Congenital forearm and wrist deformities, including Madelung's deformity, congenital radial head dislocation, and proximal radioulnar synostosis, present reconstructive challenges for upper extremity surgeons. While etiologically distinct, these developmental anomalies disrupt forearm rotation, elbow stability, and aesthetic appearance. This review examines the natural histories and management strategies necessary to restore form and function in pediatric patients. Madelung's deformity, characterized by distal radial physeal growth arrest and a tethering Vickers ligament, requires corrective osteotomies to address progressive pain and deformity. Congenital radial head dislocation necessitates radiographic evaluation to distinguish it from acquired trauma and is managed conservatively. Proximal radioulnar synostosis causes functional restrictions requiring derotational osteotomies in symptomatic patients. Precise anatomical understanding and individualized clinical judgment are essential to restore joint kinematics.

Elbow fractures in children represent a frequent but diagnostically challenging presentation in both primary and secondary care. Due to multiple ossification centers and often subtle clinical signs, these injuries are at risk of being overlooked. Missed fractures may result in malunion, growth disturbances, chronic pain, or long-term functional impairment. This review highlights three commonly underdiagnosed fracture types: medial epicondyle fractures, lateral condyle fractures, and supracondylar humeral fractures. Using illustrative case material, we discuss key aspects of clinical evaluation, pitfalls in radiographic interpretation, and the importance of systematic assessment of neurovascular status. In cases of persisting pain with initially normal radiographs, additional imaging such as oblique X-rays, ultrasound, or CT should be considered. Structured follow-up and timely referral to pediatricorthopedic expertise are essential to prevent complications. With a pragmatic, knowledge-based approach, clinicians can significantly reduce the risk of missed diagnoses and optimize functional outcomes for pediatric patients.

Congenital radial head dislocation (CRHD) is an uncommon orthopedic anomaly affecting the elbow joint and is frequently associated with other congenital deformities. This narrative review synthesizes evidence identified through targeted searches of PubMed and Web of Science, with emphasis on peer-reviewed studies addressing the epidemiology, developmental and genetic mechanisms, diagnostic evaluation, clinical differentiation, management strategies, and treatment outcomes of CRHD. CRHD may present as either unilateral or bilateral dislocation, with posterior dislocation being the most frequently reported subtype. Frequently overlooked during childhood, CRHD often becomes clinically apparent during adolescence or adulthood through symptoms such as elbow discomfort, cosmetic prominence, mechanical symptoms, and restricted joint mobility. Diagnosis remains challenging because of its variable clinical presentation and often requires careful integration of clinical history, physical examination, and imaging findings. The pathogenesis of CRHD is multifactorial and involves complex genetic, developmental, and structural abnormalities, particularly collagen type I defects, disturbances in endochondral ossification, and disproportionate growth between the ulna and radius. Management strategies range from conservative observation in asymptomatic or minimally symptomatic patients to surgical interventions, including radial head excision, ulnar osteotomy, open reduction, and annular ligament reconstruction in selected symptomatic cases. Although surgery may provide pain relief and improve forearm rotation, it carries potential complications, including wrist pain, recurrent deformity, and redislocation. Further research is needed to refine diagnostic criteria, optimize patient selection for surgery, and improve long-term functional outcomes in patients with CRHD.

BackgroundSmartphones have become essential tools in modern daily life, with usage intensifying in the post-pandemic era. Prolonged and addictive smartphone use has been increasingly associated with Musculoskeletal disorders (MSD) in the upper extremity. Beyond usage duration, device characteristics may also influence musculoskeletal strain.ObjectivesThis study examined the relationships between smartphone usage patterns, addiction levels, device dimensions, pain severity, and the 12-month prevalence of MSD in the upper extremityMaterials and MethodsA cross-sectional study was conducted among 262 adults aged 19-44 years with at least 12 months of smartphone use. Data were collected using a structured questionnaire incorporating demographic variables, smartphone usage habits, device specifications, the SNMQ, the SAS-SV and the NPRS.ResultsThe 12-month prevalence of neck, shoulder, elbow, and wrist/hand MSDs was 52.7%, 39.3%, 34%, and 51.1%, respectively. Smartphone addiction was present in 60.3% of participants and was significantly associated with shoulder, elbow, and wrist/hand MSDs. Gender showed a small but significant association with shoulder symptoms. Correlation analyses revealed small positive associations between smartphone width and neck pain, and between phone length/width and right wrist and right thumb pain. Logistic regression models identified that phone width predicted neck MSD, daily usage duration and overall body position contributed to shoulder MSD, age predicted elbow MSD, and both smartphone addiction and age predicted wrist/hand MSD.ConclusionSmartphone addiction, specific device dimensions, and behavioral factors contribute to MSD. These findings underscore the need for ergonomic device design and informed usage practices to reduce musculoskeletal strain among young adults.

