#!/usr/bin/env python3
"""
Generate a professional orthopedic academic poster (A1 landscape) as PDF.
Topic: "What Neglect Froze, Surgery Thawed" — Neglected Elbow Dislocation
Based on Rockwood & Green's, Miller's Review of Orthopaedics, Campbell's standards.
"""
from reportlab.lib.pagesizes import A1, landscape
from reportlab.lib import colors
from reportlab.lib.units import cm, mm
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.platypus import Paragraph, Table, TableStyle
from reportlab.pdfgen import canvas
from reportlab.lib.enums import TA_LEFT, TA_CENTER, TA_JUSTIFY
from reportlab.pdfbase import pdfmetrics
from reportlab.pdfbase.ttfonts import TTFont
import os

OUTPUT = "/home/daytona/workspace/elbow-poster/Neglected_Elbow_Dislocation_Poster.pdf"

# ── Colour palette ─────────────────────────────────────────────────────────────
NAVY        = colors.HexColor("#1B3A5C")   # header, section banners
STEEL       = colors.HexColor("#2D6A9F")   # sub-headers
LIGHT_BLUE  = colors.HexColor("#D6E8F7")   # column backgrounds
ACCENT      = colors.HexColor("#E8F4FD")   # alternating row tint
WHITE       = colors.white
TEXT        = colors.HexColor("#1A1A1A")
GOLD        = colors.HexColor("#C8960C")   # title accent line

# Page setup (A1 landscape)
PW, PH = landscape(A1)  # ~84.1 × 59.4 cm
M  = 1.5*cm             # margin

# ── Canvas ─────────────────────────────────────────────────────────────────────
c = canvas.Canvas(OUTPUT, pagesize=(PW, PH))
c.setTitle("Neglected Elbow Dislocation — Academic Poster")

# ────────────────────────────────────────────────────────────────────────────────
# Helper: wrapped text block using Paragraph (auto-wraps, returns height used)
# ────────────────────────────────────────────────────────────────────────────────
def register_styles():
    styles = {}
    styles["body"]    = ParagraphStyle("body",    fontName="Helvetica",        fontSize=8.5,  leading=12,  textColor=TEXT, alignment=TA_JUSTIFY, spaceAfter=3)
    styles["bullet"]  = ParagraphStyle("bullet",  fontName="Helvetica",        fontSize=8.5,  leading=12,  textColor=TEXT, alignment=TA_LEFT,    bulletIndent=4, leftIndent=12, spaceAfter=3)
    styles["heading"] = ParagraphStyle("heading", fontName="Helvetica-Bold",   fontSize=9.5,  leading=13,  textColor=STEEL, spaceAfter=4)
    styles["title"]   = ParagraphStyle("title",   fontName="Helvetica-Bold",   fontSize=22,   leading=26,  textColor=WHITE, alignment=TA_CENTER)
    styles["subtitle"]= ParagraphStyle("sub",     fontName="Helvetica-Oblique",fontSize=11,   leading=14,  textColor=WHITE, alignment=TA_CENTER)
    styles["banner"]  = ParagraphStyle("banner",  fontName="Helvetica-Bold",   fontSize=10.5, leading=13,  textColor=WHITE, alignment=TA_CENTER)
    styles["small"]   = ParagraphStyle("small",   fontName="Helvetica",        fontSize=7.5,  leading=10,  textColor=TEXT, alignment=TA_LEFT)
    styles["ref"]     = ParagraphStyle("ref",     fontName="Helvetica",        fontSize=7.5,  leading=10,  textColor=TEXT, alignment=TA_LEFT,  spaceAfter=3)
    return styles

