Background: The Ilizarov external fixation technique has been widely used for the treatment of long-bone infected non-unions. After surgical infected bone resection, to allow filling of the remaining bone gap, biomaterials with antibacterial properties could be used. The aim of this study was to report outcomes of infected tibial non-unions treated using the Ilizarov technique and antibacterial bioactive glass. Methods: Between April 2009 and December 2014, 26 patients with infected tibial non-unions were treated with the Ilizarov technique and possible use of the bioactive glass, S53P4. The Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria, a clinical and radiographic evaluating tool, was used for assessing the sample. Results: The average age at the start of treatment was 51 years. The mean follow-up time was 113 weeks. According to the ASAMI Functional Scoring System, 10 excellent (38.5%) cases and 12 good (46.1%) values were recorded. According to the ASAMI Radiological System, they were excellent in 16 (61.5%) cases and good in nine (34.6%). Conclusions: Treatment of infected tibial non-unions using the Ilizarov technique was effective in bone segment regeneration. To fill the remaining bone gap, additional bioactive glass S53P4 could be used, allowing a decrease in re-interventions and minimizing complications.
Swarms of micro-shocks having low magnitude (B0), and duration between 2 and 4 seconds are often recorded at Vulcano in the Aeolian Archipelago (Italy) close to Gran Cratere which is the most recent eruptive edifice of the island. This study describes the characteristics of such peculiar seismic events, and examines their relationship with meteorological parameters. The set of shocks considered spanned from 1984 and 1990, and is here analyzed along with the daily values of temperature, barometric pressure, humidity, and amount of rainfall. The meteorological parameters were recorded at a station which was located a few kilometers from Gran Cratere. On the basis of their features, seismic events were divided into two groups: one showing a monochromatic character with a dominant spectral peak at 9.4 Hz, the other having a wider spectrum with dominant peaks in the range between 7 and 14 Hz. From the cross-correlation analysis of seismic and meteorological data a seasonal distribution of the occurrence of such micro-shocks can be surmised. Significant relationships with a 99% confidence level were found with all meteorological parameters. In particular, rainfalls precede with a short-time interval (about one day) the occurrence of these swarms. This result inferentially leads to an origin of such shocks in the surficial part of the volcano, and a source mechanism which may be linked to activation of microfractures induced by the action of meteoric water.
Meniscus tears are the most frequent knee injuries. Menisci provide joint stability and local pressure distribution. A meniscus injury contributes to the early development of osteoarthritis. The aim of our study is to analyze the results of partial meniscectomy at 4 years follow-up, comparing time of sport recovery between lateral and medial partial meniscectomy.At our institute 94 young athletes with meniscal tear were surgically treated with partial meniscectomy. 75 (80%) were males and 19 (20%) females. Medial meniscus was interested in 74 cases (79%), lateral meniscus in 20 (21 %). Mean age at treatment was 26 ± 4, 98 (range 18-35) years. 15 (16%) patients with medial meniscus tear had associated an ACL tear, which was repaired with an arthroscopic reconstruction by hamstring.Return to sport happened significantly earlier in the medial meniscus tears group than in the lateral meniscus tears group (average time 40±4, 14 days versus 59±7, 24 days). Student's Ttest showed statistical significance (p-value = 0.0147).
Periprosthetic knee fracture occur most frequently around the distal femur and are frequently complicated due to poor bone quality and comorbidities. Surgical treatment is typically necessary and requires varied techniques of open fixation, intramedullary fixation, or revision arthroplasty, due to fracture classification. The aim of the study is to report the results obtained in the treatment of periprosthetic knee fractures, comparing the results of two surgical techniques, retrograde intramedullary nail and ORIF with plate and screws. At our institute, a sample of 23 patients with periprosthetic knee fracture were surgically treated. In detail, our patient cohort consisted of 13 women (56.52%) and 10 men (43.48%) with a mean age of 71.91 years (SD ± 12.05) whose mean follow-up was 19.14 months (SD ± 9.90). In terms of treatment, 7 of 23 patients (30.43%) were treated with retrograde Intramedullary Nail (IMN), 2 patients (8.70%) underwent to revision of the prosthesis and 14 patients (60.87%) were treated with plate and screws (ORIF). The clinical evaluation was performed using two different clinical scores as reference, the Lysholm score and the Sanders score. The goal of treatment of periprosthetic knee fractures should be an early mobilization of the patient, in order to reduce the risk of prolonged immobilization, limiting surgical risks. Intramedullary nailing reduces blood loss and provides for shorter surgical times. However, it does not allow an anatomical reduction of the fracture and it is not always possible to achieve, due to the conformation of the prosthetic box. The mean results obtained from the evaluation by Lysholm Score was 58.75 ± 10.46 in group treated with IMN and 63.60 ± 6,82 in the group treated with ORIF. Sanders Functional Evaluation Score was 63.60 ± 6,82 in group treated with IMN and 28.26 ± 6.01 in the groups treated with ORIF. The results obtained are similar to the literature. Student’s t-test showed no statistical significance (p-value >0.05). Fractures healed on average at 4 months. We observed a case of mobilization of the nail. Intramedullary nailing reduces blood loss and provides for shorter surgical times. However, it does not allow an anatomical reduction and it is not always possible to achieve, due to the conformation of the prosthetic box. The ORIF with plate and screws allows an anatomical reduction of the fracture, but involves in greater risks. It appears, therefore, more suitable in relatively young subjects. The reduction and synthesis with MIPO technique appears a good compromise. However, it is not very effective in comminuted and multi-fragmentary fractures.
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