He had also reversed type of Segond FRACTURE in medial tibia plateau. After open reduction-internal fixation of plateau FRACTURE, the posterior tibia instability disclosed the PCL AVULSION. Patient didn’t accept reoperation for PCL AVULSION. We confirm the primary reports about association of reverse Segond FRACTURE with PCL injuries. This association has not been previously reported in presence of tibia plateau FRACTURE.