S = register_styles()

def draw_section_banner(c, x, y, w, h, text, col=NAVY):
    c.setFillColor(col)
    c.roundRect(x, y, w, h, 4, stroke=0, fill=1)
    p = Paragraph(text, S["banner"])
    pw, ph = p.wrap(w - 8, h)
    p.drawOn(c, x + 4, y + (h - ph) / 2)

def draw_box(c, x, y, w, h, fill=WHITE, stroke=STEEL, radius=4):
    c.setFillColor(fill)
    c.setStrokeColor(stroke)
    c.setLineWidth(0.5)
    c.roundRect(x, y, w, h, radius, stroke=1, fill=1)

def draw_paragraphs(c, x, y, w, items, style_key="body", bullet=False):
    """Draw list of text strings inside box, returns y after last item."""
    cur_y = y
    for item in items:
        if bullet:
            p = Paragraph("• " + item, S["bullet"])
        else:
            p = Paragraph(item, S[style_key])
        pw, ph = p.wrap(w - 8, 9999)
        cur_y -= ph
        p.drawOn(c, x + 4, cur_y)
        cur_y -= 3
    return cur_y

def draw_col_bg(c, x, y, w, h):
    c.setFillColor(LIGHT_BLUE)
    c.roundRect(x, y, w, h, 6, stroke=0, fill=1)

# ══════════════════════════════════════════════════════════════════════════════
# HEADER / TITLE BAND
# ══════════════════════════════════════════════════════════════════════════════
HEADER_H = 5.5*cm
c.setFillColor(NAVY)
c.rect(0, PH - HEADER_H, PW, HEADER_H, stroke=0, fill=1)

# Gold accent stripe
c.setFillColor(GOLD)
c.rect(0, PH - HEADER_H - 4, PW, 4, stroke=0, fill=1)

# Title text
title_p = Paragraph(
    '"What Neglect Froze, Surgery Thawed"<br/>'
    '<font size="18">Reviving a Neglected Elbow Dislocation — A Case Report</font>',
    S["title"])
tw, th = title_p.wrap(PW - 6*cm, HEADER_H - 1*cm)
title_p.drawOn(c, 3*cm, PH - HEADER_H + (HEADER_H - th) / 2)

# Institution / authors placeholder
auth_p = Paragraph(
    "Department of Orthopaedic Surgery  |  Poster Presentation — Orthopaedic Conference 2026",
    S["subtitle"])
aw, ah = auth_p.wrap(PW - 6*cm, 1.2*cm)
auth_p.drawOn(c, 3*cm, PH - HEADER_H + 0.35*cm)

# ══════════════════════════════════════════════════════════════════════════════
# LAYOUT: 4 equal columns
# ══════════════════════════════════════════════════════════════════════════════
TOP_Y    = PH - HEADER_H - 4 - 0.5*cm
BOT_Y    = 1.5*cm
COL_GAP  = 0.5*cm
COLS     = 4
COL_W    = (PW - 2*M - (COLS - 1)*COL_GAP) / COLS

def col_x(n):   # 0-indexed
    return M + n*(COL_W + COL_GAP)

CONTENT_H = TOP_Y - BOT_Y

# Draw column backgrounds
for i in range(COLS):
    draw_col_bg(c, col_x(i), BOT_Y, COL_W, CONTENT_H)

# ══════════════════════════════════════════════════════════════════════════════
# COLUMN 1 — Introduction + Case Report
# ══════════════════════════════════════════════════════════════════════════════
cx, cy = col_x(0), TOP_Y

# ── INTRODUCTION ──────────────────────────────────────────────────────────────
BH = 0.65*cm
draw_section_banner(c, cx, cy - BH, COL_W, BH, "INTRODUCTION")
cy -= BH + 0.2*cm

intro_text = [
    "Neglected elbow dislocation is defined as an unreduced elbow dislocation "
    "persisting beyond <b>three weeks</b> (Rockwood &amp; Green's, 10th ed., Ch. 40). "
    "The elbow is the <b>second most commonly dislocated joint</b> in adults, with an "
    "incidence of 5.2 per 100,000 person-years (Rockwood &amp; Green's, 2025).",

