Background: Dislocations of the bilateral sacroiliac (SI) joint are serious injuries. It is extremely rare to experience SI joint
dislocation without fracture or disruption of the anterior pelvic ring. Even though SI dislocations can be fixed via several different
methods, the surgical technique should be tailored to everyone based on the patient's injuries. The treatment of these fractures
with operative intervention remains difficult because of the possibility of other injuries associated with the fractures. Only three
cases of this type of injury treated with open reduction and internal fixation (ORIF) have been reported in the literature.

Case Report: A 15-year-old girl presented with high-energy trauma. In the left hand, she had a fracture-dislocation of the wrist; in the
right ankle, she had a pilon fracture and a calcaneus fracture. Her pelvis had a bilateral SI dislocation without a fracture in the pelvic
ring. After hemodynamic stabilization, surgical management was performed for the wrist fracture-dislocation, as well as the pilon
and calcaneus fractures. Four days later, the bilateral SI dislocations were fixed. We performed closed reduction and internal
fixation (CRIF) due to the patient's situation and the high risk of infection. At the last follow-up, the fracture had united, and the
patient experienced no discomfort in performing her daily activities.

Conclusion: While the optimal method for fixing this injury is unclear, ORIF is the conventional approach for similar cases.
However, in this case, CRIF was chosen due to disadvantages associated with ORIF, such as nerve damage, swelling, incomplete bone
healing, increased pressure, blood clots, and our patient’s situation.

BACKGROUND AND OBJECTIVES:
Nerve transfers are crucial to upper brachial plexus injury reconstruction, and we describe a posterior approach for harvesting an ulnar nerve fascicle to reanimate posterior targets in C5-C7 injuries.

METHODS:
Twelve patients with traumatic upper brachial plexus injuries underwent staged nerve reconstruction between 2018 and 2025, including transfer of a selected ulnar nerve fascicle harvested through a posterior arm approach. The fascicle was transferred to the anterior branch of the axillary nerve or, in selected cases, to the motor branch of the long head of the triceps with outcomes assessed at ≥18 months.

RESULTS:
Nine patients completed follow-up, all achieving meaningful functional recovery (Medical Research Council M3-M4) of shoulder abduction or elbow extension without clinically significant ulnar donor morbidity.

CONCLUSION:
Posterior approach for ulnar nerve fascicle harvest is a safe, reproducible technique that expands donor options for deltoid and triceps reanimation in extended upper brachial plexus injuries.

Capitate shortening osteotomy is one treatment for Kienböck’s disease. We describe a minimally invasive
technique using a small transverse dorsal incision and retrograde intermetacarpal screw fixation. The
advantages are reduced dorsal soft-tissue exposure and a more central screw placement within the capitate.

Background
Septic arthritis predisposes joints to secondary osteoarthritis and complicates later arthroplasty. As arthroplasty becomes more common, surgeons increasingly encounter patients who had prior septic arthritis, yet the risk of periprosthetic joint infection (PJI) after total knee and hip arthroplasty (TKA/THA) remains unclear. This systematic review and meta-analysis assessed PJI risk in this population and examined the impact of surgical timing and procedural strategy.
Methods
A systematic search of four online databases was conducted in October 2025 according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Observational studies reporting outcomes of TKA or THA in patients who had prior septic arthritis were included. In total, 35 retrospective studies comprising 7,447 patients (4,896 knees and 2,564 hips) met the criteria. Random-effects meta-analyses were performed to estimate pooled outcomes, with subgroup and meta-regression analyses evaluating the effects of joint type, time interval from infection, and two-stage procedures.
Results
The pooled PJI rate was 2.6% (95% confidence interval 1.4 to 4.8), with higher rates after TKA (9.8%) than THA (1.1%), although publication bias was detected in the hip cohort. Longer intervals between septic arthritis and arthroplasty were associated with lower PJI risk, whereas a higher proportion of two-stage procedures correlated with increased PJI rates. The pooled aseptic revision rate was 4.1%, and the overall complication rate was 17.1%, both higher after THA. Functional outcomes improved significantly after both procedures, with greater gains observed following THA (P < 0.001).
Conclusion
Arthroplasty after a prior septic arthritis is associated with an elevated risk of PJI. A longer interval between infection and TJA reduced the risk of PJI, and two-stage arthroplasty was associated with a higher rate of PJI. These findings confirm an increased risk of PJI and complications after TJA in these patients, and two-stage arthroplasty does not appear to provide additional protection.