La Chirurgia degli organi di movimento
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The authors studied the effectiveness of locked intramedullary nailing (Grosse-Kempf) in the treatment of proximal shaft femoral fractures. They reviewed 24 cases with an average two-year follow-up and which had obtained positive clinical radiographic results in 80% of cases as compared to 88% in a previous revision of femoral shaft fractures. The difference is due to the greater difficulty encountered in intraoperative reduction of fractures from which defects in axial (varus) and rotatory (extra) alignment arise. They discuss indications as regards locking type, weight-bearing, as well as surgical techniques, which may prevent some of the most frequent problems observed.
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Osteosarcoma associated with Paget's disease is very malignant and has an extremely severe prognosis. This is also related to the usually advanced age of the patient and to the consequent impossibility of carrying out suitable chemotherapy. The case presented here is exceptional because of the young age of the patient, which allowed us to use a neoadjuvant chemotherapy protocol.
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Case Reports
Fractures of the posterior apophyseal ring of the lumbar vertebral body in young patients. Three cases.
Three cases of posterior apophyseal fracture of a lumbosacral vertebral body are described. This disco-apophyseal lesion is typical of adolescents and sports-related trauma. Like all acute and chronic apophysiolyses it is probably enhanced by a constitutional weakness of the apophyseal area, closely fused with the anulus fibrosus of the disc.