    "Delayed presentation leads to progressive pathological changes including:",
]
intro_bullets = [
    "Fibrosis and capsular contracture",
    "Heterotopic ossification",
    "Soft-tissue adhesion and muscle shortening",
    "Loss of normal osseous landmarks",
    "Neurovascular tethering (ulnar nerve most vulnerable)",
]
intro_text2 = [
    "The medial collateral ligament (MCL) — specifically the anterior band — is the "
    "<b>primary restraint to valgus stress</b>; the lateral ulnar collateral ligament (LUCL) "
    "is the primary restraint to posterolateral rotatory instability "
    "(Miller's Review of Orthopaedics, 9th ed., Table 2.5).",

    "O'Driscoll's valgus–axial–posterolateral force model describes the typical "
    "injury sequence: LCL fails first → capsule → MCL last "
    "(Rockwood &amp; Green's, Fig. 40-1).",
]

section_h = 6.5*cm
draw_box(c, cx, cy - section_h, COL_W, section_h)
inner_y = cy - 0.3*cm
for txt in intro_text:
    p = Paragraph(txt, S["body"])
    pw, ph = p.wrap(COL_W - 8, 9999)
    inner_y -= ph
    p.drawOn(c, cx + 4, inner_y)
    inner_y -= 3
for b in intro_bullets:
    p = Paragraph("• " + b, S["bullet"])
    pw, ph = p.wrap(COL_W - 14, 9999)
    inner_y -= ph
    p.drawOn(c, cx + 10, inner_y)
    inner_y -= 2
for txt in intro_text2:
    p = Paragraph(txt, S["body"])
    pw, ph = p.wrap(COL_W - 8, 9999)
    inner_y -= ph
    p.drawOn(c, cx + 4, inner_y)
    inner_y -= 3

cy = cy - section_h - 0.35*cm

# ── CASE REPORT ──────────────────────────────────────────────────────────────
draw_section_banner(c, cx, cy - BH, COL_W, BH, "CASE REPORT")
cy -= BH + 0.2*cm

case_text = [
    "<b>Patient:</b> 70-year-old female.",
    "<b>Presenting complaint:</b> Left elbow pain and inability to move the limb for "
    "3 months following a domestic fall.",
    "<b>Initial management (elsewhere):</b> Above-elbow slab immobilisation for 6 weeks. "
    "Pain persisted with severe restriction of movement → referred to our centre.",
]
case_h = 3.2*cm
draw_box(c, cx, cy - case_h, COL_W, case_h)
inner_y = cy - 0.3*cm
for txt in case_text:
    p = Paragraph(txt, S["body"])
    pw, ph = p.wrap(COL_W - 8, 9999)
    inner_y -= ph
    p.drawOn(c, cx + 4, inner_y)
    inner_y -= 4
cy = cy - case_h - 0.35*cm

# ── CLINICAL EXAMINATION ──────────────────────────────────────────────────────
draw_section_banner(c, cx, cy - BH, COL_W, BH, "CLINICAL EXAMINATION")
cy -= BH + 0.2*cm

exam_bullets = [
    "Swelling and ecchymosis over the left elbow",
    "Gross restriction: only ~20° arc of flexion–extension",
    "Supination and pronation completely restricted",
    "Tenderness over the olecranon region",
    "Disrupted isoceles triangle of bony landmarks "
    "(olecranon–medial epicondyle–lateral epicondyle)",
    "Olecranon process prominently palpable posteriorly",
    "No neurovascular deficit on presentation",
    "Radiological confirmation: neglected posterior elbow dislocation",
]
exam_h = 5.8*cm
draw_box(c, cx, cy - exam_h, COL_W, exam_h)
inner_y = cy - 0.25*cm
for b in exam_bullets:
    p = Paragraph("• " + b, S["bullet"])
    pw, ph = p.wrap(COL_W - 14, 9999)
    inner_y -= ph
    p.drawOn(c, cx + 10, inner_y)
    inner_y -= 2

cy = cy - exam_h - 0.35*cm

# ══════════════════════════════════════════════════════════════════════════════
# COLUMN 2 — Imaging / Classification + Surgical Treatment
# ══════════════════════════════════════════════════════════════════════════════
cx, cy = col_x(1), TOP_Y

