Schwannoma del nervo vago intratoracico. Descrizione di un caso singolare.

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Biopsia in toracotomia minima per la diagnosi nella patologia del polmone profondo

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Il linfangioma cistico del mediastino. Diagnostica e terapia

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Internal femoral osteosynthesis after external fixation in multiple-trauma patients

In this study the authors evaluate the results of internal synthesis of femoral fractures in polytraumatised patients initially treated by external fixation (EF). From January 2002 to December 2005, 39 femurs in 37 polytraumatised patients (average age 34.2 years, range 18-44) with closed fractures and an ISS>20 were initially treated with EF. There were three groups: Group A, 13 cases when conversion to internal osteosynthesis occurred after 4-7 days (average 5.6 days); Group B, 11 cases with a 4-6-month interval before internal osteosynthesis, and after investigation using MRI and scintigraphy with labelled leucocytes; Group C, the remaining cases treated definitively with EF. Time of healing, lower limb function, time of return to previous activities and short and long-term complications were evaluated at the follow-up. The average time of follow-up was 23 months. In Group A the time of bone healing was 123 days; there were no events of embolism but one case of pseudoarthrosis and one case of instrument failure. In Group B the time of bone healing was 274 days, with one case of pseudoarthrosis and one case of deep infection. In Group C the average healing time was 193 days, with 3 cases of screw (half-pin) osteolysis. Functional recovery was delayed by the presence of other fractures. EF is a simple, quick and safe procedure to stabilise fractures in polytraumatised patients. According to damage control orthopaedic (DCO) concepts, it is possible to replace EF with internal synthesis after an interval as this reduces the risks of internal osteosynthesis when performed in the emergency period. EF can also be maintained as definitive treatment but should a change to internal synthesis be needed, it is possible to do it safely after excluding bone infection

Analisi dei parametri emogasanalitici e dell'equilibrio acido-base nell'operato toracico

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La terapia chirurgica del cancro bronco-polmonare. Analisi al computer di una casistica selezionata del centro di Chirurgia Toracica di Modena (328 osservazioni)

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Il trattamento delle fratture del terzo prossimale di omero mediante chiodo endomidollare "Polarus"

Proximal humeral fractures are complex lesions with difficult management problems and so they are a professional struggles for orthopaedic surgeons. In literature a lot of techniques of treatment are proposed for these kind of fractures. In our study we have reviewed 30 patients with a proximal humeral fracture (Neer 2-3) with a mean age of 75 years, treated in our clinic with Polarus nail, with a mean follow-up of 7 years.We obtained 73,3% of good and excellent results, in line with literature results. The complications involved 6 patients (20%) of our study, in particular 3 cases of proximal screw pull-out, 1 case of deep infection and 2 cases of acromioclavicula impingement. The aim of our study is a review of our cases, comparing them with the literature, analysing these kind of complex fractures and the type of treatments

Tibial plateau fractures: compared outcomes between ARIF and ORIF.

The purpose of this study is to compare arthroscopic assisted reduction internal fixation (ARIF) treatment with open reduction internal fixation (ORIF) treatment in patients with tibial plateau fractures. We studied 100 patients with tibial plateau fractures (54 men and 46 women) examined by X-rays and CT scans, divided into 2 groups. Group A with associated meniscus tear was treated by ARIF technique, while in group B ORIF technique was used. The follow-up period ranged from 12 to 116 months. The patients were evaluated both clinically and radiologically according to the Rasmussen and HSS (The Hospital for Special Surgery knee-rating) scores. In group A, the average Rasmussen clinical score is 27.62 \ub1 2.60 (range, 19\u201330), while in group B is 26.81 \ub1 2.65 (range, 21\u201330). HSS score in group A was 76.36 \ub1 14.19 (range, 38\u201391) as the average clinical result, while in group B was 73.12 \ub1 14.55 (range, 45\u201391). According to Rasmussen radiological results, the average score for group A was 16.56 \ub1 2.66 (range, 8\u201318), while in group B was 15.88 \ub1 2.71 (range, 10\u201318). Sixty-nine of 100 patients in our study had associated intra-articular lesions. We had 5 early complications and 36 late complications. The study suggests that there are no differences between ARIF and ORIF treatment in Schatzker type I fractures. ARIF technique may increase the clinical outcome in Schatzker type II\u2013III\u2013IV fractures. In Schatzker type V and VI fractures, ARIF and ORIF techniques have both poor medium- and long-term results but ARIF treatment, when indicated, is the best choice for the lower rate of infections

MRI in multiple myeloma : a pictorial review of diagnostic and post-treatment findings

Magnetic resonance imaging (MRI) is increasingly being used in the diagnostic work-up of patients with multiple myeloma. Since 2014, MRI findings are included in the new diagnostic criteria proposed by the International Myeloma Working Group. Patients with smouldering myeloma presenting with more than one unequivocal focal lesion in the bone marrow on MRI are considered having symptomatic myeloma requiring treatment, regardless of the presence of lytic bone lesions. However, bone marrow evaluation with MRI offers more than only morphological information regarding the detection of focal lesions in patients with MM. The overall performance of MRI is enhanced by applying dynamic contrast-enhanced MRI and diffusion weighted imaging sequences, providing additional functional information on bone marrow vascularization and cellularity. This pictorial review provides an overview of the most important imaging findings in patients with monoclonal gammopathy of undetermined significance, smouldering myeloma and multiple myeloma, by performing a 'total' MRI investigation with implications for the diagnosis, staging and response assessment. Main message aEuro cent Conventional MRI diagnoses multiple myeloma by assessing the infiltration pattern. aEuro cent Dynamic contrast-enhanced MRI diagnoses multiple myeloma by assessing vascularization and perfusion. aEuro cent Diffusion weighted imaging evaluates bone marrow composition and cellularity in multiple myeloma. aEuro cent Combined morphological and functional MRI provides optimal bone marrow assessment for staging. aEuro cent Combined morphological and functional MRI is of considerable value in treatment follow-up