Medial tibial stress syndrome (MTSS), which also known as “shin splints,” is leg pain due to repetitive stresses. It is common among athletes, especially runners. It is estimated that up to 35% of all athletes have MTSS. As a consequence, the athletes spend less time in training and some of them refrain from exercises because of the exercise-induced pain, which adversely affects their career. The exact cause is still unclear. Some studies in the literature have suggested that the underlying mechanism is microdamage due to repetitive stresses. Risk factors include female gender, increased range of hip external rotation in males, navicular bone drop, increased body mass index, and training intensity. Patients usually complain of bilateral pain mainly in the anterior and/or medial side of their distal leg. Pain is aggravated by activity and relieved by rest. The examination may reveal swelling and tenderness, especially in the tibial posteromedial aspect along with other suggestive signs. Imaging modalities including radiographs, computed tomography, magnetic resonance imaging, and bone scintigraphy can be utilized to rule out other causes of similar presentation. Prevention is by repetitive stress avoidance, shock absorbing insoles, appropriate treatment of other stress-induced injuries, and screening for anatomical abnormalities. It is mostly treated conservatively with rest, ice and pain control. Athletes can keep training by doing different exercises that do not cause recurrent stresses. Surgery, which is rarely performed, is a treatment option in recalcitrant cases.

Objectives: Surgical site infections (SSIs) have a significant impact on morbidity, mortality, and health-care expenditures. Therefore, the aims of the current study were to examine the incidence of SSI among patients who had foot and ankle surgery at large hospital in Riyadh and to identify predictors of SSIs. Methods: This is a retrospective cohort study. This is a consecutive study of patients underwent foot and ankle surgery between 2010 and 2014. The association between variables and infection status was analyzed using a logistic regression model. Results: The study included 295 patients. The incidence of SSI was 3.42%. The age and the type of surgery were significant predictors of SSI. Conclusions: Proper postoperative monitoring for high-risk patients may facilitate reduction of SSIs following foot and ankle surgery and improves health outcomes.

Introduction: Motor vehicle accidents (MVAs) and noncompliance to seat belt have been a continuing safety issue in Saudi Arabia for decades. The aim of this study is to determine the prevalence of seat belt use and distracted driving behaviors among health-care providers in Saudi Arabia and its comparison with nonhealth-care providers. Methods: This is a cross-sectional survey. Data were collected through an online questionnaire distributed among Saudi health-care providers in Saudi Arabia through E-mails and social media using a snowball sampling approach. The data were statistically analyzed. Results: Of 695 respondents, 356 (51.2%) were health-care providers and 339 (48.8%) were nonhealth-care providers. Seat belt wearing rates were 43% among health-care providers and 13.3% among nonhealth-care providers. Most common distracting driving behavior was cell phone usage while driving in both groups (98.6% vs. 86.5%). Conclusion: The present study revealed a statistically significant difference in compliance to seat belt usage by health-care providers compared to nonhealth-care providers. We believe that this is due to a better exposure and knowledge about the consequences of the MVA cases, as well as a high awareness about traffic rules. No statistically significant difference was observed in regard to distracted driving behavior between both groups. We would like to strongly recommend the need of various levels of awareness campaigns regarding the importance of wearing seat belt and avoiding distractive driving behavior in Saudi Arabia.

Osteoid osteoma predominates all symptomatic benign bone tumors in younger patients with an incidence reaching 10%. Night pain responding to nonsteroidal anti-inflammatory pain medication, especially aspirin is its pathognomonic symptom. Osteoid osteoma lesion in the bone at tendon insertion is difficult to diagnose with pain pattern becoming atypical; clinical signs and radiographic presentations are misleading and histological features altered. The osteoid osteoma at deltoid tubercle of the humerus is rare and missed in the initial presentation. This case report describes how an osteoid osteoma of the deltoid insertion of the humerus can be different.

Osteosynthesis in orthopedic surgery involves placement of various implants inside the body as a means of fracture fixation. Certain implants have the propensity to become loose due to physiological cyclic loading or other biomechanical issues. A prominent implant often develops surrounding bursitis with or without an external wound. Removal of a prominent implant is done for clinical improvement with or without revision surgeries. A rare incidental finding of multiple rice bodies inside a bursa over an implant prominence is a rare event and has been described here with relevant details. The preoperative clinicoradiological features did not show any feature suggesting their presence, and no associated infective pathology including bacterial, mycobacterial, or fungal was identified in further investigations. A handful of cases associated with implant-related issues have been reported so far, and this case adds value to the existing literature with its rarity and learning potential.