Dystrophic epidermolysis bullosa (DEB) is characterized by skin fragility manifested by blistering and erosions with minimal trauma. Many individuals also have dystrophic or absent nails. DEB is divided into two major types depending on inheritance pattern: recessive dystrophic epidermolysis bullosa (RDEB) and dominant dystrophic epidermolysis bullosa (DDEB). Clinical findings in severe RDEB include skin fragility manifested by blistering and erosions with minimal trauma that heals with milia and scarring. Blistering and erosions affecting the whole body may be present in the neonatal period. Oral involvement may lead to mouth blistering, fusion of the tongue to the floor of the mouth, and progressive diminution of the size of the oral cavity and mouth opening. Esophageal erosions can lead to webs and strictures that can cause severe dysphagia. Malnutrition with vitamin and mineral deficiency may lead to growth deficiency in young children. Corneal erosions can lead to scarring and loss of vision. Blistering of the hands and feet followed by scarring results in contractures and pseudosyndactyly. The lifetime risk of aggressive squamous cell carcinoma (SCC) is greater than 90%. In contrast, the blistering in intermediate RDEB may be localized to hands, feet, knees, and elbows with or without involvement of flexural areas and the trunk, and without severe scarring. In DDEB, blistering is often mild and limited to hands, feet, knees, and elbows, but nonetheless heals with scarring. Dystrophic nails, especially toenails, are common and may be the only manifestation of DDEB.

Distal humerus shear fractures are uncommon intra-articular injuries including capitellum fractures, most frequently resulting from a fall on an outstretched hand where the radial head pushes the capitellum while it engages in a full elbow extension and axial load. Displaced fractures, particularly those classified as Dubberley Type 2A capitellum fracture, are typically managed surgically with open reduction and internal fixation (ORIF) to restore articular congruity and allow early mobilization. Successful nonoperative treatment in such cases remains limited with high complication rates. A 35-year-old male presented after a fall onto an outstretched hand with a painful locked elbow. Radiographs demonstrated a displaced capitellum fracture (Dubberley Type 2A), which was successfully treated with closed reduction under local anesthesia and fluoroscopic guidance, followed by immobilization and a structured rehabilitation program. At 1-year follow-up, the patient had a pain-free elbow with satisfactory range of motion and no evidence of instability, avascular necrosis, or radiographic abnormalities. This case suggests that, in carefully selected patients, closed reduction may represent a viable alternative to open fixation for displaced capitellum fractures when anatomical reduction can be achieved and maintained with close follow-up and rehabilitation.

Focal cartilage defects of the capitellum humeri are frequently underestimated, despite their substantial contribution to elbow pain and functional impairment in young and physically active patients. Arthroscopic autologous minced cartilage implantation is a single-stage biological cartilage repair technique that has shown favorable clinical and imaging outcomes in larger joints. Osteochondral lesions of the capitellum humeri of the elbow, particularly in the setting of osteochondritis dissecans, represent a challenging condition in young and physically active patients. However, detailed descriptions of the arthroscopic surgical technique and its application in the elbow joint remain limited. Therefore, the purpose of this Technical Note is to describe a step-by-step arthroscopic technique for autologous minced cartilage implantation in focal osteochondral lesions of the capitellum humeri. Indications, surgical pearls and pitfalls, and postoperative care are outlined, and the potential advantages of this technique in the treatment of elbow cartilage lesions are discussed.

Musculoskeletal disorders (MSDs) are among the most common work-related health problems and are frequently associated with prolonged sitting, poor computer workstation ergonomics, and inadequate sleep. This study aimed to determine the prevalence of MSD complaints and examine their associations with computer workstation ergonomics and sleep quality among employees at Jazan University, Saudi Arabia. A cross-sectional study was conducted between December 2024 and April 2025 among 460 university employees selected using a multistage cluster random sampling technique. Data were collected using the Nordic Musculoskeletal Questionnaire, the National Institutes of Health Computer Workstation Ergonomic Self-Assessment Checklist, and the Pittsburgh Sleep Quality Index. Data were analyzed using IBM SPSS Statistics, version 27. MSDs were highly prevalent, with the low back (65.9%), neck (65.0%), shoulders (57.2%), and upper back (46.3%) being the most commonly affected body regions, whereas the elbows were the least affected (16.7%). Male employees had significantly lower odds of hip pain (odds ratio [OR] = 0.22, 95% confidence interval [CI]: 0.07-0.66) and ankle pain (OR = 0.34, 95% CI: 0.13-0.90) than female employees. Compared with employees from the College of Arts and Humanities, those from the College of Science had significantly higher odds of wrist pain (OR = 2.12, 95% CI: 1.07-4.20), elbow pain (OR = 2.45, 95% CI: 1.09-5.53), and ankle pain (OR = 2.48, 95% CI: 1.15-5.33). Poor sleep quality was independently associated with increased odds of neck pain (OR = 1.13, 95% CI: 1.03-1.24), upper-back pain (OR = 2.47, 95% CI: 1.08-5.67), and knee pain (OR = 4.28, 95% CI: 1.70-10.80). In addition, poor workstation ergonomics were independently associated with several MSDs after adjustment for potential confounders. MSDs were highly prevalent among university employees and were independently associated with poor workstation ergonomics and poor sleep quality. These findings highlight the importance of implementing workplace ergonomic interventions and employee wellness programs to reduce the burden of MSDs. Future longitudinal studies are needed to evaluate the effectiveness of ergonomic and sleep-related interventions and to further investigate the contributions of occupational stress and screen time to MSD risk.

A traumatic nerve injury that is improperly treated or left untreated may result in a painful neuroma with compromised sensory and motor function. Affected individuals might be hesitant to donate a healthy nerve for an autologous nerve graft procedure. The use of processed nerve allografts (PNA) to reconstruct nerve injuries with painful neuromas is less often discussed. We aim to offer perspectives on treating painful neuromas with PNA when autograft reconstruction is considered not an option.