Averaged number of visits

International audienceWe introduce a new indicator for dynamical systems, namely the averaged number of visits, to estimate the frequency of visits in small regions when a map is iterated up to the inverse of the measure of this region. We compute this quantity analytically and numerically for various systems and we show that it depends on the ergodic properties of the systems and on their topological properties, such as the presence of periodic points

Early weight bearing in acetabular and pelvic fractures

The incidence of pelvic and acetabular fractures is increasing during the years, counting 37 pelvic fractures per 100000 people annually. No weight bearing or toe touch weight bearing are usually chosen in the initial management to allow fracture and ligamentous healing and avoid fracture displacement and fixation failure. On the other hand, early weight bearing may stimulate fracture healing and allow prompt functional recovery, faster return to work and recreational activities and reduce complications linked to late rehabilitation.  Aim of the study is to review the literature about weight bearing indications for pelvic and acetabular fractures to highlight clinical and biomechanical evidence supporting early weight bearing

DELAYED DIAGNOSIS OF ISOLATED CORACOID PROCESS FRACTURES: RESULTS OF 9 CASES TREATED CONSERVATIVELY

Background and aim: Isolated coracoid process fractures are more frequent than what has formerly been believed. Delayed diagnosis or misdiagnosis are not infrequent as it is difficult to notice this injury using routine radiographic projections of the shoulder. In any event, more specific views are prescribed only when a fracture is suspected. The purpose of this study is to assess the outcomes of 9 cases of isolated coracoids fractures treated conservatively after being undiagnosed and discuss the reasons of these delayed diagnoses. Materials and Methods: Between January 1984 and June 2011, 9 out of 19 isolated coracoid fractures received a delayed diagnosis. There were 7 type I fractures and 2 type II. All patients were treated conservatively. Results: All fractures, except one, consolidated. The delay of the diagnosis was greater in type II lesions rather than in type I. Differences in clinical outcomes between affected and healthy side were minimal. Delayed diagnosis was overseen by the physician in 8 cases whereas in 1 case the patient underestimated the trauma and left the injury untreated. Conclusions: An isolated coracoid fracture should always be suspected after receiving a direct blow on the shoulder or after sustaining a forceful traction of the upper arm. In these events, specific radiographic projections should be performed in order to visualise the entire length of the coracoid process and to avoid oversight, delayed diagnosis or misdiagnosis. In isolated type I undisplaced fractures and in the majority of type II fractures, conservative treatment is indicated

Misdiagnosed iuxta-articular osteoid osteoma of the calcaneus following an injury.

The diagnosis of osteoid osteoma, in usual localizations, is generally simple. In iuxta-articular localizations this tumor may be unrecognized and the diagnosis delayed. Injury has been sometimes correlated with the onset of symptoms and this can make the diagnosis even more difficult.We present a case of osteoid osteoma of the calcaneus iuxta-articular to the subtalar joint in a 17-year-old basketball player. He had a history of initial injury, ankle sprain during training, followed by pain and swelling. He was initially treated for lateral ligament lesion of the ankle with unsatisfactory results. After acute trauma the pain changed becoming chronic and mostly nocturnal disappearing when rofecoxib was taken. Standard x-ray didn’t show the lesion.Nuclear Magnetic Resonance (NMR) and scintigraphic results were not well interpreted but these clinical changes and Computed Tomography (CT) images supported the diagnosis of osteoid osteoma. The complete resection of the bone lesion resolved all the symptoms and the histological report confirmed the suspected diagnosis

La posizione della Chirurgia Plastica Ricostruttiva nel contesto delle discipline chirurgiche e nei rapporti con il Diritto e la Medicina Legale

Gli autori discutono il profilo ed il diverso ruolo della Chirurgia Plastica Ricostruttiva rispetto alle altre discipline chirurgiche, affrontando poi i problemi giuridici e medico-legale, con particolare riguardo alla responsabilità professionale del chirurgo plastic