Early self-rehabilitation in thoracolumbar fractures (a guide for patients).

The authors report the purposes and the contents of a guide entitled "Early self-rehabilitation in thoracolumbar fractures" currently used at the Division of Orthopaedics and Traumatology in the Macerata hospital, for patients affected with somatic "benign" fractures of the thoracolumbar passage (from T10 to L3). With elementary language and the support of simple images, several indications are given as to the anatomy and function of the column and its features, and the type of treatment used for fractures, so that the patient is aware of his or her lesion; the guide then becomes an actual manual for early and independent functional rehabilitation, capable of improving the physical and psychological state of the patient, in addition to favoring and accelerating healing. According to the authors, this study is useful in perfecting the relationship between physician and patient in the field of injuries of the vertebral column, which is often characterized by confusion and fear.

Intertrochanteric valgus osteotomy and sliding compression hip screw in fractures of the femoral neck.

Twenty-four patients ranging from 28 to 56 years of age with Garden grade III or IV fractures of the femoral neck are reviewed after treatment by intertrocherantic valgus osteotomy and Richards sliding compression hip screw. The rationale behind this treatment, the operative technique, and the choice of internal fixation device are all discussed. All patients were followed up after more than 2 years so that any late complications could be documented.

Immediate multiple osteosynthesis in polytrauma.

Thirty polytraumatized patients underwent immediate osteosynthesis of two or more long bone fractures for a total of 82 operations (plus an additional 14 for pelvis, hand, and foot fractures). Since 1983, according to the modern and rational concepts of "all at one time treatment", open fractures as well as associated closed lesions are stabilized immediately if the patient's general condition permits. This type of procedure requires adequate facilities as well as availability of and collaboration between teams of specialists, but it is inarguably advantageous for the patient (relief of pain, drastic reduction in the rate of embolism, improvement of respiratory and circulatory function, only one anesthesia), the surgeons (operation technically easier and shorter), and the ancillary medical personnel (easier nursing, rapid functional rehabilitation).

Antibiotic and antithromboembolic prophylaxis in prosthetic surgery of the knee.

The prevention of deep sepsis and venous thromboembolism in knee replacement surgery is of great importance for the final success of treatment. General rules of prevention must be followed when using antimicrobial drugs (environment, surgical method, patient selection). Although it does have some negative aspects (overuse, high costs, development of resistant bacteria) the administration of antibiotics is recommended, but only when it is timely, correct, and carried out for a suitable amount of time.

Internal and external fixation in complex diaphyseal and metaphyseal fractures of the humerus.

The treatment of diaphyseal and metaphyseal fractures of the humerus is often controversial, especially when these fractures are complex and/or unstable (i.e. comminuted, segmental, or with a butterfly fragment).