Pudendal symptoms after post-assisted hip arthroscopy were common, and rose with traction time

The edition in brief

A Canadian cohort of 93 patients having hip arthroscopy with a perineal post found 83% had symptoms consistent with pudendal nerve palsy early after surgery, including erectile dysfunction in 22% of men and reduced lubrication in 19% of women. Symptoms persisted beyond six months in 14% but resolved in all by a year, and each extra 10 minutes of traction raised the odds by about 59%. A Chinese multicentre study of 1,012 adults under 65 fixed with three cannulated screws derived an eight-point osteonecrosis score (age 45 or over, displacement, comminution, fracture line position) that outperformed the Garden classification (AUC 0.80 vs 0.70): osteonecrosis developed in 4% of low scorers and 42% of high scorers. A cost analysis from the CAST trial found non-operative care for displaced distal radius fractures cost about half as much as plating, and delayed plating after redisplacement cost almost the same as immediate plating. A single-centre review of renal cell carcinoma long-bone metastases found intralesional surgery was not linked to more reoperations than resection. The pearl: pain on passive stretch is the early sign of compartment syndrome.