Introduction and purpose: Rhizarthrosis of the thumb is the most common form of osteoarthritis of the hand. In some cases it courses with intense pain and severe functional limitation of the thumb or the entire hand.

The purpose of this study is to compare the results of treating rhizarthrosis with a total ARPE trapezio-metacarpal prosthesis and trapezectomy, whether or not associated with tendon interposition and ligament repair.

Materials and methods: A retrospective comparative study in which we reviewed cases of rhizarthrosis treated surgically in our hospital between 1994 and 2004. We found 75 cases, of which 28 were treated with resection arthroplasty (group A), 32 with ARPE prosthesis (group B) and 15 with bone fusion (not included in this study). The mean age was 58.85 for group A and 63.16 for group B. Mean follow-up time was 39.5 months.

We used the DASH questionnaire for the subjective clinical examination and the Jamar dynamometer for the objective examination. For radiological assessment we used the Eaton classification and Walch radiological criteria.

Results: We analysed the results using SPSS statistical software and found no significant differences between the two groups, although the subjective assessment showed better results in terms of mobility and pain remission in group B and strength in group A.

Conclusions: The aim of surgical treatment of rhizarthrosis is to achieve a stable, pain-free thumb. Several procedures are available, the success of which depends on correct indication and meticulous surgical technique.

Introduction and purpose: The purpose of this paper is to assess the results of a revision of upper and lower limb lengthening procedures performed between 1998 and 2002 in our limb-lengthening unit.

Materials and methods: Twenty patients were revised, 8 males and 12 females (mean age: 12.5 years; range: 4.5 – 20). 11 of these cases had been caused by leg length discrepancy (6 congenital malformations, 2 sequelae of osteoarthritis, 1 posttraumatic, 1 exostosing disease and 1 sequela of poliomyelitis) and in 9 cases the lengthening was performed in cases of short stature (6 achondro-plasias, 2 Turner syndromes and 1 familial short stature). The global number of lengthenings was 44 (22 tibias, 15 femurs, 6 humeruses and 1 ulna). In all cases the Verona school method was employed. The external monolateral railfixator was used (with 4 or 6 pins).

Results: The global healing index was 30.1. The lowest scores were those of the humerus and the highest those of the tibia. The most frequent complication was the superficial infection of the pins (36.3%). The most frequently isolated germ in the exudates was S. epidermidis. There were no cases of deep infection. In all cases of leg length discrepancy the desired goal was achieved.

Discussion and conclusions: The healing index obtained in our series is a reliable indicator of the good results achieved by limb lengthening procedures performed in our department.