# ── CLASSIFICATION ────────────────────────────────────────────────────────────
draw_section_banner(c, cx, cy - BH, COL_W, BH, "CLASSIFICATION & IMAGING")
cy -= BH + 0.2*cm

class_text = [
    "<b>Type (Rockwood &amp; Green's, 2025):</b> Neglected posterior simple elbow dislocation "
    "— no associated periarticular fracture confirmed on radiograph.",

    "<b>Radiographic findings:</b> Posterior displacement of radius and ulna relative to "
    "the humerus. No fracture identified. Soft-tissue calcification consistent with "
    "early heterotopic ossification.",

    "Scoring / outcome instruments applicable (per Rockwood &amp; Green's Ch. 40):",
]
class_bullets = [
    "Disabilities of Arm, Shoulder and Hand (DASH)",
    "Oxford Elbow Score (OES)",
    "Mayo Elbow Performance Score (MEPS)",
]
class_h = 4.5*cm
draw_box(c, cx, cy - class_h, COL_W, class_h)
inner_y = cy - 0.3*cm
for txt in class_text:
    p = Paragraph(txt, S["body"])
    pw, ph = p.wrap(COL_W - 8, 9999)
    inner_y -= ph
    p.drawOn(c, cx + 4, inner_y)
    inner_y -= 4
for b in class_bullets:
    p = Paragraph("• " + b, S["bullet"])
    pw, ph = p.wrap(COL_W - 14, 9999)
    inner_y -= ph
    p.drawOn(c, cx + 10, inner_y)
    inner_y -= 2
cy = cy - class_h - 0.35*cm

# IMAGE PLACEHOLDER LABEL
draw_section_banner(c, cx, cy - BH, COL_W, BH, "PRE-OPERATIVE IMAGING", col=STEEL)
cy -= BH + 0.2*cm
img_h = 4.5*cm
draw_box(c, cx, cy - img_h, COL_W, img_h, fill=ACCENT)
c.setFillColor(STEEL)
c.setFont("Helvetica-Oblique", 8.5)
c.drawCentredString(cx + COL_W/2, cy - img_h/2, "[Insert Pre-Op AP & Lateral X-rays]")
cy = cy - img_h - 0.35*cm

# ── SURGICAL TECHNIQUE ────────────────────────────────────────────────────────
draw_section_banner(c, cx, cy - BH, COL_W, BH, "SURGICAL TECHNIQUE")
cy -= BH + 0.2*cm

surg_text = [
    "Open reduction was performed via a <b>posterior approach</b> to the elbow (Bryan-Morrey), "
    "consistent with the recommended approach for neglected dislocations requiring soft-tissue "
    "release (Rockwood &amp; Green's, 2025; Coulibaly et al., 2012).",
]
surg_bullets = [
    "Careful soft-tissue release: capsulotomy, adhesiolysis, excision of fibrous tissue",
    "Elbow joint reduction achieved and confirmed under C-arm fluoroscopy",
    "K-wire temporary trans-articular fixation to maintain reduction",
    "<b>Bell-Tawse annular ligament reconstruction</b> — restores PRUJ stability "
    "(Miller's Review, 9th ed.)",
    "<b>Tommy John (UCL) ulnar collateral ligament repair</b> — primary valgus "
    "stabiliser restored (Miller's Review, 9th ed., Fig. 7-90)",
    "Neurovascular structures — ulnar nerve identified and protected throughout",
    "Layered wound closure; above-elbow posterior slab at 90° flexion, forearm pronated "
    "(Rockwood &amp; Green's postoperative protocol)",
]
surg_h = 6.5*cm
draw_box(c, cx, cy - surg_h, COL_W, surg_h)
inner_y = cy - 0.3*cm
for txt in surg_text:
    p = Paragraph(txt, S["body"])
    pw, ph = p.wrap(COL_W - 8, 9999)
    inner_y -= ph
    p.drawOn(c, cx + 4, inner_y)
    inner_y -= 4
for b in surg_bullets:
    p = Paragraph("• " + b, S["bullet"])
    pw, ph = p.wrap(COL_W - 14, 9999)
    inner_y -= ph
    p.drawOn(c, cx + 10, inner_y)
    inner_y -= 2
cy = cy - surg_h - 0.35*cm

