The DISTAL radioulnar joint (DRUJ) prostheses have been available for many years and despite their superior outcomes compared to conventional DRUJ reconstructions in both short and long-term follow-ups, they have not become as popular as common hip and knee prostheses. In the current review article, at the first step, we discussed the applied anatomy and biomechanics of the DRUJ, and secondly, we classified DRUJ prostheses according to available literature, and reviewed different types of prostheses with their outcomes. Finally we proposed simple guidelines to help the surgeon to choose the appropriate DRUJ prosthesis.

Background: The purpose of the current study was to compare the clinical and radiographic outcomes of DISTAL radius volar T plate and pre-contoured locking plate in DISTAL clavicle fracture. Methods: A total of 60 patients with Neer 2b DISTAL clavicle fracture were included in this study and undergone open reduction and internal fixation between March 2019 and November 2020 via two different plates,DISTAL radius volar T plate and DISTAL clavicle pre-contoured locking plate. All patients were followed at least two years post-operative. Union rate, time to union, need to device removal, and Constant-Murley score were assessed among them. Results: In all patients, the bony union was achieved without wound-related complications. The mean time to union in DISTAL radius volar T plate group was 3. 30. 6 and 3. 60. 7 in the pre-contoured locking plate (p =0. 14). The mean Constant-Murley score was 93. 12. 2 and 92. 1 2. 5 in T plate group and pre-contoured plate group, respectively (p =0. 09). Five cases with T plate and eight cases with pre-contoured plated were candidates for device removal (p =0. 53). Conclusion: DISTAL radius volar T plate could be a reasonable choice to manage Neer 2b DISTAL clavicle fracture as it restores functional range of motion with excellent bone union and without the necessity of device removal, besides its economical price

Boari flap construction and ureteroneocystostomy is an appropriate technique for repairing the injuries in the DISTAL ureter that result in shortening of the ureter. We report the use of laparoscopic DISTAL ureterectomy consisting resection of the bladder cuff and Boari flap construction in a patient with low-grade transitional cell carcinoma of the DISTAL ureter.

Introduction: DISTAL femur fractures are a common fracture seen in both high and low-energy traumas in young and elderly patients. The standard of care in healthy, mobile, younger patients remains open reduction and internal fixation (ORIF) through various fixation devices. However, the standard of care for comorbid and elderly patients remains unclear. In these patients, rates of nonunion vary between 6% and 20%, requiring revision surgery. Our study sought to identify patients who have gone endoprosthesis conversion to a DISTAL femur replacement following failed ORIF. Methods: This descriptive study includes a total of eight patients who underwent a revision DISTAL femoral replacement (DFR) following failure of primary DISTAL femur ORIF and data were gathered through chart review. Patient comorbidities, demographic characteristics, hospital disposition, complications, and mortality were collected and described. Results: The average age of this cohort was 52. 1 years, with 6 being female, and with a follow-up mean of 3. 02 years. The most common medical comorbidities present in these patients at the time of ORIF were diabetes, hypertension, obesity, smoking, and renal insufficiency. 87. 5% of patients were able to tolerate weight bearing following DFR conversion, compared to 62. 5% tolerating weight bearing before revision. Complications requiring revision surgery occurred in 3/8 patients, which included: aseptic loosening, prosthetic joint infection, and patellar maltracking. Conclusion: DFR in a revision setting following acute DISTAL femur ORIF can be an acceptable treatment options with outcomes similar to primary DFR. Further investigation is warranted to determine optimal timing and indications for primary DFR in a fracture setting.

The article by Basiri and coworkers details their experience with a patient with low-grade ureteral cancer on whom they performed laparoscopic DISTAL ureterectomy with a subsequent reconstruction using the Boari flap.(1) The present article helps to add evidence regarding feasibility and safety (technical and functional) of pure laparoscopic partial ureterectomy. Although it is evident that open nephroureterectomy has been standardized and can, to date, guarantee acceptable perioperative morbidity, allowing reproducible long-term oncologic results for ureteral cancer, it appears from their experience that when the candidates for surgery are appropriately selected and there is a dedicated surgical team for laparoscopy, these goals are achievable. Roupret and colleagues retrospectively reviewed 6 patients with lowgrade upper urinary tract transitional cell carcinoma treated laparoscopically, concluding that laparoscopic DISTAL ureterectomy with reimplantation is technically possible for low-risklow-grade upper urinary tract transitional cell carcinoma.(2) At this point, the exact role of laparoscopic partial ureterectomy is still under careful evaluation, as data from the literature are limited, especially regarding important issues such as long-term results and the feasibility of urinary reconstruction, which remains technically challenging.(3) Their report is noteworthy since they give us information about subsequent laparoscopic Boari flap, detailing important surgical steps. Apparently, initial goal will be to provide the same outcome as in a standard open procedure with the hope that in the future, as we gain more experience, learning curve will provide an improvement in terms of less blood loss and a decrease in length of hospital stay.

Background: Focal fibrocartilaginous dysplasia (FFCD) is a benign lesion and has been reported as a cause of tibia vara in proximal tibia and DISTAL of the femur. It is rare in upper extremity and few cases have been reported in the ulna and radius. Objectives: The aim of the study was to review and report the clinical course, radiographic presentation and treatment results of three cases of FFCD in the DISTAL radius. Patients and Methods: We reviewed the medical records, imaging files, intraoperative anatomical findings and treatment complications of three cases of FFCD in DISTAL radius. All patients underwent tethering fibrotic band resection with lengthening of extensor tendons in one case and DISTAL radius corrective osteotomy in another one. Results: All three patients were male with a mean age of 21. 3 (11-36) months. The mean follow-up period was 28 months. Clinical and radiographic examinations in patients who underwent tethering band resection without osteotomy showed considerable remodeling. Nonunion, multiple surgeries and deformity were the complications in patient who received osteotomy as a part of treatment. Conclusions: The natural history of DISTAL radius FFCD is not clear. Until receiving enough evidences regarding the natural history of this rare lesion, we can recommend the least invasive treatment for the lesion, which is the resection of the fibrous band.

Introduction: Haemophilia is one of the hereditary recessive diseases linked to sex-induced coagulation disorder and is characterized by bleeding episodes. This report presents a rare involvement of the DISTAL phalanx hemophilic pseudotumor. Case Presentation: A 21-year-old man was crushed by a closing door 18 months before. The DISTAL phalanx was fractured, and a large hematoma developed under the nail plate, which separated the nail plate from its bed. Eighteen months after the injury, plain radiographs demonstrated an expansile lesion with extensive destruction of the DISTAL phalanx. Regarding the patient’, s history and abnormal clotting tests, the development of a hemophilic pseudotumor was considered at the DISTAL phalanx due to the enlarging nature of the coagulum, which induced compression and pressure necrosis on the adjacent bone and structures. Conclusions: Hemophilic pseudotumors in the small bones are rarely reported. After a minor traumatic injury in hand, exact management and coagulopathy control are important to prevent further complications.