Choice of three different intramedullary nails in the treatment of trochanteric fractures: outcome, analysis and consideration in midterm

paragone di 3 differenti impianti per frattura pertrocanterica femoreThe purpose of this study is to compare the results obtained using three different systems of osteosynthesis, developed for the surgical treatment of fractures of the trochanteric region of the femur, based on the principle intramedullary nailing: the Gamma nail, the Affixus nail and the ZNN nail. This is a retrospective study: 72 trochanteric fractures treated with the Gamma nail, 68 treated with the Affixus nail and 69 treated with the ZNN nail, between the years 2012 and 2014, with the prerequisite of a minimum follow-up of 18 months. The fractures were classified according to the AO system; the most commonly reported subtype was the A2 fracture. Clinical and radiographic examinations were performed, both at hospital admission and post-operatively, at 1, 3, 6, 12 and 18 months. Of the 209 patients, 171 were women and 38 were men. The average age was 83.12 years old. All three systems guaranteed an early mobilization and ambulation in most of the patients. There were no significant differences in the use of the three nails in terms of recovery of previous functional capacity, or in terms of the time required for the fracture to heal. There were no advantages encountered with the use of one intramedullary nail over another and, in particular, when observing the complications and patient outcome, there were no statistically significant differences detected

Bilateral posterior fracture-dislocation of the shoulder after epileptic seizure

We present a case of a 61 year-old woman who suffered a bilateral posterior fracture-dislocation of the shoulder after an isolated episode of epileptic seizure. The patient was diagnosed at our Emergency department with x-rays and CT scans after being found unconscious. An indication for bilateral shoulder hemiprosthesis implant was initially given. However, given the peculiar pattern of the fracture, the hemiprosthesis was implanted on one side only, while the other side was treated with ORIF with four cannulated screws. After the one year, the patient had resumed her previous activities and had no complaints. We performed a review of similar cases in literature and provided a rationale for our choice of treatment and the reasons for its success

Italian Version of University of California at Los Angeles (UCLA) activity score: Cross-Cultural Adaptation

Over the last ten years, patient-oriented evaluations using questionnaires have become an important aspect of clinical outcome studies. Any questionnaire must be translated and culturally adapted in order to be used with different language groups, and the translated version must then be evaluated for reliability, validity and responsiveness which are fundamental attributes of any measurement tool. The aim of this study is the validation, translation and cross-cultural adaptation of the Italian version of UCLA activity Score, following the Guillemin criteria. The results show that our Italian version of the UCLA score has: reproducibility expressed as ICC=0.994, an internal consistency calculated as Spearman-Brown coefficient=0.754 and finally the construct validity has demonstrated a significant Pearson’s correlation coefficient with other validated hip questionnaires