# ══════════════════════════════════════════════════════════════════════════════
# COLUMN 3 — Intraoperative Photos + Outcomes
# ══════════════════════════════════════════════════════════════════════════════
cx, cy = col_x(2), TOP_Y

# INTRAOPERATIVE PHOTOS SECTION
draw_section_banner(c, cx, cy - BH, COL_W, BH, "INTRA-OPERATIVE FINDINGS")
cy -= BH + 0.2*cm

intra_h = 7.5*cm
draw_box(c, cx, cy - intra_h, COL_W, intra_h, fill=ACCENT)
c.setFillColor(STEEL)
c.setFont("Helvetica-Oblique", 8.5)
c.drawCentredString(cx + COL_W/2, cy - intra_h/2 + 1*cm, "[Insert Intra-Op Photos]")
c.drawCentredString(cx + COL_W/2, cy - intra_h/2, "(Soft-tissue release, reduction,")
c.drawCentredString(cx + COL_W/2, cy - intra_h/2 - 0.5*cm, "ligament reconstruction)")
cy = cy - intra_h - 0.35*cm

# POST-OP REHABILITATION
draw_section_banner(c, cx, cy - BH, COL_W, BH, "REHABILITATION PROTOCOL")
cy -= BH + 0.2*cm

rehab_text = [
    "Based on Rockwood &amp; Green's (2025) postoperative protocol for operative elbow dislocation:",
]
rehab_bullets = [
    "Splint at 90° flexion, forearm <b>pronated</b> for LCL protection",
    "Dressing down at 48 hours; gentle <b>active motion</b> begun at 1 week",
    "Elbow NOT immobilised beyond 2 weeks (prevents stiffness)",
    "Passive stretching deferred until 6 weeks post-op",
    "Static progressive splints / turnbuckle splinting if ROM goals unmet",
    "Light strengthening at 6 weeks; formal programme at 3 months",
    "4-month follow-up: significant functional ROM achieved",
]
rehab_h = 5.5*cm
draw_box(c, cx, cy - rehab_h, COL_W, rehab_h)
inner_y = cy - 0.3*cm
for txt in rehab_text:
    p = Paragraph(txt, S["body"])
    pw, ph = p.wrap(COL_W - 8, 9999)
    inner_y -= ph
    p.drawOn(c, cx + 4, inner_y)
    inner_y -= 4
for b in rehab_bullets:
    p = Paragraph("• " + b, S["bullet"])
    pw, ph = p.wrap(COL_W - 14, 9999)
    inner_y -= ph
    p.drawOn(c, cx + 10, inner_y)
    inner_y -= 2
cy = cy - rehab_h - 0.35*cm

# POST-OP PHOTOS
draw_section_banner(c, cx, cy - BH, COL_W, BH, "4-MONTH POST-OPERATIVE OUTCOME", col=STEEL)
cy -= BH + 0.2*cm
post_h = 4.5*cm
draw_box(c, cx, cy - post_h, COL_W, post_h, fill=ACCENT)
c.setFillColor(STEEL)
c.setFont("Helvetica-Oblique", 8.5)
c.drawCentredString(cx + COL_W/2, cy - post_h/2, "[Insert 4-Month Post-Op Photos]")
cy = cy - post_h - 0.35*cm

