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Complex tibial plateau fractures are a challenge in trauma surgery. In these fractures it is necessary to anatomically reduce the articular part of the fracture and to obtain stable fixation. The aim of this study is to review the results of a surgical technique consisting of fluoroscopic closed reduction and combined percutaneous internal and external fixation. Thirty-two complex tibial plateau fractures in 32 patients were included. Twenty-one fractures were closed, 4 were open Gustilo grade I, 3 were Gustilo grade II and 4 were Gustilo grade III. The mean age was 37.8 years (range 21–64 years). Surgery was performed with patients in transcalcaneal traction and the knee flexed at 30° was used. Through a 1-cm incision centred over the tibial metaphysis of the tibia, a 3.2-mm hole was drilled in the antero-medial tibial aspect. The tibial plateau fracture fragments were elevated using either 1 or 2 curved Kirschner wires under fluoroscopy to control the reduction. Then the fragments were fixed with 2 cannulated AO screws inserted through small incisions into the medial aspect of the tibial plateau. Knee rehabilitation started postoperatively. Weight bearing started after 8–12 weeks depending upon the radiographic appearance. All external fixators were removed in outpatient facilities. All patients were clinically and radiographically evaluated at a mean follow-up of 48 months (range 38–57 months). Clinical results were evaluated according to the Knee Society clinical score. Average healing time was 24 weeks (range 18–29 weeks). In 1 patient a non-union occurred. This patient was treated with open reduction and plate fixation. In 2 patients a varus knee deformity occurred and a surgical correction was performed. There were no surgical complications. Mean knee range of motion was 105° (range 75–125°) and mean Knee Society clinical score was 89. Twenty-five results were scored as excellent, 4 good, 2 fair and 1 poor. Using this technique there is limited soft tissue damage and virtually no periosteum damage to the fracture fragments. However anatomical reconstruction of the joint can be obtained. Furthermore knee rehabilitation can be started immediately after surgery. We think that these factors were responsible for the optimal clinical long-term results.

Metastatic lesions of the spine have recently become a debated topic in orthopaedics, because more and more patients survive long enough to require surgical treatment. The aim of this study is to review a series of 51 patients affected by metastatic lesions of the spine. Fifty-one patients affected by metastatic lesions of the spine were treated between 1987 and 2000. In 5 cases the cervical spine was involved, in 27 the thoracic and in 19 the lumbar spine. Surgery was planned according to the following labelling factors: type of malignancy, life expectancy, neurological involvement, pain, site of lesion, lesion extension and spine stability. Surgical treatment consisted of: minimally invasive cord decompression in 3 cases, posterior stabilization in 21, posterior stabilization and cord decompression in 13 cases, anterior resection and reconstruction of anterior column associated or not at posterior stabilization in 14 cases. Two patients died due to complications related to surgery. At the last available follow-up of 4 (±2.5) years, 29 patients had excellent results, 16 had good results, 2 fair and 2 poor results. One fair and 1 poor result had recurrence of the metastatic lesions of the spine and needed another operation. We believe that surgical treatment of metastatic lesion of the spine has a positive cost/benefit ratio for the patient's condition; in fact most of our patients had improvement of quality of life. The labelling factors of each lesion have to be carefully studied together with the oncologist to decide the correct surgical option because unsatisfactory results could be sometimes related to incorrect evaluation of the evolution of the neoplasm.

Abstract Tumoral lesions related to Paget’s disease may be classified as malignant, benign or pseudotumoral. While sarcomatous degeneration is the most feared complication, awareness of benign and pseudotumoral lesions is essential for assisting in accurate histological interpretation of the biopsy sample, which may avoid unnecessary repeat biopsies. We present the first case of a juxta-articular subperiosteal ganglion associated with Paget’s disease, with classic imaging characteristics, especially on CT examination. The well-defined soft tissue mass at the medial aspect of the obturator rim, adjacent to a small fracture in pagetic quadrilateral plate, showed an ossified rim and internal gas lucencies, these being the hallmarks of a juxta-articular subperiosteal ganglion. On MRI, the lesion was of intermediate signal intensity on T1-weighted sequences, increased signal intensity on T2-weighted sequences, with rim enhancement after gadolinium contrast injection and preservation of fatty marrow signal of the underlying pagetic bone. Identification of the entity avoided an unnecessary biopsy or surgical intervention.

Abstract We describe a case of chronic Salter-Harris I injury of the proximal tibial epiphysis. To our knowledge such an injury has not been described in the English language literature. The radiological appearance can mimic chronic infection. The possibility of chronic athletic stress-related change should be considered in such scenarios to avoid a misdiagnosis.

