ObjectiveThe purpose of this study is to evaluate the performance of dynamic hip screw for the treatment of dislocated femoral neck fractures in young patients, focusing on osteonecrosis.MethodsA series of 53 patients with less than 55 years of age were retrospectively evaluated. All patients had dislocated femoral neck fractures (Garden III or IV) and were treated with DHS. Ficat's staging system was used to evaluate avascular necrosis.ResultsThere were 38 (71.7%) males and 15 (28.3%) females, with an overall mean age at the onset of fracture of 41.9 years (±12.8). According to Garden's classification, 21 (39.6%) fractures were classified as type III and 32 (60.4%) were considered totally dislocated, Garden IV. Fracture healing was achieved in 39 patients (73.6%). Thirteen cases of avascular necrosis were observed (24.6%).ConclusionsThe incidence of avascular necrosis in young patients with a displaced femoral neck fractures treated with DHS was 24.6%. No statistically significant association was found between times elapsed to surgery, fracture displacement, and presence of derotation screw with osteonecrosis. Level of evidence IV.

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The research proposes a surgical technique for patients with chronic pubic symphysis diastasis and bladder herniation by means of a pelvic reconstruction technique. Three patients were treated initially in other hospitals and referred to us. All presented with pubic symphysis diastasis greater than 7 cm and bladder herniation. Two patients were initially treated with external fixation, and in one patient, the symphysis diastasis had been completely neglected. All cases presented good evolution with the proposed technique, which is described in details in the paper.

Objective: To study the influence of patellar resurfacing on quality of life under a standardised score. The chosen score was the Knee Society Score (KSS), which considers range of motion, pain, contractors, alignment and stability. Methods: Retrospective review of 60 patients submitted to total knee arthroplasty (TKA) was divided into two groups: with patellar resurfacing (PR) and without patellar resurfacing (NPR). We reviewed data from these patients containing the KSS, which are routinely used in our service. Data were analysed from 2013 to 2014, with a minimal patient follow-up of 18 months. Results: There were no unsatisfactory scores in our study. Total scores (KSS) were similar between the groups (mean KSS: PR = 88.36 ± 9.64; NPR = 84.26 ± 9.44 [p = 0.1]). While stratifying into groups (poor, fair, good, excellent), we found excellent results in 84.8% of PR versus 59.3% NPR (p = 0.056). These data did not reach statistical significance and can therefore be considered a coincidental result. Conclusion: Although these results did not show statistical significance (p = 0.056), patellar resurfacing patients tend to get more "excellent" results after 18 months of follow-up in quality of life when evaluated by KSS. Perhaps a larger amount of patients would suffice to acquire statistical significance in a future study.