# ══════════════════════════════════════════════════════════════════════════════
# COLUMN 4 — Discussion + Conclusion + References
# ══════════════════════════════════════════════════════════════════════════════
cx, cy = col_x(3), TOP_Y

# ── DISCUSSION ────────────────────────────────────────────────────────────────
draw_section_banner(c, cx, cy - BH, COL_W, BH, "DISCUSSION")
cy -= BH + 0.2*cm

disc_text = [
    "Neglected elbow dislocations represent a challenging reconstructive problem. "
    "Closed reduction is invariably unsuccessful beyond 3 weeks due to fibrosis, "
    "heterotopic ossification, and capsular contracture "
    "(Rockwood &amp; Green's, 10th ed., 2025).",

    "<b>Pathomechanics:</b> The anterior band of the MCL provides the primary restraint "
    "to valgus stress; the LUCL is the key stabiliser against posterolateral rotatory "
    "instability. Both structures require reconstruction in chronic cases "
    "(Miller's Review, 9th ed.).",

    "<b>Surgical approach:</b> The posterior approach allows simultaneous medial and "
    "lateral access, enabling comprehensive soft-tissue release and bilateral ligament "
    "reconstruction. Coulibaly et al. (2012, <i>Orthop Traumatol Surg Res</i>) reported "
    "satisfactory functional results in 22 patients using this approach.",

    "<b>Ligament reconstruction:</b>",
]
disc_bullets_1 = [
    "Bell-Tawse procedure — reconstructs the annular ligament stabilising the "
    "proximal radioulnar joint (Miller's Review, 9th ed.)",
    "Tommy John UCL reconstruction — the gold standard for MCL insufficiency; "
    "~75–80% of athletes return to sport (Miller's Review, 9th ed.)",
]
disc_text2 = [
    "<b>Heterotopic ossification (HO):</b> A recognised complication of chronic "
    "dislocation. Sumarwoto et al. (2023) demonstrated that double-approach surgery "
    "in neglected cases yielded acceptable functional outcomes despite HO.",

    "<b>Outcomes scoring:</b> DASH, Oxford Elbow Score, and Mayo Elbow Performance "
    "Score are the recommended instruments (Rockwood &amp; Green's, 2025).",

    "Early physiotherapy is critical: active motion is preferred over passive, "
    "stabilising the joint by muscle co-contraction "
    "(Rockwood &amp; Green's postoperative care protocol).",
]
disc_h = 10.0*cm
draw_box(c, cx, cy - disc_h, COL_W, disc_h)
inner_y = cy - 0.3*cm
for txt in disc_text:
    p = Paragraph(txt, S["body"])
    pw, ph = p.wrap(COL_W - 8, 9999)
    inner_y -= ph
    p.drawOn(c, cx + 4, inner_y)
    inner_y -= 4
for b in disc_bullets_1:
    p = Paragraph("• " + b, S["bullet"])
    pw, ph = p.wrap(COL_W - 14, 9999)
    inner_y -= ph
    p.drawOn(c, cx + 10, inner_y)
    inner_y -= 2
for txt in disc_text2:
    p = Paragraph(txt, S["body"])
    pw, ph = p.wrap(COL_W - 8, 9999)
    inner_y -= ph
    p.drawOn(c, cx + 4, inner_y)
    inner_y -= 4
cy = cy - disc_h - 0.35*cm

# ── CONCLUSION ────────────────────────────────────────────────────────────────
draw_section_banner(c, cx, cy - BH, COL_W, BH, "CONCLUSION")
cy -= BH + 0.2*cm

