The use of knee mega-prosthesis for the management of distal femoral fractures: A systematic review

Introduction: Distal femur fractures (DFFs) are unusual and difficult to deal, especially in elderly patients. A consensus about a gold-standard treatment has not been reached yet. Available options include both conservative and surgical management. In elderly patients a prosthetic replacement could be a valid treatment option. Literature is lacking about the use of mega-prosthesis in this type of fractures. The purpose of the present systematic review is to examine which fracture, both acute and chronic, involving distal femur should be treated by using a mega-prosthesis. Materials and Methods: Studies were identified by searching electronic databases. All studies that enrolled people of any age affected by a DFFs treated by using a megaprosthesis were included. Primary outcomes of the present reviews were: ROM, functional assessment and complications. Two review authors independently selected eligible trials. Disagreements at any stage were resolved by consensus or a third party adjudication. Descriptive statics was used to summarize the data. Results: Thirteen article were finally included in the review. One hundred-four patients were treated with knee megaprosthesis. Three categories of patients were identified: 29 patients were affected by supracondylar femur fracture; 51 patients occurred with a periprosthetic fracture; 24 patients suffered a non-union of a previous supracondylar fracture. The follow-up varied between 6 months to 58 months. All studies showed good results in terms of improving quality of life, resuming activities of daily living (ADLs), early mobilization, ROM, shorter hospital stay. Although not frequent, the only reported complications were infection and aseptic loosening. Discussion: The present review showed that the use of knee megaprosthetic implants could represent a valid treatment option aiming to reduce patients’ immobilitazion and hospital stay. Good clinical outcomes with low rate of complications were reported by all included studies. Literature is lacking about long-term outcomes and complications. Moreover studies comparing knee prostheses and other types of surgical treatment (intramedullary nails, plate fixation system) are needed. Conclusions: Megaprosthesis represent a viable treatment option in patients affected by DFFs (either acute, periprostethic or non-union) because they allow immediate weight-bearing, shorter hospital stay, a fast recovery of knee function and ADLs

Contributo alla flora del Parco Nazionale della Majella

Viene presentato un ulteriore contributo alla ricca flora del Parco Nazionale della Majella. In particolare, 15 nuove entità vengono segnalate per la prima volta ed una viene confermata nell’area protetta. Per altre entità, rare sul territorio regionale, vengono segnalate nuove stazioni all’interno del Parco. Il contributo conferma come la ricerca sul campo sia di fondamentale importanza per approfondire le conoscenze sul patrimonio naturale, anche nel caso di territori abbastanza ben conosciuti come quello del Parco Nazionale della Majella.A further contribution to the rich flora of the Majella National Park is presented. In particular, 15 entities are reported for the first time and one is confirmed in the protected area. New localities are also indicated, inside the Park, for some plant species that are very rare in the Abruzzo region. It is confirmed that field research is of crucial importance in expanding our knowledge of the natural heritage, even in a fairly well known territory as that of the Majella National Park

New national and regional Annex I Habitat records: From #45 to #59

New Italian data on the distribution of Annex I Habitats are reported in this contribution. Specifically, 8 new occurrences in Natura 2000 sites are presented and 27 new cells are added in the EEA 10 km × 10 km reference grid. The new data refer to the Italian administrative regions of Apulia, Campania, Calabria, Lazio, Tuscany, Umbria, Sardinia, and Sicily

Aggiunte e rettifiche alla Flora del Parco Nazionale d'Abruzzo.

The present contribution to the flora of Parco Nazionale d'Abruzzo is composed of 94 entities: 56 are nee for this area. Among these Erigeron angulosus (previously known in Italy only for the Alps) and Panicum dichotomiflorum are new for central Italy; Alchemilla straminea, Scandix pecten-veneris subsp. macroryncha, Lamium galeobdolon subsp. galeobdolon, Erigeron atticus, Galinsoga parviflora, Crupina crupinastrum, Allium rotundum, Eleocharis uniglumis are new for Abruzzo; Barbarea stricta, Impatiens balfourii, Solidago canadensis, Erigeron atticus are new for Lazio and Veronica verna is new for Molise

Gagea tisoniana, a new species of Gagea Salisb. sect. Gagea (Liliaceae) from central Italy

Gagea tisoniana Peruzzi et al. sp. nov. is described and its taxonomic relationship is discussed. The new species, which appears endemic to C Italy, is close to G. pratensis (Pers.) Dumort., G. pusilla (F. W. Schmidt) Sweet and to other mainly poorly known (i.e. G. succedanea Griseb. et Schenk, G. transversalis Stev., G. paczoskii (Zapal.) Grossh.) or as yet undescribed taxa from E Europe and E Mediterranean area. The recognition of the new taxon G. tisoniana is claimed on the basis of anatomical, karyological, ecological and phytogeographical data. Maps of the Italian distribution of G. pratensis (2n = 60), G. pusilla (2n = 24) and G. tisoniana (2n = 24) are presented, together with an analytical identification key. Finally, G. pratensis is here recorded for the first time in Tuscany (Monte Cetona)