Introduction: In order to manage the high number of patients with upper limb fractures that require surgical treat‐ ment, it is essential to have a well‐defined structure, in order to promote an adequate response to each type of orthope‐ dic pathology and to fit the reality of all other pathologies. In order to reduce hospital stays and promote better treat‐ ment of patients, our service promoted the deferred treatment of numerous pathologies in the area of traumatology. The aim of the study was to assess the type of pathologies, patient characteristics, degree of satisfaction and pain con‐ trol of patients with upper limb fractures, treated in a deferred manner in our hospital, in 2020, a severely marked year by the global pandemic context by COVID‐19. Methods: We developed a retrospective observational study with the evaluation of 71 patients treated in a deferred manner and who waited at their home for a call for surgical treatment. Results: We recorded an average age of 49 years (14‐71), with 40 males (56.3%). The most frequent diagnoses were distal radius fracture (36.6%; n=26), metacarpal fracture (19.7%, n=14) and phalangeal fractures (11.3%, n=8). The average time from coming to the emergency department until definitive surgical treatment was 7 days and the most frequent anesthetic risk was ASA 2 (in 64.6%). After a telephone call made in May 2021, it was possible to assess 36 of the 65 patients operated, with 89% reporting satisfaction with the possibility of waiting for surgical treatment at home and 92% reporting recommending this type of strategy. About pain control at home, while waiting for surgery, applying the VAS score: the mean was 1.94 (0 – 9). We applied the score (QuickDASH) to all patients with distal radius fractures included in the group, with a mean of 18.2 points (0 – 65.9; SD 18.65). Conclusion: Deferred treatment of upper limb traumatic pathology was satisfactory for patients, who recommended the treatment and allowed pain control throughout the clinical course.

Introduction: The article presents a descriptive analysis of tennis injuries among athletes participating in the Porto Open, an outside, hard court tournament encompassed within the ATP 125 category in the tennis circuit. This study aims to provide insights into injury patterns, its prevalence, and potential risk factors. Methods: We conducted a retrospective observational study to analyze tennis‐related injuries among athletes participating in the Porto Open 2023.   Results:The study included 50 male athletes from 20 different nationalities, with Portuguese (n=13; 26%) and French (n=12; 24%) nationalities being the most frequent. Conclusion: Through an examination of the different types of injuries, affected anatomical regions, and injury mechanisms, this analysis aims to provide pertinent insights to enhance injury prevention strategies and promote the overall well‐being of athletes.

Introduction: Our purpose was to evaluate the differences in metaglene positioning in deltopectoral and anterosuperior approach in total reverse shoulder arthroplasty. Methods: Patients who underwent total reverse shoulder arthroplasty for degenerative or traumatic pathology within a 10‐year period were selected. Two groups were created: group 1, deltopectoral approach; group 2, anterosuperior approach. The metaglene positioning was evaluated through anteroposterior radiography by the methods of Lévigne et al and Maurer et al. Statistical study was performed by Mann‐Whitney U‐test. Results: A total of 145 patients were admitted, 33 submited to deltopectoral approach and 112 anterosuperior. Surgery for degenerative pathology occurred in 106, for trauma in 39. The overall median age was 70 years (64‐75), in degenerative pathology 68 years (62‐72), in trauma 76 years (69‐81). Overhang showed no significant difference (p=0.882), 5.1±2.2 mm group 1 and 5.4±2 mm group 2. The tilt showed significant difference (p=0.005), 103.2±11o group 1 and 96.8±9.7o group 2. The beta angle showed significant difference (p=0.001), 81.4±7.3o group 1 and 74.6±8.6o group 2. When comparing traumatic and degenerative pathology, the overhang did not show significant difference (p=0.06), 5.8±1.6 mm traumatic pathology and 5.1±2.2 mm degenerative pathology. The tilt was signifi‐ cantly different (p<0.001), 104.8±10° traumatic pathology and 95.8±9.4o degenerative pathology. The beta angle was significantly different (zc wq <0.001), 82.5±6.6o traumatic pathology and 73.8±8.4o degenerative pathology. Conclusion: The approaches did not differ in the craniocaudal positioning of the metaglene, but tilt was lower in the anterosuperior approach and may correlate with future complications. Patients who had surgery for traumatic pathology showed greater inferior tilt of the metaglene.

Groin pain is a common injury in professional footbal and widely acknowledged as a complex medical issue. Iliopsoas pathology stands as the second‐most common cause of athletic groin injury, yet iliopsoas traumatic muscle injuries are infrequent and inadequately documented in the literature. This case report outlines a grade 2 myotendinous junction injury of the iliopsoas in a football player competing in the Portuguese First League, combining an early rehabilitation protocol with ultrasound‐guided hematoma evacuation and LP‐PRP injection, enabling return to play 23 days after injury with no reported re‐injury over a period exceeding 12 months.

Hip fracture‐dislocations in children and adolescents are rare and severe injuries. Surgical treatment is urgent and, even with adequate and timely treatment, the complication rate is high. The most common complication is osteonecrosis of the femoral head and the main risk factors include fracture type and displacement. A 13‐year‐old boy presented after a high‐energy trauma, having sustained a fracture‐dislocation of the left hip, with complete separation of the proximal femoral epiphysis, incarcerated in a fracture of the acetabulum. He underwent surgery with open reduction of the femoral epiphysis and fixation with two Kirschener wires, hip joint reduction, open reduction of the acetabulum fracture and internal fixation with a reconstruction plate. The immediate postoperative evolution was favorable, but at 10 months radiological signs of osteonecrosis of the femoral head were already visible. Clinically, 5 years after the accident, he maintains good function, with a Non Arthritic Hip Score of 80/100. Pediatric hip fracture‐dislocation is a therapeutic challenge and has a poor prognosis. In addition to timely and appropriate treatment, it is essential to manage the expectations of patients and their families.