conc_text = [
    "Chronic neglected elbow dislocations are not \"surgical lost causes.\" "
    "This case demonstrates that with:",
]
conc_bullets = [
    "Timely referral to a specialist unit",
    "Systematic open reduction via posterior approach",
    "Bilateral ligament reconstruction (Bell-Tawse + Tommy John UCL)",
    "Evidence-based early active physiotherapy",
]
conc_text2 = [
    "...satisfactory functional outcomes can be restored at any age. "
    "Adherence to the principles outlined in Rockwood &amp; Green's (2025) "
    "and Miller's Review (9th ed.) underpins successful management.",
]
conc_h = 4.5*cm
draw_box(c, cx, cy - conc_h, COL_W, conc_h, fill=ACCENT)
inner_y = cy - 0.3*cm
for txt in conc_text + conc_text2:
    p = Paragraph(txt, S["body"])
    pw, ph = p.wrap(COL_W - 8, 9999)
    inner_y -= ph
    p.drawOn(c, cx + 4, inner_y)
    inner_y -= 4
for b in conc_bullets:
    p = Paragraph("• " + b, S["bullet"])
    pw, ph = p.wrap(COL_W - 14, 9999)
    inner_y -= ph
    p.drawOn(c, cx + 10, inner_y)
    inner_y -= 2
cy = cy - conc_h - 0.35*cm

# ── REFERENCES ────────────────────────────────────────────────────────────────
draw_section_banner(c, cx, cy - BH, COL_W, BH, "REFERENCES", col=STEEL)
cy -= BH + 0.2*cm

refs = [
    "1. Court-Brown CM, Heckman JD, McQueen MM et al. <i>Rockwood and Green's Fractures "
    "in Adults</i>, 10th ed. Philadelphia: Wolters Kluwer; 2025. Ch. 40 (Simple Elbow "
    "Dislocation), pp. 1648–1659.",

    "2. Miller MD, Thompson SR. <i>Miller's Review of Orthopaedics</i>, 9th ed. "
    "Philadelphia: Elsevier; 2023. Ch. 7 (Elbow Trauma), pp. 2510–2590.",

    "3. Freeman BL. Old unreduced dislocations. In: Crenshaw AH, editor. "
    "<i>Campbell's Operative Orthopaedics</i>, 9th ed. St. Louis: Mosby; 1998. "
    "pp. 2673–2674.",

    "4. Elzohairy MM. Neglected posterior dislocation of the elbow. "
    "<i>Injury</i>. 2009;40:197–200.",

    "5. Coulibaly NF, Tiemdjo H, Sane AD et al. Posterior approach for surgical "
    "treatment of neglected elbow dislocation. <i>Orthop Traumatol Surg Res</i>. "
    "2012;98(5):543–548. PMID: 22857889.",

    "6. Sumarwoto T, Hadinoto SA, Aprilya D et al. Functional outcomes of neglected "
    "elbow dislocation treated with double approach surgery. "
    "<i>Orthop Res Rev</i>. 2023;15:193–201. PMID: 37752900.",

    "7. Gavrilă MT, Cristea V, Stefan C. Treatment of neglected elbow dislocation "
    "with secondary heterotopic ossification. <i>Diseases</i>. 2025. PMID: 41294909.",
]
ref_h = 5.5*cm
draw_box(c, cx, cy - ref_h, COL_W, ref_h)
inner_y = cy - 0.3*cm
for r in refs:
    p = Paragraph(r, S["ref"])
    pw, ph = p.wrap(COL_W - 8, 9999)
    inner_y -= ph
    p.drawOn(c, cx + 4, inner_y)
    inner_y -= 2

# ══════════════════════════════════════════════════════════════════════════════
# FOOTER
# ══════════════════════════════════════════════════════════════════════════════
c.setFillColor(NAVY)
c.rect(0, 0, PW, 1.4*cm, stroke=0, fill=1)
c.setFillColor(WHITE)
c.setFont("Helvetica", 8)
c.drawCentredString(PW/2, 0.5*cm,
    "Content based on Rockwood & Green's Fractures in Adults (10th ed, 2025) | "
    "Miller's Review of Orthopaedics (9th ed) | Campbell's Operative Orthopaedics (9th ed)")

# ── SAVE ──────────────────────────────────────────────────────────────────────
c.save()
print(f"Poster saved to: {OUTPUT}")