EVOLUTION AND HEALING OF FRAGILITY FRACTURES OF THE PROXIMAL FEMUR

After a traumatic fracture a physiological process begins to heal the fracture. The steps of the process are inflammation, granulation, formation of fibrous callus and finally bone. There are many factors that may influence the healing of the fracture: adequate blood supply, good contact between bone fragments, good stability of the fracture, general health, age, smoking, related pathology, use of drugs, etc. In elderly patients the variations in bone structure and healing processes have a negative influence on fracture healing. Fragility fractures require careful placement of the implants to reduce the risk of failure of osteosynthesis. Appropriate surgical devices and facilitation factors must be used to allow bone healing

Posterior Subtalar Dislocation

A subtalar dislocation of the foot is an uncommon injury, and cases of posterior subtalar dislocation are even rarer. This injury is characterized by a simultaneous dislocation of talocalcaneal and talonavicular joints while tibiotalar and calcaneocuboid articulations remain intact. Subtalar dislocation is commonly accompanied by fractures of the malleoli, talus, or fifth metatarsal and by a rotational component of the subtalar joint. Subtalar dislocation can occur in any direction and produces significant deformity. This article presents a case of pure posterior subtalar dislocation in an 80-year-old man who presented with pain and deformity in his left ankle following a motorcycle accident. Radiographs demonstrated dislocation of both the talonavicular and talocalcaneal joints. The calcaneus was displaced posteriorly without medial or lateral displacement. No rotational component of the calcaneus was noted, suggesting the trauma was in pure hyperplantar flexion. We hypothesize that pure hyperplantar flexion could lead to a progressive subtalar ligament weakening that may result in a complete ligament rupture if the plantar flexion force is prolonged. This could be observed in the presence of good bone quality and if the force is applied distally at the navicular bone

Case report: laser Nd:YAG e rieducazione funzionale nella sindrome del piriforme

La sindrome del piriforme \ue8 caratterizzata da una lombalgia con interessamento del gluteo e con possibile irradiazione all'arto inferiore; pu\uf2 essere definita come una patologia dovuta ad intrappolamento, compressione o irritazione del nervo sciatico a livello del muscolo piriforme con o senza deficit neurologici. In questo studio \ue8 stata valutata l'efficacia della sinergia terapeutica tra laser Neodimio:YAG e rieducazione funzionale nella riduzione del dolore e nel miglioramento dell'indipendenza funzionale in una paziente affetta da sindrome del piriforme

Acromion Clavicular Joint Reconstruction with LARS Ligament in Acute Dislocation

Background: The acromion clavicular joint dislocations are common injuries of the shoulder. The severity is dependent upon the degree of ligamentous injury. Surgical treatment is typically performed in higher grade acromioclavicular separation with several static and dynamic operative procedures with or without primary ligament replacement. Methods: 47 patients with acute Rockwood type III, IV, and V injuries were treated surgically with LARS reconstruction. The success of technique was evaluated by radiographic outcomes for each patient at every follow-up visit (one,three, 12 months), while to assess pain reduction and clinical evaluation Visual Analogue scale score (VAS) and Constant-Murley score (CMA) was performed, respectively. An One Way Analysis of Variance (Kruskal-Wallis test), a multiple comparison Turket test, or a t-test (Mann-Whitney Rank Sum Test) were used when required. Results: Follow-up radiographs revealed maintenance of anatomical reduction in 41 patients, and no bone erosions has been identified. In short-term joint functional recovery has been observed. Indeed, after 12 months pain on the VAS-scale in all groups decreased significantly (P < 0.05), and the CMS revealed a significant overall improvement (P < 0.05). Conclusion: These data demonstrate that the use of the LARS allows to provide stability to the joint and especially to ensure its natural elasticity, relieving pain and improving joint function already one month post-surgery. Level of evidence: II

Service level Indication: A proposal for QoS monitoring in SLA -based multidomain networks

The offering of QoS based communication services has to face several challenges. Among these, the provisioning of an open and formalised framework for the collection and interchange of monitoring and performance data is feit as one of the most important issues to be solved. Indeed, this is true in seenarios where multiple providers are teaming (intentionally or not) for the construction of a complex service to be sold to a final user, like in the case of the creation of a virtual private network spanning multiple network Operators and infrastructures. In this case, failures in providing certain required Ievels in the quality parameters should be dealt with an immediate attribution of responsibility across the different entities involved in the end-to-end provisioning of the service. But also in cases apparently much simpler, for example when an user requires a video strearning service across a single operator network infrastructure, there is a demand for mechanisms for the measurement of the received quality of service across all the elements involved in the service provisioning: the server system, the network infrastructure, the dient terminal and the user application. lt is clear that this is a complex problem, involving different technologies, disciplines and research areas. In this paper, starting from the ongoing work in the definition of standard interfaces for the Quality of Service negotiation (Service Level Agreements) and control (Service Level Specifications), as weil as from the work ongoing in the IPFIX and IPPM working groups from the IETF, we introduce a new document specifically for delivering monitoring information to user applications. We called such a document Service Level Indication. We here aim at sketching a possible starting point for a research discussion. © 2003 by Springer Science+Business Media Dordrecht

Tailoring the thermal conductivity of rubber nanocomposites by inorganic systems: Opportunities and challenges for their application in tires formulation

The development of effective thermally conductive rubber nanocomposites for heat management represents a tricky point for several modern technologies, ranging from electronic devices to the tire industry. Since rubber materials generally exhibit poor thermal transfer, the addition of high loadings of different carbon‐based or inorganic thermally conductive fillers is mandatory to achieve satisfactory heat dissipation performance. However, this dramatically alters the mechanical behavior of the final materials, representing a real limitation to their application. Moreover, upon fillers’ incorporation into the polymer matrix, interfacial thermal resistance arises due to differences between the phonon spectra and scattering at the hybrid interface between the phases. Thus, a suitable filler functionalization is required to avoid discontinuities in the thermal transfer. In this challenging scenario, the present review aims at summarizing the most recent efforts to improve the thermal conductivity of rubber nanocomposites by exploiting, in particular, inorganic and hybrid filler systems, focusing on those that may guarantee a viable transfer of lab-scale formulations to technological applicable solutions. The intrinsic relationship among the filler’s loading, structure, morphology, and interfacial features and the heat transfer in the rubber matrix will be explored in depth, with the ambition of providing some methodological tools for a more profitable design of thermally conductive rubber nanocomposites, especially those for the formulation of tires