Introduction: Stemless shoulder prostheses were introduced as a new shoulder replacement system designed to reduce the potential risks associated with the humeral component and achieve better functional results by lowering the surgical complication rates. This systematic review aims to assess the latest available published findings regarding stemless shoulder replacement. Methods: A search in PubMed, Scopus, and Clarivate Web of Science databases was performed, selecting publications that reported the constant score for functional assessment in patients submitted to shoulder arthroplasty with a stem­ less prosthesis. Results: Three types of shoulder arthroplasties were identified, with a constant score average between 63.4% and 73.3% and with a revision rate average between 2.8% and 3.4%. These results were similar among studies with differ­ ent follow­up duration: 6 months to 9 years. Conclusion: Shoulder arthroplasty with stemless prosthesis is very promising with favourable results in the short and medium­terms regarding improvement in the shoulder function, pain relief and patient satisfaction and low rates of complications.

Introduction: Periprosthetic hip fractures (PHF) represent an important complication after hip arthroplasty. The management of Vancouver B1 fractures remains elusive. While most stems may present radiographically as stable, stem fixation may in fact be compromised. Choosing plate osteosynthesis as a treatment in this type of fractures, trusting radiographic studies alone may lead to implant failure. Methods: We reviewed 10 years of our institution ́s clinical records (2011­2021) and found a total of 161 PHF. Twenty five cases of B1 periprosthetic fractures were included in our study, after their presenting radiographs were blindly reviewed. All PHFs were submitted to arthrotomy, dislocation and stability assessment. Stable implants were submitted to plate osteosynthesis, and unstable implants were submitted to revision arthroplasty. Demographic information, duration of surgery, blood loss, inpatient complications, functional outcomes, and outpatient outcomes and complications were recorded. Mean time of follow­up was 47 months. Results: Seventy­two percent of of initially classified B1 type fractures presented with a loose stem and required revision arthroplasty. Time until supported ambulation was lower in the revision arthroplasty group (p= 0.01) while surgical time, blood loss after surgery, and inpatient complications presented similar results in both groups. Negative outpatient outcomes showed similar rates in both groups. Conclusion: Most radiographically well­fixed implants were in fact unstable. Stability assessment using radiographic studies alone proves insufficient and may lead to inadequate osteosynthesis treatment. As such, in­operative stability testing in all B1 type fractures is paramount. Revision arthroplasty permitted early ambulation and showed no greater complications when comparing with osteosynthesis.

Introduction: Compartment syndrome (CS) is an orthopedic emergency. Diagnosis is particularly difficult in children because of the challenges inherent to communication and clinical examination. This paper aims to present a pediatric case series of CS and to analyze its etiology, diagnosis, treatment and complications as well as to assess the quality of life of the patients at least 1 year after the event. Methods: Retrospective study of children with CS treated at our institution between 2009-2020. Demographic characteristics and data on etiology, diagnosis, treatment and complications were analyzed. Quality of life was assessed using the Kidscreen 10 scale. Results: Nine patients with CS were identified 8 male, median age 10 years. The most frequent etiologies were traumatic (n=5), postoperative (n=2), viper bite (n=1) and infectious (n=1). The lower limb was involved in 5 cases, the upper limb in 3 and the lower and upper limb bilaterally in one. In 6 patients there was an associated fracture. Median follow up was 8 months. Complete functional recovery was seen in 5 patients. Complications occurred in 4: two patients with decreased joint mobility, one patient with sensory motor deficit and one patient requiring amputation. The median Kidscreen 10 score was 49. Conclusion: Adequate and well timed treatment of CS allows complete functional recovery in most patients and a good quality of life, although a high complication rate is expected.

Introduction: Thumb arthritis is a common condition. Its prevalence increases with age and predominantly affects females.   Methods: In the period from January 2009 to December 2014, 105 patients were submitted to trapezectomy, ligament reconstruction and tendon interposition for basilar thumb arthritis grades III and IV, of which 40 patients (42 hands) were included in the study. The majority, 92.5%, were females, with an average age of 59.6 ± 7.18 years, 52.5% were operated with an abductor pollicis longus tendon technique as described by Mathoulin and 47.5% with flexor carpi radialis tendon as described by Burton‐Pellegrini. The mean follow‐up time was 122.15 ± 25.3 months.   Results: The mean DASH score was 20.38±19.63, mean VAS score 2.3±302, Kapandji score 8.29±2.11, grip strength 19.5 ±10.91 kg, pulp pinch force 3.9±2.39 kg and lateral pinch force 4.77±2.33 kg. In terms of satisfaction 59.52% referred to maximum satisfaction with the surgery (5/5), 23.80% (4/5), 4.76% (3/5), 4.76% (2/5) and 7.14% minimum satisfaction (1/5). Analytically, males presented a greater grasp strength and lateral pinch and basilar thumb arthritis grade IV had worse outcomes. There are no significant differences in the results obtained with the different surgical techniques.   Conclusion: Trapezectomy and ligament reconstruction and tendon interposition present good medium‐long‐term func‐ tional results for the treatment of basilar thumb arthritis without statistically significant differences between Burton Pellegrini and Mathoulin techniques.