Some endodontic sealers have been shown to cause local and systemic effects, mainly due to microleakage of chemicals from the sealer. To avoid the risk of toxic effects in vivo, the biological compatibility of filling materials has to be assessed. In vitro compatibility of Proroot™ MTA cement in comparison with two different fillers used in clinical practice, was examined by testing the adherence, viability, proliferation and secretion of collagen of osteoblast-like cells. In our experimental system, Saos-2 cells challenged with Proroot™ MTA for 24 and 72 h showed a better behaviour than the cells exposed to the other compounds under assay. We found that the cells attached to the rough surface of Proroot™ MTA cement and spread onto the rough surface. Moreover, the cells on Proroot™ MTA were viable, grew, and released some collagen even at 72 h, while cell metabolism and growth was dramatically reduced onto sEBA and amalgam surfaces. A parallel behaviour was found after the cells were challenged with extracts of the different fillers. In conclusion, according to our in vitro study, Proroot™ MTA showed a good interaction with bone-forming cells: such behaviour may partially account for its satisfying clinical performance.

The North Western Sahara Aquifer System (NWSAS), shared by Algeria, Tunisia and Libya, stretches over a million km2Over the last thirty years, the boreholes abstraction raised from 0.6 to 2.5 billion m3/year. This rate of abstraction involves many risks : strong impact on neighbouring countries, salinisation, outlets drying up, etc... Simulations on the NWSAS Madel have enabled to pinpoint location of the most vulnerable areas and map the risks facing the aquifer system. The three countries concerned by the future of the NWSAS need to work together to develop a joint management system for the basin. A consultation mechanism has been instituted and gradually put in operation.

New observations of six fields from the low galactic latitude BG survey are presented. The radio sources within each of these fields appear to be of a predominantly extragalactic nature. However, one object is in close positional proximity to the pulsar 1922 + 20 and the possibility of their association is considered. The extended source BGE 0323 + 65 is shown to be unlikely to exist.

Benefits of femoral offset restoration during total hip arthroplasty should be the reduction of bearing surfaces wear, implant loosening and dislocation rates. Modular neck stems ensure offset customization, but fretting corrosion and catastrophic failures are well-documented complications. Since clinical evidences are needed to substantiate the effectiveness of femoral offset restoration and promote modular neck choice, we systematically reviewed the literature to ascertain whether femoral offset itself has a proven clinical influence: (1) on bearing surfaces wear, (2) implant loosening and (3) dislocation rates. A systematic literature screening was conducted to find papers dealing with the influence of femoral offset on wear, dislocation and loosening, including articles with conventional radiographic femoral offset assessment and with comparative design. Observational studies, case reports, instructional course lectures, cadaveric and animal studies as well as biomechanical studies, letters to the editor, surgical techniques or technical notes were all excluded. No limits about publication date were supplied, but only papers in English were taken into account. Data were extracted into an anonymous spreadsheet. Offset values, dislocation rates, wear rates, follow-up and surgical approaches were all detailed. Ten manuscripts were finally selected. A statistically significant correlation between femoral offset restoration and the reduction of conventional ultra-high-molecular-weight polyethylene wear was found in two out of three papers investigating this issue, but no correlations were found between femoral offset and dislocation rates or implant loosening. Femoral offset modification influences ultra-high-molecular-weight polyethylene liners wear, but no correlation was found with dislocation rates or implant loosening. Advantages on wear can be counterbalanced by the use of hard bearing surfaces or highly cross linked polyethylene liners, besides the availability of larger femoral heads improving implant stability further reduces the importance of femoral offset restoration by means of modularity. We believe that efforts in restoring femoral offset during total hip arthroplasty do not translate into tangible clinical profits and consequently we do not advise the routinely usage of modular neck stems in total hip arthroplasty. Level of evidence: level III, systematic review of case-control studies.

In the period 2012 June–2013 October, the Sardinia Radio Telescope (SRT) went through the technical commissioning phase. The characterization involved three first-light receivers, ranging in frequency between 300MHz and 26GHz, connected to a Total Power back-end. It also tested and employed the telescope active surface installed in the main reflector of the antenna. The instrument status and performance proved to be in good agreement with the expectations in terms of surface panels alignment (at present 300μmrms to be improved with microwave holography), gain (∼0.6K/Jy in the given frequency range), pointing accuracy (5 arcsec at 22GHz) and overall single-dish operational capabilities. Unresolved issues include the commissioning of the receiver centered at 350MHz, which was compromised by several radio frequency interferences, and a lower-than-expected aperture efficiency for the 22-GHz receiver when pointing at low elevations. Nevertheless, the SRT, at present completing its Astronomical Validation phase, is positively approaching its opening to the scientific community.

For Very Long Baseline Interferometry (VLBI), the fringe spacing is extremely narrow compared to the field of view imposed by the primary beam of each element. This means that an extremely large number of resolution units can potentially be imaged from a single observation.