This device permits to obtain transosseous sutures with cortical fixation; to greatly reduce the problems of lack of bone resistance; to decrease motion at tendon-footprint interface improving fatigue resistance; to make the stress-load distribution homogeneous at the footprint, thus optimizing biological healing. A later evaluation will be necessary, especially for the incidence of retears.

Hertel's criteria are important in the surgical planning, but they are not sufficient: an accurate evaluation of the calcar area fracture in three planes is required. All fractures involving calcar area should be studied with CT.

The treatment for displaced mid-shaft clavicle fracture is highly controversial. In the last years, several biomechanical studies showed better functional results after surgical treatment. The purpose of this study is to evaluate the use of pre-contoured angular stability plate in this type of fracture. From June 2005 to July 2009, we have surgically treated 89 patients with displaced clavicle fracture. We have reevaluated 68 patients for a total of 70 interventions. Outcomes were assessed with Constant score, Dash questionnaire and X-rays. The mean follow-up period was 2 years. Excellent and good results were achieved for all the patients revaluated. The mean Constant score was 94.1 pt, and DASH score was 4.1. We had two cases of nonunion (2.9 %), while there was no case of infection and vascular or nervous lesions. A review of the international literature indicates that there is not a largely accepted gold standard for the treatment for displaced mid-shaft clavicle fractures. In the last 10 years, biomechanical and clinical studies have shown that nonoperative treatment for this type of fractures, with marked shortening or diastasis of the clavicle superior to 2 cm, may result in lower functional outcomes or higher percentage of nonunion. Nowadays, a lot of surgical options are available for the treatment for displaced mid-shaft clavicle fractures. Our experience with pre-contoured angular stability plates has shown excellent clinical outcome. On the basis of our study, we support the use of pre-contoured angular stability plate.

No abstract

Transosseous rotator cuff tear repair was first described in 1944. Over the years, it has represented the gold standard for such lesions. Through open and mini-open approaches, as well as the arthroscopic approach, the transosseous repair system represents one of the most reliable surgical techniques from a biological and mechanical perspective. Nevertheless, further improvements are required. This article describes an arthroscopic rotator cuff tear transosseous repair system, developed in collaboration with NCS Lab (Carpi, Italy): the Sharc-FT using the Taylor Stitcher. Our first experience in the clinical application of the arthroscopic technique using the transosseous suture system has shown encouraging clinical outcomes, confirming its efficacy. The patient satisfaction rate was high, and no patient expressed concern about the implant. The complication rate was very low. By improving the suture technique in the treatment of rotator cuff tears, a remarkable increase in the success rate in the treatment of this pathology could be reached; nevertheless, complications such as retears of the rotator cuff still occur.